Ectopic pancreas is commonly located at stomach, duodenum and jejunum. It is a relatively rare entity and is usually of no clinical importance which especially is a very rare source of massive upper gastrointestinal bleeding. We have recently experienced a case of an ectopic pancreas in the second portion of the duodenum which was proven to be a source of massive gastrointestinal bleeding by duodenoscopy and was confirmed by surgical exploration.
Duodenoscopy ; Duodenum* ; Esophagus* ; Hemorrhage* ; Intestines* ; Jejunum ; Pancreas* ; Stomach*

Vibrio cholerae non-O1/O139 strains are the organisms that are biochemically indistinguishable from V. cholerae but do not agglutinate in Vibrio cholerae O1 and O139 antisera. V. cholerae non-O1/O139 strains are associated with gastroenteritis and extraintestinal infections such as bacteremia, peritonitis and wound infections. Gastroenteritis by V. cholerae non-O1/O139 is uncommon in Korea. We isolated V. cholerae non-O1/O139 from a stool specimen of a one year-old female with diarrhea and high fever.
Bacteremia ; Cholera ; Diarrhea ; Female ; Fever ; Gastroenteritis* ; Humans ; Immune Sera ; Korea ; Peritonitis ; Vibrio cholerae O1 ; Vibrio cholerae* ; Wound Infection

Adenocarcinoma of small intestine is rare disease, but its incidence of iluem is the least of small intestinal adenocarcinoma. Its rarity and vague symptoms results in delayed diagnosis, treatment and poor prognosis, Recently we experienced a 65 years old man of ileal adenocarcinoma with liver metastasis, which does not obstuct intestinal lumen, We treat the metastatic tumor with chemoembolization(lipiodol and doxorubicin) through the hepatic artery and so we report the case with review of literature.
Adenocarcinoma ; Aged ; Delayed Diagnosis ; Hepatic Artery ; Humans ; Incidence ; Intestine, Small ; Liver ; Neoplasm Metastasis* ; Prognosis ; Rare Diseases

BACKGROUND/AIMS: We analyzed patients with abdominal pain of undetermined etiology, referred to physiatrists by gastroenterologists, and determined the clinical features of patients with abdominal wall pain. METHODS: A retrospective chart review of 100 patients referred by gastroenterologists over 4 years was performed. A visceral etiology of abdominal pain was excluded by the gastroenterology work-up using radiologic and endoscopic studies, and medical treatment. The clinical features and outcomes of abdominal wall pain were examined. We determined the long-term outcome by telephone. RESULTS: Of 100 patients with abdominal pain of undetermined etiology, 89% of the patients were identified as having pain arising in the abdominal wall, and the right flank area was the most common site of pain. The pain had a musculoskeletal origin in 90.4% of the patients and a neurogenic origin in 9.6%. Treatment by the physiatrists resulted in complete or partial pain relief in 73% of the patients. The diagnosis remained unchanged after a mean of 22.67 (range 6.5-55) months in 95.5% of the patients. Long-term effects of management were seen in 73.6% of the patients. CONCLUSIONS: In a small group of patients with abdominal pain of unknown etiology, the source of pain could be in the abdominal wall. Recognizing abdominal wall pain could lead to an accurate diagnosis, reduced medical costs and effective treatment.
Abdominal Pain ; Abdominal Wall ; Gastroenterology ; Humans ; Retrospective Studies

Cytomegalovirus (CMV) infection is often asymptomatic in immunocompetent patients, but it could be reactivated to incur several serious complications in immunocompromized patients. There are several case reports of CMV induced vasculitis and endothelial cell inflammation that cause ischemia of organs in immunocompromised patients. However, CMV infection causing splenic infarct is rare in immunocompetent patients. Only twenty cases have been reported worldwide and this case report appears to be the first documented case of CMV infection causing splenic infarction in immunocompetent patient in Korea.
Adult* ; Cytomegalovirus* ; Endothelial Cells ; Humans ; Immunocompromised Host ; Inflammation ; Ischemia ; Korea ; Splenic Infarction ; Vasculitis

Cytomegalovirus (CMV) infection is often asymptomatic in immunocompetent patients, but it could be reactivated to incur several serious complications in immunocompromized patients. There are several case reports of CMV induced vasculitis and endothelial cell inflammation that cause ischemia of organs in immunocompromised patients. However, CMV infection causing splenic infarct is rare in immunocompetent patients. Only twenty cases have been reported worldwide and this case report appears to be the first documented case of CMV infection causing splenic infarction in immunocompetent patient in Korea.
Adult* ; Cytomegalovirus* ; Endothelial Cells ; Humans ; Immunocompromised Host ; Inflammation ; Ischemia ; Korea ; Splenic Infarction ; Vasculitis

