Eosinophilic gastroenteritis is an uncommon disease characterized by eosinophilic infiltration in the bowel wall and presents various symptoms depending on the affected site and bowel layer. Pseudomembranous colitis is an antibiotic-associated infection caused by abnormal overgrowth of the toxin-producing Clostridium difficile in the large bowel. A 16-year-old boy was admitted with abdominal pain for 6 days. On admission, we performed an endoscopy and diagnosed gastroduodenitis. Then, we prescribed gastritis medication but he still presented with diffuse abdominal pain and fever above 38.0degrees C after admission. We considered infectious enterocolitis, so we prescribed an antibiotic. The next day, he presented with bloody diarrhea. A diagnosis of pseudomembranous colitis was confirmed by a colonoscopic examination with a biopsy. We also obtained a diagnosis of eosinophilic gastroenteritis through a histological diagnosis. This is the first case of the simultaneous occurrence of eosinophilic gastroenteritis and pseudomembranous colitis in the Korean medical literature. We report this case with a brief review of the literature.
Abdominal Pain ; Adolescent ; Biopsy ; Clostridium ; Clostridium difficile ; Diarrhea ; Endoscopy ; Enteritis ; Enterocolitis ; Enterocolitis, Pseudomembranous ; Eosinophilia ; Eosinophils ; Fever ; Gastritis ; Gastroenteritis ; Humans

Acute lymphoblastic leukemia is a cancer of blood cells. It is known as lymphoblastic lymphoma when it involves lymph nodes rather than the blood and bone marrow. The gastrointestinal tract is a predominant site for extra-nodal lymphomas. But, B-lymphoblastic leukemia/lymphoma more frequently presents in the leukemic form than in the lymphomatous form. We herein report a case of B-lymphoblastic leukemia/lymphoma detected as a laterally spreading tumor in the colon. A 54-year-old man was referred to our hospital for removal of multiple colonic polyps. A colonoscopy revealed multiple colonic polyps and several colonic laterally spreading tumors. An esophagogastroduodenoscopy revealed several raised erosive lesions on the fundus and several variable sized sessile polypoid lesions on the duodenum. We diagnosed B-lymphoblastic leukemia/lymphoma following biopsies of the lesions.
Biopsy ; Blood Cells ; Bone Marrow ; Colon ; Colonic Polyps ; Colonoscopy ; Duodenum ; Endoscopy, Digestive System ; Gastrointestinal Tract ; Humans ; Lymph Nodes ; Lymphoma ; Middle Aged ; Precursor Cell Lymphoblastic Leukemia-Lymphoma

Typhoid fever, the most serious human salmonellosis, is a systemic infectious disease caused by Salmonella enterica serovar Typhi and is characterized by prolonged fever, bacteremia, and multiplication of the organism within mononuclear phagocytic cells of the liver, spleen, lymph nodes, and Peyer's patches. The characteristic lesion of typhoid fever is an ulceration of the small intestinal lymphoid tissue, particularly the Peyer's patches. The usual histological findings of typhoid ulcer are necrosis and histiocytic proliferation that phagocytizes erythrocytes and degenerated lymphocytes. A granuloma is an unusual histopathological presentation of a typhoid lesion. Even if granulomas have been reported in the bone marrow, liver, and spleen in cases of typhoid fever, granulomas in primary ulcers of the ileum and transverse colon have been reported very rarely. We experienced a case of typhoid fever in which ill-defined granulomas were seen in ulcers of the terminal ileum and transverse colon.
Bacteremia ; Bone Marrow ; Colon, Transverse ; Communicable Diseases ; Erythrocytes ; Fever ; Granuloma ; Humans ; Ileum ; Liver ; Lymph Nodes ; Lymphocytes ; Lymphoid Tissue ; Necrosis ; Peyer's Patches ; Phagocytes ; Salmonella Infections ; Salmonella typhi ; Spleen ; Typhoid Fever ; Ulcer

Duodenal perforation associated with endoscopic retrograde cholangiopancreatography is very uncommon. However, it usually requires early diagnosis and surgical management. Perforations are commonly caused by endoscopic sphincterotomy, biliary or duodenal stent placement, guidewire-related causes, and endoscopy itself. Perforatioins can follow various clinical courses, and management depends on the cause of the perforation. Among the above causes, guidewire-induced perforation is very rare and related reports and analyses are limited. Herein we describe four cases of guidewire-induced periampullary perforation during endoscopic retrograde cholangiopancreatography, and analyze clinical characteristics and management.
Cholangiopancreatography, Endoscopic Retrograde ; Early Diagnosis ; Endoscopy ; Sphincterotomy, Endoscopic ; Stents

