We report a case of subcutaneous phaeohyphomycosis caused by Exophiala(E,) jeanselmei in a 66-year-old female, who showed a mild tender, 4.5x3.5cm sized, erythematous cystic mass with satellite lesions on the left forearm for 4 months. Histopathologically, suppurative granulomatous inflammation, brownish conidia in a chain and hyphae were observed. Fungal culture grew out the typical black-gray velvety colonies of E. jeanselmei after 2 weeks. The isolate grow well at 25 C, but very poorly at 37 C. No growth could be observed at 40 C. Sporulation adequate for evaluation was present on the malt extract agar. We confirmed E. jeanselmei by colony and microscopic morphology, temperature tolerance and sugar assimilation tests. The patient had been treated with itraconazole for 6 momths. Complete remission was observed.
Agar ; Aged ; Exophiala* ; Female ; Forearm ; Humans ; Hyphae ; Inflammation ; Itraconazole ; Phaeohyphomycosis* ; Spores, Fungal

Bezoars are concretions of foreign bodies found in the gastrointestinal tract. In the past, most common method for the treatment of bezoar was surgical management. However, the current treatment methods include chemical dissolution and endoscopic mechanical lithotripsy. There were few reports on the treatment of phytobezoars by nasogastric Cola lavage. However, there was no report succeeded by oral route alone. In our two cases, phytobezoars were treated by oral administration of Coca-Cola. Our patients drank 700-800 mL of Coca-Cola daily, and after two months, complete dissolutions of bezoars were achieved. We report two cases of phytobezoars completely treated by drinking Coca-Cola.
Administration, Oral ; Aged ; Bezoars/diagnosis/*therapy ; *Carbonated Beverages ; Endoscopy, Gastrointestinal ; *Gastrointestinal Tract ; Humans ; Male ; Middle Aged

Bile leak is one of the complications of both open and laparoscopic cholecystectomy. The majority of postcholecystectomy leaks occur from the cystic duct stump. Due to their location and small size, accessory ducts are vulnerable to injury during cholecystectomy. A clinical significant leak from the injured accessory bile duct is rare and has rarely been reported in Korea. Endoscopic retrograde cholangiopancreatography (ERCP) has a major role both in detecting such a leak, determining its site, and in managing it. A case was experienced involving a significant bile leak after laparoscopic cholecystectomy from the accessory bile duct in a 49 year-old man. The site of the leak was diagnosed by ERCP and the leak was successfully treated endoscopically by using biliary stenting. However, the diagnosis of the accessory bile duct was established only by a follow-up ERCP done after the healing of the bile leak. This case in herein reported with a review of the related literature.
Bile Ducts* ; Bile* ; Cholangiopancreatography, Endoscopic Retrograde ; Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Cystic Duct ; Diagnosis ; Follow-Up Studies ; Humans ; Korea ; Middle Aged ; Stents

Although most of pseudocysts as one of complications of pancreatitis occur primarily within the pancreas, the extrapancreatic locations of pseudocysts, especially in the liver, are rare events. With advanced technology of imaging studies including abdominal computed tomography, ultrasonography, and magnetic resonance imaging, their frequency seems to be increasing. We report here a case of left intrahepatic pancreatic pseudocyst following acute pancreatitis. Percutaneous puncture revealed a high level of amylase and lipase in the collection, confirming the diagnosis of intrahepatic pseudocyst. Symptomatic intrahepatic pseudocysts can be managed surgically, transcutaneously or endoscopically, and asymptomatic intrahepatic pseudocysts can be treated conservatively. We report this case with a review of literature.
Acute Disease ; Aged ; Humans ; Liver Diseases/*diagnosis/etiology/ultrasonography ; Magnetic Resonance Imaging ; Male ; Pancreatic Pseudocyst/*diagnosis/etiology/ultrasonography ; Pancreatitis, Alcoholic/complications/*diagnosis/ultrasonography ; Tomography, X-Ray Computed

A rare primary segmental omental infarction in an adult. Infarction of a part of the greater omentum has been recognized as an uncommon condition that may mimic other acute abdominal conditions, particularly acute appendicitis and acute cholecystitis. The presentation and course are seldom typical of appendicitis or cholecystitis. A greater omental infarction may occur without a recognizable cause, and may be termed "primary" (idiopathic), but in some cases, a cause is discovered, such as; mechanical interference with the blood supply to the omentum secondary to torsion, or systemic disorders such as cardiac, vascular, and hematological disease. The inflammatory necrotic mass resulting from the infarction produces somatic pain at its location in the abdomen. For unknown reasons the infarction occurs most commonly in the right half of the abdomen, especially the lower quadrant. An sign of peritoneal irritation, tenderness, and muscle guarding are the principal findings elicited on palpitation of the abdomen. Occasionally, a point of exquisite tenderness may be detected; this usually corresponds to the site of the infarction. Recognizing the typical imaging featuresan ovoid or cake-like mass in the omental fat with surrouding inflammatory changesof this condition is important, as most cases can be managed without surgery. We report a case of an adult patient with acute abdominal pain who was diagnosed with a right-sided segmental omental infarction.
Abdomen ; Abdominal Pain ; Adult* ; Appendicitis ; Cholecystitis ; Cholecystitis, Acute ; Hematologic Diseases ; Humans ; Infarction* ; Nociceptive Pain ; Omentum

Adenocarcinoma of the appendix is a rare neoplasm. Metastatic adenocarcinoma of the appendix from stomach adenocarcinoma is also a very rare finding. A 72-year-old man complained of right lower quadrant abdominal pain for 10 days, and he was diagnosed with acute appendicitis. Appendectomy was performed by a general surgeon. Adenocarcinoma was found on the postoperative biopsy. Subsequently, gastric adenocarcinoma was diagnosed on the gastroscopy with biopsy, and this was proven to be the original site of the appendiceal adenocarcinoma.
Abdominal Pain ; Adenocarcinoma* ; Aged ; Appendectomy ; Appendicitis ; Appendix* ; Biopsy ; Gastroscopy ; Humans ; Stomach*

Inflammatory fibroid polyp is a polypoid lesion of the gastrointestinal tract, composed of fibrous tissue, blood vessels, and inflammatory infiltration often dominated by eosinophilic leukocytes. It is infrequent, localized, and non-neoplastic condition. It is most often formed in the gastric antrum and ileum, and rarely in the esophagus, small bowel or colon. The polyp in the stomach is mainly located in the submucosa of the antrum, and may cause intermittent epigastric pain, vomiting, antral obstructive symptoms or rarely bleeding. When present in small bowel, it is usually localized in the ileum and presents with obstructive symptoms but clincal manifestations are different according to the location. Intussusception resulting from the mass is not common. We report a case of inflammatory fibroid polyp of the cecum causing intussusception. A 42-year-old male patient was referred to the hospital for the evaluation of right lower quadrant abdominal pain and palpable mass. A contrast-enhanced CT scan of the whole abdomen and colonoscopic examination revealed intussusception with a cecal mass. Inflammatory fibroid polyp causing intussusception was histologically confirmed by surgical wedge resection.
Abdomen ; Abdominal Pain ; Adult ; Blood Vessels ; Cecum* ; Colon ; Eosinophils ; Esophagus ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Ileum ; Intussusception* ; Leiomyoma* ; Leukocytes ; Male ; Polyps* ; Pyloric Antrum ; Stomach ; Tomography, X-Ray Computed ; Vomiting