Background: The aim of this study was to analyze the inhibitory effects of copper, brass (78% copper, 22% tin), and stainless steel surfaces on multidrug-resistant Acinetobacter baumannii (MRAB), extended-spectrum beta-lactamase (ESBL) Escherichia coli , and carbapenem-resistant Klebsiella pneumoniae (CRKP). Methods: MRAB, ESBL E. coli, and CRKP were isolated at Uijeongbu St. Mary's Hospital in 2020. A. baumannii ATCC BAA-747, E. coli ATCC 25922, and K. pneumoniae ATCC 700603 were used as reference strains. The initial bacterial cell count of each inoculum was adjusted to 8 log CFU/mL using phosphate buffered saline, Copper, brass, and stainless steel plates were inoculated with 9 mL of MRAB, ESBL E. coli, and CRKP inoculum solutions. The bacterial cell count was measured from the beginning to the 20th day in an incubator maintained at 35°C. Results: MRAB, ESBL E. coli, and CRKP isolates were not detected on the copper and brass plates after 4, 5.5, and 6.5 hours, respectively. MRAB, ESBL E. coli, and CRKP isolates were not detected on the stainless steel plate after 15, 20, and 20 days, respectively. The bactericidal effects of copper and brass were much stronger than those of stainless steel. Conclusion The use of copper and copper alloys should be considered to prevent crossinfection in hospitals.

Background: Early prediction of bacteremia is important because sepsis may develop if bacteremia is not treated in time. We aimed to determine whether blood tests are clinically useful in predicting gram-negative versus gram-positive bacteremia. Methods: We retrospectively analyzed the medical records of 16,569 patients who underwent blood culture testing among those who visited St. Mary’s Hospital of Uijeongbu, Catholic University from January 1, 2018 to December 31, 2018. After excluding 15,580 patients with insufficient data for analysis, the total study population was 989. Results: In the multivariable logistic regression analysis for gram-negative bacteremia, after adjusting for major variables, procalcitonin (odds ratio [OR] 1.02, P < 0.001), high-sensitivity C-reactive protein (OR 1.03, P = 0.010), and albumin (OR 0.55, P = 0.010) were significant. In the same model, lactic acid (OR 1.08, P = 0.010), blood urea nitrogen (BUN) (OR 1.02, P = 0.010), and albumin (OR 0.50, P = 0.005) were significant for gram-positive bacteremia.We constructed blood indicators by combining blood tests that were significant in multivariable logistic regression analysis. Comparing the area under the curve (AUC) of the receiver operating characteristic curve, the AUC of the procalcitonin/albumin ratio in gramnegative bacteremia was significantly higher than that of procalcitonin (0.846 vs. 0.837, P = 0.005), and the AUC of the BUN/albumin ratio in gram-positive bacteremia was significantly higher than that of BUN (0.709 vs. 0.679, P = 0.007). Conclusion The procalcitonin/albumin ratio is expected to be helpful in the early prediction of gram-negative bacteremia, whereas the BUN/albumin ratio in the early prediction of grampositive bacteremia.

Two unusual presentations of carcinoma of the right colon are described. One of the two patients presented with huge abdominal abscess with adhesed to surrounding small bowels and the other presented with anterior abdominal wall abscess. Colonic carcinoma very rarely presents as abdominal wall abscess, retropertoneal abscess, groin inflammatory mass, subcutaneous thigh abscess, and obstruction with diastatic rupture of cecum. The appearance of the abscess may antecede any gastrointestinal symptoms, thus lessening the surgeon's suspicion of carcinoma. The literature has been reviewed and the pathology that characterizes such lesions and this management is discussed. The bulky colonic tumors with extensive local invasion and negative mesenteric lymph nodes have a relatively good prognosis if adequate resection is performed.
Abdominal Abscess ; Abdominal Wall ; Abscess* ; Cecum ; Colon* ; Colonic Neoplasms* ; Groin ; Humans ; Lymph Nodes ; Pathology ; Prognosis ; Rupture ; Thigh

Dysphagia lusoria is used to describe the symptomatic compression of the esophagus from an anomalous vessel of the aortic arch. A right aortic arch with an aberrant left subclavian artery is the most common type of aortic arch abnormalities, followed by double aortic arch, and then an aberrant right subclavian artery. These anomalous vessels may cause dysphagia from the compression of the esophagus in adults, but they usually do not produce symptoms and they are usually found incidentally. Several cases of adult dysphagia lusoria have been reported in Korea, but there has been no reported case in an adolescent. We experienced a case of a 17-year-old female who suffered from dysphagia. We evaluated the possible causes of her dysphagia by performing esophagogastroduodenoscopy, esophagoraphy, esophageal manometry and chest computed tomography. We finally diagnosed this case as dysphagia lusoria caused by an aberrant right subclavian artery.
Adolescent ; Adult ; Aneurysm ; Aorta, Thoracic ; Cardiovascular Abnormalities ; Deglutition Disorders ; Endoscopy, Digestive System ; Esophagus ; Female ; Glycosaminoglycans ; Humans ; Korea ; Manometry ; Subclavian Artery ; Thorax