, Jihyun Lee, Yeji Han, Seog Ki Min, Min-Sun Cho, Yeon-Ah Sung A substantial proportion of adrenal incidentalomas demonstrates subtle hormonal hypersecretion; however, adenomas that cosecrete aldosterone and cortisol are rare. We here report a case of an adrenal mass that was incidentally detected on a computed tomography scan in a 57-year-old man. The patient had a 10-year history of diabetes mellitus and a 5-year history of hypertension. Evaluation revealed hyperaldosteronemia with an elevated plasma aldosterone-to-renin ratio, hypokalemia, unsuppressed cortisol after dexamethasone administration, and elevated urinary free cortisol concentration. The appearance of the right adrenalectomy specimen indicated adrenal adenoma. Postoperatively, the blood glucose and blood pressure control improved and the urinary cortisol and aldosterone-to-renin ratio normalized. A complete endocrine evaluation in patients with incidentally discovered adrenal masses should be performed, even if the patient has a long-standing history of hypertension and diabetes, to avoid any postoperative adrenal crises.
, Sung-Ae Jung, Hyun Joo Song, Jae Jung Park, Kyung Jong Lee, Eun Kyung Baek, Seog Ki Min Nowadays, upper gastrointestinal endoscopy is very commonly performed procedure as a diagnostic tool or therapeutic purpose. Although perforation rate during diagnostic evaluation has been reported as low about 0.03%, gastrointestinal perforation is a critical problem to the patients owing to significant morbidity and hospital stay. Therefore, all endoscopists should know the risk factors for the perforation and pay attention to avoid this complication. We experienced a case of 66 year-old-male with duodenal microperforation after endoscopic biopsy. During endoscopic examination, a submucosal mass was detected at duodenal second portion and endoscopic biopsy was performed. After this, he complained of severe abdominal pain during colonoscopy. Emergent simple abdomen and abdominal computed tomography revealed multiple free air in retroperitoneal space and duodenal perforation was suspicious. He was treated with primary closure and then recovered completely. Therefore, we report a case with microperforation after endoscopic duodenal biopsy.
, Seog Ki Min, Hyeon Kook Lee, Woon Sup Han The purpose of study is to compare the laparoscopic appendectomy with the open appendectomy in the clinical outcomes.
From March 2001 to June 204, a total 118 appendectomy were retrospectively reviewed. These were comprised of 57 laparoscopic appendectomy (LA), and 61 open appendectomy (OA) selected by random method among 1193 poen appendectomy cases during same period. Hospital stay, length of operation times, recovery of bowel function, postoperative complication, postoperative pain, pathologic classification were compared in both groups.
The operation times were 68.6 minutes (LA) and 51.6 minutes (OA), respectively (p=0.021). There no statistical differences in the duration of hospital stay, recovery of bowel function, complication rate, although LA group trend the shorter duration of the hospital stay, faster recovery of bowel function and low rarte of complication than OA group. The patient's satisfaction was higher in LA group than OA because of the operation wound scar.
The LA was no difference clinical outcomes except operation time as compared with OA. LA, however, may be have the merit of minimal invasive surgery and satisfaction of patient. So, LA method is attractive option for the management of appendicitis.
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