Congenital hepatic fibrosis is a developmental abnormality that may appear either sporadically or in a familial form. It is an inherited disease defined pathologically by bands of fibrous tissue within the liver, and is occasionally associated with cystic kidney disease. A 21-year-old woman was admitted to our hospital for evaluation of pancytopenia. She showed esophageal varices, hepatomegaly and splenomegaly, but had normal results on her liver function test. Peripheral stigmata of chronic liver disease such as palmar erythema or spider angioma was not found. Hepatosplenomegaly, polycystic kidney and psoas muscle cyst were detected through an abdominal CT and MRI. The patient is diagnosis was confirmed as congenital hepatic fibrosis using laparoscopic liver biopsy. The first case of congenital hepatic fibrosis associated with polycystic kidney disease in Korea is herein reported.
Biopsy ; Christianity ; Diagnosis ; Erythema ; Esophageal and Gastric Varices ; Female ; Fibrosis* ; Hemangioma ; Hepatomegaly ; Humans ; Kidney Diseases, Cystic ; Korea ; Liver ; Liver Diseases ; Liver Function Tests ; Magnetic Resonance Imaging ; Pancytopenia ; Polycystic Kidney Diseases* ; Psoas Muscles ; Spiders ; Splenomegaly ; Tomography, X-Ray Computed ; Young Adult

Fairly specific and important duodenoscopic findings for diagnosing mucinous ductal ectasia (MDE) of pancreas include a prominant ampulla, patulous ampullary orifice and extrusion of mucin through the ampulla. However, we have experienced two cases of mucinous ductal ectasia without these pathognomonic appearance of ampulla. Initially, two cases were admitted for evaluation of pancreatic multicystic lesions, and MDE was incidentally found. Their pancreatographic findings showed normal main duct and cystic dilatation confined to the branch ducts. On gross findings of surgical specimens, a duct dilatation with gelatinous mucin was localized at the uncinate process of the pancreas. Microscopically, the ductal epithelia containing mucin were lined with well-differentiated tall columnar cells showing focal hyperplastic change. We report these unusual cases of MDE with review of the literatures.
Dilatation ; Dilatation, Pathologic* ; Gelatin ; Mucins* ; Pancreas*

Percutaneous transhepatic biliary catheterization (PTC) has not only been increasingly used in the localization of benign and malignant lesions, but it is also considered rapid, safe and effective method to establish internal and external drainage for decompression of biliary obstructions. Infections and granulomas at the catheter entry site can occasionally develop, but are easily managed. However, such technique, when used both for obtaining malignant cells for diagnosis and for percutaneous decompression of the biliary tract can exposure the patient at risk for dissemination of the tumor along the catheter tract. This rare complication has been observed in a patient who underwent percutaneous transhepatic biliary drainage (PTBD) for malignant biliary tract obstruction. Although tumor cell seeding along the catheter tract is a very rare complication, we think that PTBD should be avoided when curative resection is planned.
Bile Ducts* ; Bile* ; Biliary Tract ; Catheterization ; Catheters ; Cholangiocarcinoma* ; Decompression ; Diagnosis ; Drainage* ; Granuloma ; Humans ; Neoplasm Metastasis*

A case of systemic amyloidosis involving the upper and lower gastrointestinal tract is presented. The initial manifestation of this case was bloody diarrhea. On colonoscopy, multiple submucosal hematomas and irregular ulcerations of the sigmoid and descending colon were found. The pathologic diagnosis was confirmed by an endoscopic mucosal biopsy of the gastrointestinal tract and the specimen revealed massive amyloid deposits in the wall of the upper and lower intestinal tract. With intensive medical treatment, the submucosal hematoma disappeared and the ulcerations decreased in size. However, on the 29th day, the patient was expired due to unexpected sepsis.
Amyloidosis* ; Biopsy ; Colon, Descending ; Colon, Sigmoid ; Colonoscopy ; Diagnosis ; Diarrhea ; Gastrointestinal Tract ; Hematoma* ; Hemorrhage* ; Humans ; Lower Gastrointestinal Tract* ; Plaque, Amyloid ; Sepsis ; Ulcer

