Granulocytic sarcoma (GS) is a rare extramedullary tumor composed of immature myeloid precursor cells. GS is associated with acute or chronic myeloid leukemia; it has rarely been reported in non-leukemic patients. We report two cases of GS with unusual presentations; neither had bone marrow involvement. The first case was a GS presenting with multiple intra-abdominal masses in a 43-year-old man. Computed tomography (CT) of the abdomen showed masses in the small bowel and right adrenal gland. The second case was a patient with a GS presenting with symptoms of spinal cord compression in a 32-year-old man. Magnetic resonance imaging (MRI) showed an extradural mass in the spinal canal at the T3-T5 levels. Blood smear and bone marrow studies were normal. These cases show that GS should be included in the differential diagnosis of intra-abdominal masses and extradural spinal cord tumors, even in the absence of leukemia.
Abdomen ; Adrenal Glands ; Adult ; Bone Marrow ; Diagnosis, Differential ; Humans ; Leukemia ; Magnetic Resonance Imaging ; Sarcoma, Myeloid ; Spinal Canal ; Spinal Cord Compression ; Spinal Cord Neoplasms

Hypertriglyceridemia-induced pancreatitis is a rare, but serious, complication of pregnancy. We report a case of acute pancreatitis associated with type V hyperlipoproteinemia in pregnancy. A 36-year-old primigravida was admitted at 16 weeks of gestation with severe abdominal pain. Chemical analysis showed high serum pancreatic enzymes and very high serum triglyceride. Abdominal magnetic resonance imaging (MRI) showed diffuse swelling of the pancreas and a peripancreatic fluid collection. A diagnosis of acute pancreatitis with type V hyperlipoproteinemia was made. She recovered from the acute pancreatitis with conservative management and the serum triglyceride decreased rapidly with dietary restriction of fat, insulin/glucose, fenofibrate, and omega-3. We review the management of hypertriglyceridemia-induced acute pancreatitis in pregnancy.
Abdominal Pain ; Adult ; Fenofibrate ; Humans ; Hyperlipoproteinemia Type V ; Hypertriglyceridemia ; Magnetic Resonance Imaging ; Pancreas ; Pancreatitis ; Pregnancy

BACKGROUND: Surgical site infection (SSI) is prominent among the total incidence of healthcare-associated infections, and is a major contributing factor in the trend of increasing medical costs. There have been numerous efforts to analyze the conditions and causes of SSI for the purpose of prevention. In this study of SSI development after gastric surgery, we evaluated the prevalence of specific pathogens and compared the clinical characteristics observed between gram-positive (GPB) and gram-negative bacteria (GNB). MATERIALS AND METHODS: We conducted a retrospective study of patients who developed SSI within 30 days after gastric surgery at 13 clinics in Korea, between January 2007 and December 2008. Only those cases of SSI which included confirmed pathogen were included in this study. RESULTS: Among the 121 patients who developed SSI, GPB were observed in 32 patients and 36 cases, and GNB were isolated in 32 patients and 36 cases. Methicillin resistant Staphylococcus aureus (MRSA) was the most frequently isolated pathogen in this analysis. There were no differences observed between the GPB and GNB group in terms of baseline characteristics, patient or procedure related risk factors, or factors associated with prophylactic antibiotics. CONCLUSIONS: In the previous studies of the occurrence of SSI after gastric surgery, it was reported that the majority of observed pathogens were enteric GNB. Further studies of the incidence of SSI after gastric surgery, particularly those related to MRSA infection, are necessary.
Gram-Negative Bacteria ; Gram-Positive Bacteria ; Humans ; Incidence ; Korea ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Prevalence ; Retrospective Studies ; Risk Factors ; Staphylococcus aureus