Adult ; Endometriosis ; complications ; Female ; Humans ; Ileal Diseases ; etiology ; Intestinal Diseases ; complications ; Intestinal Perforation ; etiology

Two unusual cases of small intestinal intussusception presenting as bowel obstruction are presented. They both had freckle-like pigmentation of the perioral area, palms and soles of the feet with intestinal polyps which acted as lead points in the intussusception. Peutz-Jeghers syndrome was diagnosed. This report highlights the high risk of cancer of the intestines and extra-intestinal sites associated with this interesting but rare condition.
Adolescent ; Adult ; Female ; Humans ; Ileal Diseases/*complications ; *Ileocecal Valve ; Intussusception/*etiology ; Male ; Peutz-Jeghers Syndrome/*complications

Adult intussusception secondary to primary sarcoma is a rare cause of small bowel obstruction. Only a few cases of malignant fibrous histiocytoma (MFH) of small bowel presenting as an intussusception have been reported in the literatures. We report a case of small bowel obstruction associated with jejuno-ileal intussusception caused by MFH. A 75-year-old man was admitted with an one-month history of vomiting and epigastric pain aggravated with meals. He was diagnosed as an jejuno-ileal intussusception based on CT scanning and underwent small bowel resection and anastomosis. Resected specimens revealed a polypoid tumor in the ileum and the histology of the tumor was consistent with MFH.
Aged ; English Abstract ; Histiocytoma, Fibrous/*complications/diagnosis ; Humans ; Ileal Diseases/*etiology ; Ileal Neoplasms/*complications/diagnosis ; Intussusception/*etiology ; Jejunal Diseases/*etiology ; Male

Adolescent ; Humans ; Ileal Diseases ; etiology ; Intussusception ; etiology ; Lymphoma, B-Cell ; complications ; Male

Cytomegalovirus (CMV) infections are commonly reported in severely immunocompromised hosts and ulcers of the alimentary tract are frequently observed in systemic CMV infections. However, invasive and ulcerative disease of the gastrointestinal (GI) tract caused by CMV has also been reported in healthy adults. Many reports show that a CMV infection can produce localized ulcerations in the esophagus, stomach, small intestine, and colon in nonimmunocompromised individuals. The most common site of involvement by CMV infection in the GI tract is the colon followed by the upper GI tract and the least common site is the small intestine. Although GI bleeding is one of the major presenting symptoms of patients with CMV infections of the GI tract, lower GI bleeding due to CMV ileal ulcers in immunocompetent patients, to our knowledge, has not been reported in the English literature. Recently, we experienced a case of lower GI bleeding due to CMV ileal ulcers in a 57-year-old man who had no evidence of immunocompromise. This case suggests that small intestinal ulcers due to CMV infection should be included in the differential diagnosis of lower GI bleeding even in immunocompetent hosts.
Case Report ; Cytomegalovirus Infections/complications* ; Gastrointestinal Hemorrhage/etiology* ; Human ; Ileal Diseases/complications* ; Male ; Middle Age ; Ulcer/complications*

Ileovesical fistula is a very rare clinical entity, the most frequent cause of which is Crohn's disease. Furthermore, it is an exceptionally rare complication of malignancies. We experienced one case of ileovesical fistula which had been caused by hepatocellular carcinoma (HCC) arising from the noncirrhotic liver. A 27-year-old man was diagnosed with HCC in a noncirrhotic liver. Despite treatment with transarterial chemoembolization (TACE), the disease status became more aggravated. The patient complained of dysuria, fecaluria, and intermittent lower abdominal pain. Pelvic CT scan showed a soft tissue mass of 6 cm abutting on the distal ileum which was downwardly displaced. Barium study of the small bowel showed a fistula between the small bowel loop and the urinary bladder. Upon operation, adhesion and fistula were found between the ileum and the urinary bladder. The microscopic findings of the surgical specimen were compatible with metastatic HCC. We confirmed that ileovesical fistula had been caused by metastatic HCC.
Adult ; Bladder Fistula/*etiology ; Carcinoma, Hepatocellular/*complications ; Humans ; Ileal Diseases/*etiology ; Intestinal Fistula/*etiology ; Liver Neoplasms/*complications ; Male

