Aberrant migration of thymic tissue occurs as an ectopic thymus in the mediastinum, base of skull, tracheal bifurcation, and cervical region. A recent review of the literature by Nowak et al. showed over 70 reported cases of aberrant thymus or thymic cyst in patients who presented with primary neck masses. Authors experienced a case of ectopic cervical thymus and reviewed the literature. A one-year-old boy with left neck swelling which had been noticed since one month of age visited out patient clinic. Ultrasonography showed a well-defined cystic mass containing homogeneous, low-echogenic content locating in the lateral aspect of the left carotid sheath. Operation was performed under the impression of branchial cleft cyst. At surgery, a multiseptated, well-encapsulated, brownish and doughy mass which was extending into the vicinity of the carotid bifurcation with sland stalk-like portion ending between the hypoglossal nerve and external carotid artery was excised completely. The cut-surface showed homogenous solid mass, and on frozen section the tissue revealed a normal thymic histology. Postoperative ultrasonography showed bilateral thymus in the superior mediastinum. The patient has no immunologic problem and is doing well now.
Branchioma ; Carotid Artery, External ; Child ; Frozen Sections ; Humans ; Hypoglossal Nerve ; Male ; Mediastinal Cyst ; Mediastinum ; Neck ; Skull Base ; Thymus Gland ; Ultrasonography

A 68-year-old woman visited our emergency center because of hematemesis. An emergency endoscopy showed an exposed vessel with blood flowing into the upper esophagus. Angiography revealed the presence of extravasation of contrast at the level of the aortic arch and a tortuous fistula between the aortic arch and esophagus. Chest computerized tomography demonstrated the presence of an aortoesophageal fistula and air bubbles inside the fistula. The patient had emergency surgery and the intraoperative findings revealed an aortoesophageal fistula and necrotic materials with a foul odor at the upper esophagus. Primary closure and wrapping of the aorta were performed, but primary closure of the esophagus was impossible because of necrosis. An aortoesophageal fistula is a rare but life-threatening disease. As shown for this patient, an exposed vessel without ulceration at the upper esophagus should raise suspicion of an aortoesophageal fistula and a CT scan or angiography should be performed before endoscopic intervention.
Aged ; Angiography ; Aorta ; Aorta, Thoracic ; Emergencies ; Endoscopy ; Esophagus ; Female ; Fistula* ; Hematemesis ; Humans ; Necrosis ; Odors ; Thorax ; Tomography, X-Ray Computed ; Ulcer

Rendu-Osler-Weber disease is characterized by hereditary transmission, and by the presence of multiple telangiectases of the skin, mucous membranes, and internal organs. We present a case of Rendu-Osler-Weber disease with bleeding from gastric telangiectases that was successfully treated by endoscopy with the use of argon plasma coagulation (APC). A 65-year-old woman presented with melena. Endoscopy disclosed multiple telangiecatses in the whole stomach. APC was performed at an output of 50 W and with an argon gas flow rate of 2 L/min. Only multiple ulcers at the treated sites were seen 7 days after the procedure and fibrotic scars with contracted mucosal folds without active bleeding signs were noted 2 months later.
Aged ; Argon ; Argon Plasma Coagulation ; Cicatrix ; Contracts ; Endoscopy ; Female ; Hemorrhage ; Humans ; Melena ; Mucous Membrane ; Skin ; Stomach ; Telangiectasia, Hereditary Hemorrhagic ; Telangiectasis ; Ulcer

BACKGROUND/AIMS: Left colonic diverticulitis is relatively common in western nations. Although the incidence of colonic diverticulitis is increasing in Korea, very little is known regarding its clinical characteristics in korean patients. METHODS: We compared the clinical characteristics of right versus left colonic diverticulitis via the retrospective review of 37 cases treated at the Kyungpook National University Hospital, Korea, from July 1998 to December 2006. Diagnosis was confirmed via computed tomography (CT), barium study, colonoscopy, and/or surgery. RESULTS: Eighteen men and 19 women (median age, 45.0 years; range, 21~75 years) were included. The ratio of right to left colonic diverticulitis was 30:7. The male to female ratio for right colonic diverticulitis was 16:14 and the median age was 38.5 years (range, 21~72 years). The male to female ratio for left colonic diverticulitis was 2:5 and the mean age was 57.0 years (range, 45~75 years). Left colonic diverticulitis was more frequently associated with intestinal perforation (p=0.001) and old age (p=0.005). Surgical intervention was more common in left versus right colonic diverticulitis (p=0.009). CONCLUSIONS: These results indicate that although left colonic diverticulitis is relatively rare among koreans, it develops later in life and is more frequently complicated than right colonic diverticulitis.
Barium ; Colon ; Colonoscopy ; Diverticulitis, Colonic ; Female ; Humans ; Incidence ; Intestinal Perforation ; Korea ; Male ; Retrospective Studies