Necrotizing fasciitis (NF) is an uncommon, life-threatening infection of the subcutaneous tissue and superficial fascia. The clinical course of NF is rapid and progressive, and it is often fatal despite the appropriate therapy. The prognosis of NF depends on a timely diagnosis and then proper treatment. At onset it may not be possible to clearly distinguish NF from minor soft-tissue infections. Although infection are common due to the use of steroids and immunosuppressive agents in patients with systemic lupus erythematous (SLE), it is interesting that NF has rarely been reported with SLE. Here, we present two cases of NF with SLE.
Fasciitis, Necrotizing ; Humans ; Immunosuppressive Agents ; Prognosis ; Steroids ; Subcutaneous Tissue

The Dieulafoy's lesion is an unusual cause of gastrointestinal hemorrhage that results from the erosion of abnormally large submucosal artery. The lesion is usually located in the stomach, although it may occur anywhere in the gastrointestinal tract. Lower GI bleeding from Dieulafoy- like lesion of rectum is very rare. We describe one patient with extragastric Dieulafoy's disease, in the rectum. Diagnosis was made by endoscopy. Recently, endoscopy is important in the treatment of Dieulafoy-like lesion of rectum including epinephrine injection and coagulation therapy. We treated with the endoscopic management using ligation technique. We report a case that the 65-year old women had a extragastric Dieulafoy's lesion on the rectum, treated by endoscopic ligation with O-ring.
Aged ; Arteries ; Diagnosis ; Endoscopy ; Epinephrine ; Female ; Gastrointestinal Hemorrhage ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Ligation* ; Rectum* ; Stomach

BACKGROUND/AIMS: Endoscopic band ligation (EBL) has now emerged as the method of choice for treatment of esophageal variceal bleeding. However, only small numbers of patients with upper gastrointestinal (UGI) bleeding from non-esophageal varices have been treated in this way. We studied the usefulness of EBL in UGI bleeding without esophageal varices during emergency endoscopy. METHODS: During January 1997 to December 2000, 28 patients (54.7 13.2 years, male:female=22:6) of non-variceal bleeding at upper GI tract were treated by endoscopic ligation, using Stiegmann-Goff clear view band ligation device. Bleeding was identified from gastric Dieulafoy's lesion (n=15), Mallory-Weiss syndrome (n=8), and small ulcer (n=5). RESULTS: Ten of the 28 patients had underlying diseases, including liver cirrhosis (n=5), chronic renal failure (n=2), essential hypertension (n=2), and sepsis (n=1). The Dieulafoy's lesions were mostly located on the fundus and the body. There was active bleeding in 19 (spurting, 8: oozing, 11) and only exposed vessel in 9. EBL was successful in 27 of 28 cases (97%) during admission, and one patient had rebleeding during follow-up period ranging from 6 months to 24 months. CONCLUSIONS: EBL is an available, inexpensive, and easily learned method of treatment for patients with non-variceal gastrointestinal hemorrhage such as Dieulafoy's lesion, Mallory-Weiss syndrome, and small ulcer with active bleeding.
Emergencies ; Endoscopy ; Esophageal and Gastric Varices ; Follow-Up Studies ; Gastrointestinal Hemorrhage ; Hemorrhage* ; Humans ; Hypertension ; Kidney Failure, Chronic ; Ligation* ; Liver Cirrhosis ; Mallory-Weiss Syndrome ; Sepsis ; Ulcer ; Upper Gastrointestinal Tract ; Varicose Veins

Gastrointestinal stromal tumors (GIST) form a group of uncommon neoplasms originated from the pleuripotential mesenchymal cell. There is no final conclusion about accurate diagnosis and prognostic factors of GIST. Clinical presentation is not specific and intraperitoneal bleeding is a very rare complication. We report a case of a malignant GIST complicated by intraperitoneal hemorrhage, which was diagnosed by abdominal CT and EUS before operation. A subtotal gastrectomy was perfomed without complication. The patient is still alive without recurrence.
Diagnosis ; Gastrectomy ; Gastrointestinal Stromal Tumors* ; Hemoperitoneum* ; Hemorrhage ; Humans ; Recurrence ; Rupture* ; Stomach* ; Tomography, X-Ray Computed

Gastrointestinal stromal tumors (GIST) form a group of uncommon neoplasms originated from the pleuripotential mesenchymal cell. There is no final conclusion about accurate diagnosis and prognostic factors of GIST. Clinical presentation is not specific and intraperitoneal bleeding is a very rare complication. We report a case of a malignant GIST complicated by intraperitoneal hemorrhage, which was diagnosed by abdominal CT and EUS before operation. A subtotal gastrectomy was perfomed without complication. The patient is still alive without recurrence.
Diagnosis ; Gastrectomy ; Gastrointestinal Stromal Tumors* ; Hemoperitoneum* ; Hemorrhage ; Humans ; Recurrence ; Rupture* ; Stomach* ; Tomography, X-Ray Computed