The clinical manifestations of intestinal tuberculosis are non-specific. But, abdominal pain, low grade fever, weight loss, anorexia, and diarrhea are major symptoms of intestinal tuberculosis. Massive bleeding has been reported as a rare manifestation of intestinal tuberculosis. Massive hematochezia from intestinal tuberculosis has rarely been reported in the medical literature. Also, most of them were treated with anti-tuberculosis medication only or with surgery. We treated a case of intestinal tuberculosis presenting massive hematochezia with colonoscopic coagulation therapy and anti-tuberculosis medication. Here, we report a Korean man who presented with massive hematochezia from ileal tuberculosis and treated by endoscopic coagulation therapy.
Adult ; English Abstract ; Gastrointestinal Hemorrhage/*etiology/therapy ; *Hemostasis, Endoscopic ; Humans ; Ileal Diseases/*complications/diagnosis ; Male ; Tuberculosis, Gastrointestinal/*complications/diagnosis

No abstract available.
Adult ; Constriction, Pathologic ; Crohn Disease/*complications ; Endoscopy, Gastrointestinal ; Humans ; Ileal Diseases/*diagnosis/etiology/pathology ; Ileum/pathology ; Male

Usual sources of subphrenic abscess with intestinal fistula are previous abdominal operation, inflammatory bowel disease and malignancy. Reported cases of intestinal fistula caused by adenocarcinoma were complicated by direct invasion. In this report, a 70-year-old male had a subphrenic abscess with intestinal fistula and the cause was a metastatic adenocarcinoma of unknown origin. As far as we know, this has not been reported previously in the literatures. The abscess went on chronic course for six months because intermittent administration of antibiotics modified its clinical presentation. The fistulous tract between the abscess and ileum was demonstrated by tubogram via the drainage catheter in abscess. The patient underwent surgical treatment because the cause of fistula was obscure. Invasion of the ileum by metastatic adenocarcinoma was diagnosed by the histologic examination of surgical specimen. Therefore, when a fistula develops without any apparent cause, there is a possibility of malignancy, and surgical approach must be considered. An early surgical approach will prevent the delay in treatment and reduce the mortality.
Adenocarcinoma/complications/diagnosis/*secondary ; Aged ; English Abstract ; Humans ; Ileal Diseases/diagnosis/*etiology ; Ileal Neoplasms/complications/diagnosis/*secondary ; Intestinal Fistula/diagnosis/*etiology ; Male ; *Neoplasms, Unknown Primary ; Subphrenic Abscess/diagnosis/*etiology

Reactive hemophagocytic syndrome or hemophagocytic lymphohistiocytosis, is characterized by the proliferation of benign histiocytes showing phagocytosis of blood cells in hematopoietic organs including bone marrow, spleen, or lymph nodes, accompanied by fever, hepatosplenomegaly, hepatic dysfunction, pancytopenia, and hypertriglyceridemia. The pathogenesis of reactive hemophagocytic syndrome is unknown. It is often associated with infection, malignant neoplasm, autoimmune disease, drugs and various immunodeficiencies. The prognosis of this syndrome is poor and the causes of death are hemorrhage, infection, or multiorgan failure. We experienced a case of hemophagocytic syndrome with terminal ileal ulcers, not associated with other causes. Thus, we report this case with a review of literatures.
Adult ; Fatal Outcome ; Humans ; Ileal Diseases/complications/*diagnosis ; Lymphohistiocytosis, Hemophagocytic/complications/*diagnosis/pathology ; Male ; Tomography, X-Ray Computed ; Ulcer/complications/*diagnosis