Colonoscopy-Induced Acute Diverticulitis

Even though colonoscopy is a common and widely performed procedure, it can cause many complications. If any sign of inflammation is observed, a perforation or postpolypectomy coagulation syndrome should be considered. Diverticulitis, a very rare complication with an incidence of 0.04% to 0.08%, also can occur after the diagnostic and therapeutic procedure. We report a case of acute diverticulitis after colonoscopy, diagnosed with typical computed tomography findings after excluding other complications. The patient was treated in the same manner as for complicated diverticulitis, with bowel rest, hydration, and broad-spectrum antibiotics. Acute diverticulitis as a rare complication can occur following prolonged colonoscopy or colonoscopic polypectomy, especially in those with additional risk factors such as obesity and smoking.

A Case of Gastric Neuroendocrine Carcinoma Presenting as Early Gastric Cancer Diagnosed by Endoscopic Submucosal Dissection

Gastric neuroendocrine carcinomas are very rare, when compared with gastric adenocarinomas. In addition, it is difficult to distinguish between gastric adenocarcinoma and gastric neuroendocrine carcinoma histol-ogically without immunohistochemical staining. In most of the reported cases, neuroendocrine carcinomas were diagnosed at an advanced stage, confirmed postoperatively by histological examinations using immunohistochemical staining and associated with a poor prognosis. A 55-year-old woman was diagnosed as cellular atypia by screening endoscopy for her health check-up at a local clinic. Histological examination from the endoscopic specimen revealed suspicious early gastric cancer. Endoscopic submucosal dissection was performed for therapeutic and diagnostic purposes and the pathologic findings revealed neuroendocrine carcinoma. Herein, we report a case of gastric neuroendocrine carcinoma presenting as early gastric cancer that was diagnosed by endoscopic submucosal dissection.

A Case of Gastric Neuroendocrine Carcinoma Presenting as Early Gastric Cancer Diagnosed by Endoscopic Submucosal Dissection

Gastric neuroendocrine carcinomas are very rare, when compared with gastric adenocarinomas. In addition, it is difficult to distinguish between gastric adenocarcinoma and gastric neuroendocrine carcinoma histol-ogically without immunohistochemical staining. In most of the reported cases, neuroendocrine carcinomas were diagnosed at an advanced stage, confirmed postoperatively by histological examinations using immunohistochemical staining and associated with a poor prognosis. A 55-year-old woman was diagnosed as cellular atypia by screening endoscopy for her health check-up at a local clinic. Histological examination from the endoscopic specimen revealed suspicious early gastric cancer. Endoscopic submucosal dissection was performed for therapeutic and diagnostic purposes and the pathologic findings revealed neuroendocrine carcinoma. Herein, we report a case of gastric neuroendocrine carcinoma presenting as early gastric cancer that was diagnosed by endoscopic submucosal dissection.

A Case of Fitz-Hugh-Curtis Syndrome in a Male / 대한소화기학회지

Fitz-Hugh-Curtis syndrome has been described as focal perihepatitis accompanying pelvic inflammatory disease caused by Neisseria gonorrhea and Chlamydia trachomatis. The highest incidence occurs in young, sexually active females. However, the syndrome has been reported to occur infrequently in males, according to the foreign literature. The predominant symptoms are right upper quadrant pain and tenderness, and pleuritic right sided chest pain. The clinical presentation is similar in men and women. In women, the spread of infection to liver capsule is thought to occur directly from infected fallopian tube via the right paracolic gutter. In men, hematogenous and lymphatic spread is thought to be postulated. Recently, we experienced a case of Fitz-Hugh-Curtis syndrome occurred in a man. As far as we know, it is the first report in Korea, and we report a case with a review of the literature.

Two Cases of Gastric Marginal Zone B Cell Lymphoma Treated with a Single Agent Chemotherapy / 대한소화기내시경학회지

Gastric marginal zone B cell lymphoma of the MALT type (MALT lymphoma) is usually accompanied by a Helicobacter pylori (H. pylori) infection. Most gastric MALT lymphomas regress after the eradication of H. pylori. Therefore, H. pylori eradication therapy is an effective first-line treatment for gastric MALT lymphoma. A second-line treatment for patients who fail to respond to eradication therapy, including radiotherapy and chemotherapy, produces a good response and survival rate. We encountered 2 cases of H. pylori eradication-resistant gastric MALT lymphoma, which were treated with cyclophosphamide monotherapy. A complete response was obtained in both cases after a treatment duration of 3 months and remission continued for 15 and 18 months, respectively. Treatment-related toxicity was mild. Oral monochemotherapy might be an alternative, effective and safe treatment modality for patients with gastric MALT lymphoma who are resistant to H. pylori eradication therapy.

A Case of Splenic Pseudoaneurysmal Rupture Misrecognized as Bleeding from Gastric Submucosal Tumor / 대한소화기내시경학회지

Splenic arterial pseudoaneurysm is an uncommon life-threatening complication of acute and chronic pancreatitis. Pseudoaneurysm can lead to massive bleeding into the abdominal cavity and the retroperitoneum. Less commonly, it may rupture directly into the stomach, small bowel or pancreatic duct and may present as an acute gastrointestinal hemorrhage. It can be diagnosed by various imaging modalities including computerized tomography, ultrasound and angiography. Percutaneous transvascular embolization of the pseudoaneurysm is one of the alternative treatment methods. Here we present a case of splenic arterial pseudoaneurysmal rupture misrecognized as bleeding from a gastric submucosal tumor in patient with hematemesis. We also review the literature.

Toxic hepatitis associated with Polygoni multiflori / 대한간학회지

Toxic hepatitis has been reported as a major cause of acute hepatitis, but its potential induction by herbal remedies and/or health foods is usually neglected. We experienced a case of toxic hepatitis associated with Polygoni multiflori, a Chinese herb commonly known as Ho-Shou-Wu. A 54-year-old woman consumed Ho-Shou-Wu for 1 month, after which she experienced fatigue and overall weakness. A diagnosis of toxic hepatitis was made based on her clinical history, the findings for viral markers and other laboratory data, and ultrasonography. Her condition improved considerably after she stopped taking Ho-Shou-Wu. However, she resumed taking Ho-Shou-Wu immediately after discharge from hospital, which aggravated her symptoms and liver function. She was immediately readmitted and stopped taking Ho-Shou-Wu. Her relapse into hepatitis immediate after resuming consumption of the herb is strongly indicative of the validity of Koch's postulate in this case.