, Tae-Hun Kim, Min-sun Ryu, Da-Yeon Oh, Myung-Eun Song, Shina Lee, Jae-In Ryu, Hye-In Kim, Il-Hwan Moon, Kwon Yoo The causes of pyogenic liver abscess has been known as biliary tract disease or intrabadominal infection but the large proportions of the patients has no apparent underlying disorders. Recently colonic mucosal lesions were reported in patients with cryptogenic liver abscess and it has been suggested that colonic mucosal break may play a role in developing liver abscess in otherwise healthy patients. We experienced a patient of severe recurrent liver abscess complicated with endophthalmitis only 3 months after successful treatment of initial cryptogenic liver abscess and a polypoid colon cancer was discovered by chance. It seems prudent to proceed colonoscopic examination in patients with cryptogenic liver abscess especially when it is recurrent.
, Yoo-Ri Kim, Hyun-Mi Heo, Suh-Eun Bae, Myung-Won Lee, Yun-Jung Choi, Go-Heun Kim, Tae-Hun Kim, Kwon Yoo, Il-Hwan Moon Hepatocellular carcinoma(HCC)is one of common causes of cancer-related death in Korea where the majority of HCC patients were Hepaitc B virus(HBV)carriers and have cirrhosis. Transarterial chemoembolization(TACE)is commonly applied to the treatment of multinodular HCC in Korea and careful selection of candidate is important for the risk of various side effects. Besides common side effects as fever, nausea, abdominal pain and elevation of liver enzyme, TACE may predispose to hepatic failure, ischemic cholecystitis, pulmonary embolism, cerebral embolism and pneumonitis. In previous studies, some cases of pulmonary and cerebral embolism cases were reported but lipiodol pneumonitis after TACE was rarely reported. A 65-year-old woman with a multinodular HCC associated with HBV infection, was treated with TACE. Seven days after the procedure, nonspecific respiratory symptoms such as dyspnea and dry cough developed. Chest X-ray and chest computed tomography showed diffuse ground glass opacities in whole lung fields, suggestive of lipiodol pneumonitis. After several days of supportive care with steroid administration, radiologic abnormalities and subjective symptoms were much improved, considered that the disease was compatible with lipiodol pneumonitis.
Citations
, Doe-Young Kim, Hye-Kyung Jung, Il-Hwan Moon, Sue-Yeun Shin, Jae-Jin Kwak Milk of calcium bile or limy bile is a rare disorder in which the gallbladder lumen is filled with a thick, paste-like, radio-opaque material. Churchman first reported a case of curious deposition of calcium salts within the gallbladder in 1911. Volkmann first used the term Kalkmilchgalle or milk of calcium bile in 1926. The radio-opaque material is almost entirely composed of calcium carbonate by weight. The mechanisms by which bile turns limy and radio-opaque or the time required for this biochemical alteration to occur are not well understood. The limy bile is found mostly in a gallbladder complicated by cholecystitis. Recently, we experienced a 33 year old woman who had a milk of calcium bile in the gallbladder lumen. We report this case with a review of literature.
, Doe-Young Kim, Hye-Kyoung Jung, Seung-Hyun Nam, Il-Hwan Moon, Hea-Soo Koo Nowadays increasing use of abdominal ultrasound in routine check-up may increase the detection rate asymtomatic cystic lesions of pancreas. Even through the majority of the cystic lesions of pancreas is pseudocyst, about 10-15% of those lesions are caused by pancreatic cystic tumor. In the pancreatic cystic tumor, especially, mucinous cystic tumor should be exicised due to its malignant potential, while the pancreatic pseudocyst or serous cystic tumon can be observed for a period or treated medically. Several clinical, radiological, biochemical and pathologic guidelines have been developed in order to distinguish among them. Among pancreatic cystic tumors, mucinous cystic adenocarcinoma is very rare and accounts for only 1% of all pancreatic neoplasms. Unlike extremely poor prognosis of pancreatic adenocarcinoma, mucinous cystic adenocarcinoma has an indolent course and shows a good prognosis after its curative resection. Recently we experienced a 69-year-old woman who had a mucinous cystic adenocarcinoma of the pancreas. We report this case with a review of literature.
, Sung Ae Jung, Min A Yu, Young Ju Choi, Ji Yoon Cho, Su Hyun Kim, Kwon Yoo, Il-Hwan Moon The aim of this study was to evaluate the clinicopathologic characteristics of the colorectal polyps in people under 50 years old.
From January to August 2001, the colonoscopic finding and pathologic reports of 527 patients under 50 years old who underwent colonoscopy were reviewed retrospectively. The advanced polyp was defined as an adenoma more than 10mm in diameter or with the histology of villous or high grade dysplasia.
Total 94 colonic polyps(17.8%) were analyzed. On age distribution, 65 cases(69.1%) were in forth decade, 25 cases(26.6%) in third decade. Abdominal pain(29.8%) was the most common cause of taking the colonoscopic examination followed by rectal bleeding(18.1%), asymptomatic screening(12.7%). Rectosigmoid area was the most common site of polyps in 63.8%. On the pathologic review, adenoma was found 55.1%, inflammatory polyp 38.5% and hyperplastic polyp 6.4%. Advanced adenomas were 17.9%(17/156) and adenomas with focal carcinomatous changes were 1.9%(3/156). Patients who had symptoms of abdominal pain or rectal bleeding, multiple polyps or familial history of colorectal cancer had a higher prevalence of advanced adenoma than that of non-advanced adenoma(
This study showed that major symptoms of patients with advanced polyps under 50 years old were abdominal pain and rectal bleeding. The symptoms, multiplicity of polyp and family history were important indicator of advanced polyps. Further study was needed for reasonable indication and cost effectiveness for colonoscopic examination in young age people.
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