Biliary papillomatosis is a rare disease with a high risk of recurrence and malignant transformation. Therapeutic options include partial hepatectomy, Whipple's procedure and liver transplantation. If there is no surgical option left due to several reasons, local palliative procedures such as biliary stenting and drainage for the treatment of cholestasis are considered, but tumor growth cannot be influenced. Photodynamic therapy might be a new additional, palliative option for patients with biliary papillomatosis who are not eligible for surgery. Benign biliary stricture is a rare complication of photodynamic therapy. We report here a case of a 63-year-old male who developed benign biliary stricture after photodynamic therapy using the photosensitizer photofrin.
Cholestasis ; Constriction, Pathologic ; Dihematoporphyrin Ether ; Drainage ; Hepatectomy ; Humans ; Liver Transplantation ; Male ; Middle Aged ; Papilloma ; Photochemotherapy ; Rare Diseases ; Recurrence ; Stents

Pancreatic cancer is usually unresectable upon diagnosis, and treatment aims to optimize the quality of the patient's life by managing symptoms, and, particularly, by providing adequate pain control. When the pain is refractory to opioids, interventions such as celiac plexus neurolysis (CPN) can be considered. Endoscopic ultrasound (EUS)-guided CPN has been introduced for pancreatic cancer. Reported herein is a case of a 75 year-old man with pancreatic cancer who was treated with opioids due to severe abdominal pain. EUS-guided CPN was performed for pain control, and the opioid administration was discontinued as the pain improved dramatically. However, the patient experienced opioid withdrawal symptoms, including anxiety, insomnia, nausea, and vomiting. Thus, although EUS-guided CPN successfully reduced pain in a patient undergoing such treatment and to whom opioid was administered, opioid administration should not be abruptly discontinued. Rather, the opioid dose should be reduced gradually to avoid drug withdrawal.
Abdominal Pain ; Analgesics, Opioid ; Anxiety ; Celiac Plexus ; Humans ; Nausea ; Pancreatic Neoplasms ; Sleep Initiation and Maintenance Disorders ; Substance Withdrawal Syndrome ; Vomiting

The development of total biliary casts is very unusual, and especially in patients who have not undergone liver transplantation. There are only a few reports of total biliary casts in non-liver transplantation patients who have antiphospholipid antibody syndrome, B-cell non-Hodgkin's lymphoma, cholecystectomy or allogenic hematopoietic stem cell transplantation. Here we present the case of a previously well 77-year-old man who developed a total biliary casts without any risk factors and there was no obvious liver insult. The casts were managed endoscopically.
Aged ; Antiphospholipid Syndrome ; B-Lymphocytes ; Cholangiopancreatography, Endoscopic Retrograde ; Cholecystectomy ; Hematopoietic Stem Cell Transplantation ; Humans ; Liver ; Liver Transplantation ; Lymphoma, Non-Hodgkin ; Risk Factors ; Superior Mesenteric Artery Syndrome ; Transplants

Intussusception occurs when a segment of the bowel invaginates into the lumen of an adjacent distal segment. Intussusception in adults is a rare disease, accounting for only 5% of all cases. Asymptomatic small bowel intussusception in adults without a lead point is usually transient. When the length of the intussusception is less than 3.5 cm, it can be managed conservatively. This case was an asymptomatic small bowel intussusception without a lead point, which was discovered incidentally during an abdominal computed tomography scan. Spontaneous reduction in the intussusception was observed without any complications while maintaining conservative treatment only.
Accounting ; Adult ; Humans ; Intestine, Small ; Intussusception ; Rare Diseases

Stercoral perforation of the colon is a rare disease. Yet, in recent times, the number of reported cases has increased because of the growing elderly population. Stercoral perforation of the colon usually occurs in the elderly or bedridden patients with chronic constipation. Stercoral perforation may cause a massive hemorrhage or peritonitis. The prognosis of stercoral perforation is poor, as the reported postoperative mortality is 35~40%. So, early diagnosis and proper treatment are very important for improving survival. However, making an early diagnosis may be difficult because of the nonspecific initial symptoms. We experienced a case of stercoral perforation that was diagnosed by colonoscopy. The defect was in the sigmoid colon, and it was covered with peritoneum. The patient completely recovered after resection and anastomosis of the perforated colon. We report here on this case with a review of the relevant literature.
Aged ; Colon ; Colon, Sigmoid ; Colonoscopy ; Constipation ; Early Diagnosis ; Hemorrhage ; Humans ; Peritoneum ; Peritonitis ; Prognosis ; Rare Diseases

Intraductal papillary mucinous neoplasm of the pancreas (IPMN) is a precancerous lesion with a well-described adenocarcinoma sequence. The rate of progression of IPMN appears to be very slow; however, patients with IPMN may be at increased risk for extrapancreatic malignancies. A 55-year-old female was diagnosed with IPMN of the pancreas and a duodenal polyp in 2004. After an approximate 3 year loss to follow-up, she was readmitted for managing abdominal pain and underwent Whipple's operation. Herein, we report a case of a patient with malignant IPMN accompanied by duodenal adenocarcinoma arising from a duodenal polyp.
Abdominal Pain ; Adenocarcinoma ; Duodenal Neoplasms ; Female ; Follow-Up Studies ; Humans ; Middle Aged ; Mucins ; Neoplasms, Multiple Primary ; Pancreas ; Pancreatic Neoplasms ; Polyps