1.A Case of Optic Neuritis Associated with Crohn's Disease.
Sung Hee HAN ; Oh Young LEE ; Sun Young YANG ; Dae Won JUN ; Hang Lak LEE ; Yong Cheol JEON ; Dong Soo HAN ; Joo Hyun SOHN ; Byung Chul YOON ; Ho Soon CHOI ; Joon Soo HAHM ; Min Ho LEE ; Dong Hoo LEE ; Choon Suhk KEE
The Korean Journal of Gastroenterology 2006;48(1):42-45
In Crohn's disease, neurologic complications such as cerebrovascular accident, headache, peripheral neuropathy have been reported sporadically. The pathogenesis of these neurologic complications is still unknown and controversial. We experienced a 22-year-old man, with Crohn's disease accompanied by optic neuritis. Loss of visual acuity was developed during the worsening course of enterocutaneous fistula. After high dose steroid treatment, his visual acuity and neurologic symptoms improved immediately.
Adult
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Crohn Disease/*complications/drug therapy/pathology
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Humans
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Intestinal Fistula/complications
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Male
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Optic Neuritis/*complications/diagnosis
2.Diagnosis and management of Crohn disease complicated with gastrointestinal fistulae.
Jian-an REN ; Qing-song TAO ; Xin-bo WANG ; Yun-zhao ZHAO ; Shu-jian HONG ; Guo-sheng GU ; Lei LIU ; Jie-shou LI
Chinese Journal of Gastrointestinal Surgery 2005;8(2):117-120
OBJECTIVETo investigate the diagnosis and treatment of patients with Crohn disease (CD) complicated with gastrointestinal fistulae.
METHODSClinical data of sixty-two cases with CD complicated with gastrointestinal fistula e from 1978 to 2004 were analyzed.
RESULTSThese were 68 external fistulae in 6 2 patients including recurrent fistulae in 6 cases, internal fistulae in 8 cases . Twenty- seven fistulae were located in the terminal ileum and 21 fistulae wer e located in ileocolic anastomosis site. The main surgery included 14 ileocecal resections with primary anastomosis and 26 resections of original ileocolic anastomosis with fistula and re-anastomosis. The incidence of recurrence was lower (15.4% ) in patients with postoperative medication including sulfasalazine and immunomodulator than that (34.8% ) in patients without postoperative immunomodulator,but the recurrence time was longer [(40+/- 17) months] in patients with postoperative medication than that [(8+/- 3)months] in the patients without postoperative specific medication.
CONCLUSIONSMost CD fistulae are external fistulae,most of the external fistulae are treated by resection of the fistula and anastomosis. Specific medication including sulfasalazine,mesalamine and immunomodulators should be used to prevent postoperative complications and CD recurrence.
Adult ; Crohn Disease ; complications ; diagnosis ; surgery ; Female ; Humans ; Intestinal Fistula ; complications ; diagnosis ; surgery ; Male ; Middle Aged
3.A Case of Lower Gastrointestinal Bleeding Caused by Primary Iliac Arterio-colic Fistula.
Young Il KIM ; Seon Young PARK ; Won Joo KI ; Ho Seok KI ; Kyoung Won YOON ; Hyun Soo KIM ; Sung Kyu CHOI ; Jong Sun REW
The Korean Journal of Gastroenterology 2010;56(2):113-116
Arterio-enteric fistula is a very rare cause of massive lower gastrointestinal hemorrhage. We report here on a case of massive hematochezia caused by iliac arterio-colic fistula in a 60-year-old woman who had a recent history of spinal surgery for herniated nucleus pulposus. Abdomen computed tomography showed the extravasation of radiocontrast media from right iliac artery encased by an intraabdominal abscess into the adjacent dilatated colon. Also, diagnostic angiography revealed the active extravasation of radiocontrast media via a fistula between right iliac artery and colon. Although successful endovascular exclusion of the fistula with stent graft and coils was performed, disseminated intravascular coagulation and multi-organ failure were developed.
Colonic Diseases/complications/*diagnosis
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Female
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Gastrointestinal Hemorrhage/*etiology
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Humans
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Iliac Artery/*radiography
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Intestinal Fistula/complications/*diagnosis
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Middle Aged
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Stents
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Tomography, X-Ray Computed
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Vascular Fistula/complications/*diagnosis
4.A Case of Cholecysto-gastro-colonic Fistula with Upper Gastrointestinal Bleeding.
Min Kyu PARK ; Yun Jin CHUNG ; In Yub BAEK ; Hyeong Seok KIM ; Sang Soo BAE ; Su Ok LEE ; Kyoung Suk LEE ; Jong Kyu KWON
The Korean Journal of Gastroenterology 2013;61(5):290-293
Biliary enteric fistula is an abnormal pathway often caused by biliary disease. It is difficult to diagnose the disease because patients have nonspecific symptoms. A 67-year-old woman presented with hematemesis and melena. She was diagnosed with Dieulafoy lesion on the gastric antrum and underwent endoscopic hemostasis using hemoclips. Follow-up upper gastrointestinal endoscopy revealed an abnormal opening on a previous treated site that was suggestive of biliary enteric fistula. Abdomen simple X-ray and abdominal dynamic CT scan showed pneumobilia and cholecysto-gastric fistula. The patient had cholecystectomy and wedge resection of the gastric antrum, followed by right extended hemicolectomy because of severe adhesive lesion between the gallbladder and colon. She was diagnosed with cholecysto-gastro-colic fistula postoperatively. We report on this case and give a brief review of the literatures.
