1.Unusual Giant Arteriovenous Malformation in Jejunum: A Case Report.
Journal of the Korean Association of Pediatric Surgeons 2017;23(2):52-54
Polypoid or tumorous arteriovenous malformation (AVM) of small intestine is rare and can be misdiagnosed as other tumorous conditions. We experienced a rare case of giant jejunal AVM in a 15-year-old boy, who complained of intense abdominal pain. Ultrasonography and contrast-enhanced CT revealed a 13.5-cm-sized multiseptated cystic mass arising in small intestine, which was mimicking submucosal tumor. It was successfully treated by surgical resection. The specimen showed a multilobulated outbulging submucosal mass in jejunum. Histopathologic evalulation confirmed AVM located in the submucosa, muscularis propria and subserosa. This case is the largest AVM of small intestine among which has ever been reported.
Abdominal Pain
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Adolescent
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Arteriovenous Malformations*
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Humans
;
Intestine, Small
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Jejunum*
;
Male
;
Tomography, X-Ray Computed
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Ultrasonography
2.Evaluation of a Seton Procedure Combined With Infliximab Therapy (Early vs. Late) in Perianal Fistula With Crohn Disease
Myunghoon JEON ; Kihwan SONG ; Jail KOO ; Sohyun KIM
Annals of Coloproctology 2019;35(5):249-253
PURPOSE: We assessed the clinical outcomes of a seton procedure combined with early versus late institution of infliximab (IFX) therapy. METHODS: This retrospective study comprised 76 patients who underwent surgery for perianal fistula associated with Crohn disease between January 2014 and November 2017. All patients underwent loose seton drainage combined with IFX therapy. Patients categorized as the early group (EG, 49 patients) received IFX therapy within 30 days of completion of the seton procedure. Patients categorized as the late group (LG, 27 patients) received IFX therapy >30 days after the seton procedure. IFX therapy was administered as induction and maintenance therapy. RESULTS: There were no statistically significant intergroup differences in clinical characteristics of the patients. The mean follow-up was 21.0 ± 11.6 months in the EG and 34.5 ± 18.4 months in the LG (P = 0.001). The mean interval between seton procedure and IFX induction therapy was 12.2 days in the EG and 250.2 days in the LG (P = 0.002). Complete remission was observed in 32 patients (65.3%) in the EG and 17 patients (63.0%) in the LG (P = 0.844). Fistula recurrence was observed in 6 patients (7.9%). All recurrences occurred in a previous perianal fistula tract. CONCLUSION: Patients showed a good response to a seton procedure combined with IFX therapy regardless of the time of initiation of IFX therapy.
Crohn Disease
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Drainage
;
Fistula
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Follow-Up Studies
;
Humans
;
Infliximab
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Recurrence
;
Retrospective Studies