Diagnosis and Symptomatic Treatment of Early Reactive Cardiac Amyloidosis in Systemic Sclerosis

Systemic sclerosis as a connective tissue disease could affect all internal organs of the body and could also manifest as a cutaneous lesion. Cardiac involvement leading to cardiac manifestations in systemic sclerosis patients is not rare. However, cardiac amyloidosis combined with systemic sclerosis is extremely rare. Although there were no definite treatment options in this case, symptomatic treatment is the cornerstone of the management plan. In this case report, we described a correct diagnosis and symptomatic medical care of early reactive cardiac amyloidosis with systemic sclerosis and summarize the current state of the relevant literature.

Obstructive Jaundice Due to Compression of the Common Bile Duct by Variant Right Hepatic Artery / 대한췌담도학회지

Extrahepatic bile duct can be compressed by right hepatic artery (RHA) and cause a variety of hepatobiliary symptoms. This condition is referred to as RHA syndrome. A 20-year-old man was admitted because of jaundice. No stones or tumor were visible on CT scan and endoscopic retrograde cholangiopancreatography. However, RHA was seen traversing and compressing the mid common bile duct (CBD) with resultant upstream dilatation. The patient was diagnosed with obstructive jaundice due to compression of the CBD by variant RHA originating from gastroduodenal artery. After separation and mobilization of the variant RHA, obstructive jaundice was resolved. Herein, we report a case of a variant form of RHA syndrome that was successfully managed by surgery.

Asymptomatic Small Bowel Lymphoma Discovered Incidentally Following Ileal Intubation During Screening Colonoscopy / 대한내과학회지

Primary lymphoma of the small intestine is commonly diagnosed after serious complications, such as bowel perforation and bleeding. It results from vague symptoms and the lack of routine screening programs due to low prevalence. Ileal intubation can be used for screening and diagnosis of various small intestinal diseases. However, the value of routine terminal ileum intubation during colonoscopy remains controversial because of its low diagnostic yield. In Korea, there has been no report of asymptomatic primary lymphoma of the small intestine discovered through ileal intubation during colonoscopy. Thus, we report a case of asymptomatic primary lymphoma of the small intestine diagnosed incidentally through terminal ileum intubation during screening colonoscopy, and we review the literature on small intestinal lymphoma and the value of routine ileal intubation.

A Case of Descending Thoracic and Abdominal Aortic Aneurysm with Ankylosing Spondylitis

Ankylosing spondylitis (AS) is a systemic inflammatory disorder that affects the axial skeleton. It often involves the extra-articular organs. Cardiovascular involvement is one of the extra-articular manifestations, which is mostly represented by aortic root, valvular heart disease, and conduction disturbances. An aortic sclerosing inflammatory process induces aortic root thickening and rigidity. An aortic aneurysmal change is a rare complication that often leads to life threatening conditions. A few cases regarding aortic aneurysm have been reported, but there are no reported cases in Korea. We report the first case of descending thoracic and abdominal aortic aneurysm in a patient with ankylosing spondylitis.

Spontaneous Renal Artery Dissection in a Patient with Protein C and S Deficiency / 대한내과학회지

Spontaneous renal artery dissection without aortic dissection in normotensive patients is rarely reported. Spontaneous renal artery dissection is also an uncommon cause of renal infarction that occurs, though rarely, in patients with hypercoagulable states such as protein C and S deficiency. We report here a case of spontaneous renal artery dissection and renal infarction associated with protein C and S deficiency.