Aged
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Biliary Fistula/complications/*diagnosis/surgery
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Cholecystectomy
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Endoscopy, Gastrointestinal
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Female
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Gastric Fistula/complications/*diagnosis/surgery
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Gastrointestinal Hemorrhage/complications/*diagnosis
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Humans
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Intestinal Fistula/complications/*diagnosis/surgery
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Tomography, X-Ray Computed
5.Enterobiliary Fistula as a Complication of Eosinophilic Gastroenteritis: a Case Report.
Korean Journal of Radiology 2008;9(3):275-278
Eosinophilic gasteroenteritis is an uncommon disease with variable clinical features characterized by eosinophilic infiltration. Clinical manifestations range from non-specific gastrointestinal complaints such as nausea, vomiting, crampy abdominal pain, and diarrhea to specific findings such as malabsorption, protein loosing enteropathy, luminal obstruction, eosinophilic ascites and effusion. We report here on a case of eosinophilic gastroenteritis causing enterobiliary fistula which is an extremely unusual complication.
Aged
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Biliary Fistula/diagnosis/*etiology
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Cholangiopancreatography, Magnetic Resonance
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Duodenal Diseases/*etiology
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Eosinophilia/complications
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Gastroenteritis/*complications
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Humans
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Intestinal Fistula/diagnosis/*etiology
;
Male
6.A case of Behcet's syndrome with supeior vena cava syndrome.
Dong Soo HAN ; Jin Bae KIM ; Oh Young LEE ; Joo Hyun SOHN ; Kyung Nam PARK ; Choong Ki PARK
The Korean Journal of Internal Medicine 1998;13(1):72-75
Behcet's syndrome is a multi-systemic and chronic disorder that affects many organs. It has been suggested that the diagnosis was based on the presence of the 'major' and 'minor' clinical criteria. When thromobophlebitis, arthritis, central nervous system or gastrointestinal lesions are also present. Behcet's syndrome will be thought to be present in the appropriate geographic area. We report a case of superior vena cava syndrome caused by Behcet's disease in a 40-year-old man with recurrent oral aphthous ulcers and skin rashes on the anterior chest wall. There were multiple thrombosis of the superior vena cava, innominate and subclavian veins. This patient also had a solitary cecal ulcer with an ileocecal fistula and downhill varix. The chest CT, veno-cavography, pulmonary angiography and colon study were taken and follow-up was performed.
Adult
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Behcet's Syndrome/diagnosis
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Behcet's Syndrome/complications*
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Cecal Diseases/complications
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Human
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Intestinal Fistula/complications
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Male
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Superior Vena Cava Syndrome/etiology*
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Superior Vena Cava Syndrome/diagnosis
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Ulcer/complications
9.Diagnosis and Treatment of Bleeding Meckel's Diverticulum.
Young Soo HUH ; Bum Ryul KIM ; Jung Hoon YUN ; Dong Min KWACK
Journal of the Korean Association of Pediatric Surgeons 2001;7(1):42-45
The major complications of Meckel's diverticulum(MD) are bleeding, intestinal obstruction, infection, umbilical fistula and perforation. Although the relative incidences vary between authors, bleeding is the most common complication in children. The aim of our study is to show the symptomatic guideline for the diagnosis of the bleeding MD. Eight cases with bleeding MD which were operated upon at the department of Pediatric Surgery, Yeungnam University Hospital from April 1985 to April 2001 were reviewed. Half of the patients were under 2 years of age and all patients were male. All patients were preoperatively diagnosed by previous history of intestinal bleeding (melena, hematochezia) and 99mTc pertechnetate MD scan. Segmental resection and end-to-end anastomosis was performed in 6 patients and diverticulectomy in 2 patients. Heterotropic gastric mucosa was found in 6 patients. Postoperative complication was not observed in any cases. In conclusion, in any male children with obscure intestinal bleeding, especially less than 2 years of age, bleeding MD must be suspected. It seems to us that 99mTc pertechnetate MD scan is a useful tool to diagnose bleeding MD.
Child
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Diagnosis*
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Fistula
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Gastric Mucosa
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Hemorrhage*
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Humans
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Incidence
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Intestinal Obstruction
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Male
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Meckel Diverticulum*
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Postoperative Complications
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Sodium Pertechnetate Tc 99m
10.Sigmoidovesical Fistula Caused by Diverticulitis Detected with Sigmoidoscopy.
Yong Wook JUNG ; Jung Hyun YOO ; Jung Soo LEE ; Byung Ik JANG ; Kyeong Ok KIM ; Sang Hun JUNG
The Korean Journal of Gastroenterology 2011;58(5):284-287
Enterovesical fistular is an abnormal communication between the intestine and the bladder. It represents a rare complication of intestinal diverticulitis, colorectal malignancy, bladder cancer, inflammatory bowel disease, radiotherapy, and trauma. The most common etiology is diverticular disease. A 70-year-old man came to our hospital due to frequent urinary tract infection, dysuria, pneumaturia and fecaluria. Sigmoidoscopy revealed a large diverticulum with impacted stool at the sigmoid colon. When the scope was inserted into the site, the patient complained of severe urgency and pneumaturia. CT scan was performed. 1.5 cm sized fistular tract between the sigmoid colon and bladder was noted. According to the endoscopy and CT finding, the diagnosis of colovesical fistula was made. The patient underwent surgical intervention. At laparotomy, there were multiple diverticula and fistular tract was noted.
Aged
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Colon, Sigmoid/*pathology
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Diverticulitis/complications/*surgery
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Humans
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Intestinal Fistula/*diagnosis/etiology/surgery
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Male
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Sigmoidoscopy
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Tomography, X-Ray Computed