A psoas abscess is a rare clinical entity that presents diagnostic and therapeutic challenges. Tuberculous vertebral osteomyelitis was formerly the principal cause of a psoas abscess, but now psoas abscesses most commonly result from direct extension of intraabdominal infections. Occasionally, a psoas abscess results from extension of a perinephric abscess due to secondary infection of a retroperitoneal hematoma. Staphylococcus aureus is the most common cause of psoas abscess secondary to vertebral osteomyelitis. Tuberculosis, malnutrition, alcoholism, diabetes mellitus, rheumatoid arthritis and steroid use are responsible for compromise in host defenses and consequent increase in the relative risk of psoas abscess. Bilateral psoas abscesses are rare. A 66-year old woman with rheuamoid arthritis presented bilateral psoas abscesses. We report a case of bilateral psoas abscesses in rheumatoid arthritis confirmed by surgical drainage and tissue culture. To our knowledge, this is the second case report of bilateral psoas abscesses due to Staphylococcus aureus in a patient of rheumatoid arthritis in a world.
Abscess ; Aged ; Alcoholism ; Arthritis ; Arthritis, Rheumatoid* ; Coinfection ; Diabetes Mellitus ; Drainage ; Female ; Hematoma ; Humans ; Intraabdominal Infections ; Malnutrition ; Osteomyelitis ; Psoas Abscess* ; Staphylococcus aureus ; Tuberculosis

Diverticular disease of the colon in Korea is different from developed Western countries. Diverticulosis leads to the complications in about 20% of cases. The diverticulitis of the right colon is difficult to be differentiated from acute appendicitis. According as increase of elderly populations, incidence of the diverticulitis of the left colon increase. Therefore we should be differenciated from other diseases. In very rare case, frequent recurrence and recovery of the diverticulitis leads to a chronic state with complications such perforation, microabscess, fistula, adhesion and fibrous hypertrophy. These findings may be misdiagnosed as malignancy because of protruding mass and stricture on colonoscopy. We present a case of an pseudotumor that looks like a malignancy in the sigmoid on colonoscopy. After surgical resection, the lesion turned out to be a complicated diverticulitis.
Aged ; Appendicitis ; Colon ; Colon, Sigmoid* ; Colonoscopy ; Constriction, Pathologic ; Diverticulitis* ; Diverticulum ; Fistula ; Humans ; Hypertrophy ; Incidence ; Korea ; Recurrence

BACKGROUND/AIMS: There is no consensus as to the best treatment for non-variceal, non-ulcer gastrointestinal hemorrhage. Endoscopic band ligation is an inexpensive, readily available, and easily learned technique in contrast to conventional thermal methods of endoscopic hemostasis. The purpose of this study is to define the effectiveness of endoscopic band ligation for non-variceal, non-ulcer gastrointestinal hemorrhage and post-polypectomy hemorrhage. METHODS: Twenty eight patients were treated by band ligation between July 1996 and October 2000. The lesions treated were: Dieulafoy's lesion in 13, Mallory-Weiss tear in 7, angiodysplasia in 1, post-polypectomy bleeding in 4, post-endoscopic mucosal resection bleeding in 2, post-endoscopic biopsy bleeding in 1. RESULTS: Endoscopic band ligation was successful in 25 of 28 cases. Additional sclerotherapy was necessary in two cases of Dieulafoy's lesion. The remaining case was early band detachment. CONCLUSIONS: Endoscopic band ligation is effective for non-variceal, non-ulcer bleeding. It has the advantage of ease of use and is relatively inexpensive.
Angiodysplasia ; Biopsy ; Consensus ; Gastrointestinal Hemorrhage* ; Hemorrhage* ; Hemostasis, Endoscopic ; Humans ; Ligation* ; Mallory-Weiss Syndrome ; Sclerotherapy

Mesenchymal tumors including hemangiopericytomas, hepatocellular tumors, adrenal carcinomas, and a variety of other large tumors have been reported to produce excessive amounts of insulin-like growth factor (IGF) type II precursor, which binds weakly to insulin receptors and strongly to IGF-I receptors, leading to insulin like actions. In addition to increased IGF-II production, IGF-II bioavailability is increased due to complex alterations in circulating binding proteins. The authors of this article diagnosed non-islet cell tumor hypoglycemia from an 81-year-old male patient suffering from repetitive fasting hypoglycemia while he has not received any treatment for pulmonary hemangiopericytoma diagnosed in the past. Moreover, this topic is getting reported as the authors have experienced a significant improvement of catamnesis by a treatment with glucocorticoid.
Aged, 80 and over ; Biological Availability ; Carrier Proteins ; Hemangiopericytoma ; Humans ; Hypoglycemia* ; Insulin ; Insulin-Like Growth Factor I ; Insulin-Like Growth Factor II ; Male ; Receptor, IGF Type 1 ; Receptor, Insulin