The incidence of colorectal cancer has been increased gradually and it was about 6.9% of all malignancies in Korea. Early diagnosis was recognized as the most important factor influencing the prognosis of colorectal cancer and the incidence of early colorectal cancer was increasing. Thus great change was observed in the treatment of early colorectal cancer, endoscopic therapy as well as curative surgical resection is being accepted. We report a case of effective and safe endoscopic therapy for early rectal cancer in 5S-year-old male patient. He presented with rectal prolapse and bleeding of a year's duration. A large polypoid mass with fine nodular surface and thick, short stalk was seen in the rectum at 4cm above the anal verge during flexible sigmoidoscopy. After the histologic examination of specimen obtained by bite biopsy, CT scan of pelvic cavity and ultrasonogram of abdomen, the tumor was removed safe and completely by 2 sessions of piecemeal polypectomies and strip biopsy. He has been well without symptoms and signs of recurrence of rectal cancer for 20 months.
Abdomen ; Biopsy* ; Colorectal Neoplasms ; Early Diagnosis ; Hemorrhage ; Humans ; Incidence ; Korea ; Male ; Prognosis ; Rectal Neoplasms* ; Rectal Prolapse ; Rectum ; Recurrence ; Sigmoidoscopy ; Tomography, X-Ray Computed ; Ultrasonography

Peliosis hepatis is characterized by the presence in the liver of blood-filled cavities, which may or may not be lined with sinusoidal cells. The individual cysts or cavities usually do not exceed several centimeters in diameter. The cysts are typically continuous with adjacent, more normal sinusoids, and they sometimes can be seen in continuity with hepatic venous tributaries. The lesion is usually diagnosed by gross or microscopic examination. When suspected, it can be diagnosed by percutaneous liver biopsy. In the past, peliosis hepatis is primarily associated with wasting diseases, such as tuberculosis, malignancy, and chronic suppurative infection. However, recently peliosis hepatis is seen most commonly in association with the administration of anabolic steroids or HIV infection. We report a case of peliosis hepatis that is diagnosed by peritoneoscopic live biopsy and not associated with known disease.
Biopsy* ; HIV Infections ; Laparoscopy ; Liver* ; Peliosis Hepatis* ; Steroids ; Tuberculosis ; Wasting Syndrome

The success and rapid spread of laparoscopic cholecystectomy have prompt the application of laparoscopic approach to abdominal surgical problems. As better in- strumentation is introduced, more complicated surgical procedrues will be performed. In some hematologic disorders, splenectomy was required to cope with these disorders. So laparoscopic splenectomy also has been perfomed inspite of several specific difficulties for handling and mobilization of a parenchymatous organ and the retrieval of the specimen. We experienced a case of idiopathic thrombocytopenic purpura which was treated safely and successfully by laparoscopic splenectomy in 35-year-old female. This technique allows the patient to return to normal activity sooner than with open splenectomy.
Adult ; Cholecystectomy, Laparoscopic ; Female ; Humans ; Purpura, Thrombocytopenic, Idiopathic* ; Splenectomy*

Obstructive jaundice of the bile duct resulting from tumor-producing copious, thick mucin, causing ductal obstruction and dilatation, has been reported very rarely. Also, the benign bile duct neoplasm is extremely rare. We report a case of a mucin-secreting villous adenoma of common hepatic duct causing obstructive jaundice and cholangitis. The patient was a 72-year-old male and had a 3 yeared history of common hepatic mass unchanged remarkably in size. The abdominal ultrasonogram and computed tomography revealed well circumscribed, more than 2cm sized mass on the CHD and ductal dilatation. We were able to get an interesting cholangioram showing irregular, nodular, ill defined filling defect in the extrahepatic bile duct, different from US and CT findings, And it was just caused by thick, copious mucin from the tumar. This case was confirmed as mucin-secreting villous adenoma after surgery.
Adenoma, Villous* ; Aged ; Bile Duct Neoplasms ; Bile Ducts ; Bile Ducts, Extrahepatic ; Cholangitis ; Dilatation ; Hepatic Duct, Common* ; Humans ; Jaundice, Obstructive ; Male ; Mucins* ; Ultrasonography

Adenoma is a benign epithelial lesion with malignant potential and can be found at any site of the gastrointestinal tract. Adenoma of the common bile duct is a rare and unusual cause of bile duct obstruction. We report a case of tubulovillous adenoma of the common bile duct at the cystic duct opening. A 1.8X1.2X1 cm sized, round and lobulated mass was noted on abdominal sonogram, CT scan and endoscopic retrograde cholangiogram, and it was confirmed and treated by surgical resection.
Adenoma* ; Cholestasis ; Common Bile Duct* ; Cystic Duct* ; Gastrointestinal Tract ; Tomography, X-Ray Computed

Both duodenal ulcer and gastric cancer are common, and it is well known that the pathophysiology of the two is different. The presence of a duodenal ulcer is believed to protect against the development of a gastric malignancy. However gastric cancer may occur in the presence of active or chronic duodenal ulcer disease. Although rare in incidence of coexistence of duodenal ulcer and gastric cancer, physician must be alert to the strange association of duodenal ulcer and gastric cancer. Here, we present 3 cases with coexistence of duodenal ulcer and gastric cancer, diagnosed by endoscopy.
Duodenal Ulcer* ; Endoscopy ; Incidence ; Stomach Neoplasms*