Hymenoptera stings can result in local and systematic symptoms due to their toxic and allergic contents. Although serious sequela are rare, the occurrence of an anaphylactic reaction is considered to be very dangerous and can potentially cause death. Oropharyngeal stings, though infrequent, can cause local edema and airway obstruction due to an anaphylactic reaction and requires immediate epinephrine, antihistamine, steroid treatment and close observation over several days. Careful observation of the oropharyngeal and laryngopharyngeal area using upper gastrointestinal endoscopy is highly recommended, especially for detection of possible edematous swelling in the arytenoid cartilage area. Here we report two cases of patients complaining pain due to edematous swelling in the arytenoid cartilage area caused by hymenoptera stings after accidentally drinking water with a bee in it.
Airway Obstruction ; Anaphylaxis ; Arytenoid Cartilage ; Bees ; Bites and Stings ; Drinking Water ; Edema ; Endoscopy, Gastrointestinal ; Epinephrine ; Humans ; Hymenoptera

Gastric cavernous hemangioma is a relatively rare benign gastric disease. Gastric hemangiomas are most commonly encountered in adulthood, although they can occur in any age group. While surgical resection is the curative treatment, endoscopic resection can be performed for treatment of selected cases. The patient was a 53-year-old male who was referred for evaluation of incidentally detected gastric subepithelial tumor with dense vascularity and oozing on the apex of the lesion. An EUS revealed a homogenously hypoechoic mass confined to the submucosal layer that showed no continuity with adjacent vessels, and there was no regional lymphadenopathy. Endoscopic submucosal dissection was successfully performed with en bloc resection. The final diagnosis was benign cavernous hemangioma of the stomach.
Hemangioma ; Hemangioma, Cavernous ; Humans ; Male ; Middle Aged ; Stomach ; Stomach Diseases

Renal involvement in systemic lupus erythematosus (SLE) is a typical manifestation of the disease. The occurrence of non-lupus nephritis, especially IgA nephropathy (IgAN), in patients with SLE has rarely been reported. We describe the case of a 21-year-old woman who was diagnosed with IgAN and subacute necrotizing lymphadenitis, and her renal lesion biopsy was typical of lupus nephritis (ISN/RPS Class III). Although IgAN and lupus nephritis share some common physiopathological characteristics, their laboratory, histopathologic findings, and the extra-renal clinical manifestations are different and support a different pathogenesis. Our case highlights the importance of a renal biopsy in patients with lupus and urinary alterations despite underlying IgAN. A correct diagnosis would permit the most appropriate immunosuppressive treatments to be considered.
Biopsy ; Female ; Glomerulonephritis, IGA ; Humans ; Immunoglobulin A ; Kidney ; Lupus Erythematosus, Systemic ; Lupus Nephritis ; Lymphadenitis ; Nephritis ; Young Adult

Intestinal malrotation occurs because of an arrest of normal rotation of the embryonic gut. It is often diagnosed in first month of life because of acute complications and requires surgical management. If it is not detected at a young age, it is diagnosed incidentally in advanced age. It is very rarely reported at advanced age with symptoms. In Korea in the last 30 years only about 10 such cases have been reported. In 2010, intestinal malrotation was reported at advanced age in only one case who had acute duodenal obstruction due to non-rotation of the pre-arterial segment of mid-gut. Therefore, we report a case of a 45-year-old man with non-rotation of pre-arterial segment with duodenal obstruction who had complained chronic and mild epigastric discomfort from a year ago.
Duodenal Obstruction ; Korea

Thin basement membrane nephropathy (TBMN) is characterized by persistent hematuria, mild proteinuria, normal renal function and family history of hematuria. Many studies report that TBMN commonly occurs together with other glomerular diseases such as minimal change nephrotic syndrome, membranous nephropathy, IgA nephropathy and focal segmental glomerulosclerosis. Especially, the case of TBMN with minimal change nephrotic syndrome has been rare. We report a case of adult minimal change nephrotic syndrome with TBMN in a 44-year-old female with general edema and microscopic hematuria. On renal biopsy, electron microscopic examination demonstrated diffuse thinning of glomerular basement membrane with the thickness less than 250nm and diffuse foot process effacement. Treatment with corticosteroid resulted in complete remission of proteinuria.
Adult ; Basement Membrane ; Biopsy ; Edema ; Electrons ; Female ; Foot ; Glomerular Basement Membrane ; Glomerulonephritis, IGA ; Glomerulonephritis, Membranous ; Glomerulosclerosis, Focal Segmental ; Hematuria ; Humans ; Nephrosis, Lipoid ; Proteinuria

Bromate is an oxidizing agent used as a permanent wave neutralizer. Accidental or deliberate ingestion of bromate has rarely been reported, but is potentially severe. We report a 36-year-old female hairdresser, who was admitted due to nausea and vomiting after ingestion of sodium bromate. The patient was successfully treated with hemodialysis therapy and renal function recovered without any complication. The clinicians must remember that early therapeutic measures, including hemodialysis, should be taken as soon as possible to prevent irreversible hearing loss and renal failure.
Acute Kidney Injury ; Adult ; Bromates ; Eating ; Female ; Hearing Loss ; Humans ; Nausea ; Renal Dialysis ; Renal Insufficiency ; Sodium ; Sodium Compounds ; Vomiting

Infections are the second leading cause of mortality among patients with end-stage renal disease (ESRD). Recently, colonization or infection with vancomycin-resistant enterococci (VRE) is increasing in prevalence at many institutions and is often reported in dialysis patients. Enterococci are generally considered to be of low pathogenicity but may cause urinary tract infection, bacteremia, endocarditis or meningitis in debilitated patients. Three cases of VRE peritonitis in patients on CAPD were reported, but there was no report of VRE urinary tract infection (UTI) in hemodialysis patients in Korea. We present a case of VRE UTI with pseudomembranous colitis (PMC) in an ESRD patient with anal VRE colonization. The VRE UTI was treated successfully with linezolid.
Acetamides ; Bacteremia ; Coinfection ; Colon ; Dialysis ; Endocarditis ; Enterococcus ; Enterocolitis, Pseudomembranous ; Humans ; Kidney Failure, Chronic ; Korea ; Meningitis ; Oxazolidinones ; Peritoneal Dialysis, Continuous Ambulatory ; Peritonitis ; Prevalence ; Renal Dialysis ; Urinary Tract ; Urinary Tract Infections ; Vancomycin ; Vancomycin Resistance ; Linezolid

In the present report, we describe an unusual case of an intramural gastric abscess caused by a foreign body, detected in the form of a subepithelial tumor. A 64-year-old woman was referred to our gastroenterology clinic for further evaluation of a gastric subepithelial tumor. The patient presented with a 1-month history of sustained dull epigastric pain. Esophagogastroduodenoscopy revealed an ill-demarcated, round, smooth, protruding lesion with a small central erosion on the great curvature of the proximal antrum. Endoscopic ultrasonography indicated the presence of an ovoid, heterogeneous, hypoechoic lesion with small echogenic foci located in the submucosa and muscularis propria layers. An abdominal computed tomography scan showed focal gastric wall thickening and regional lymph node enlargement. Endoscopic submucosal dissection was performed for definite diagnosis and management. Thus, we detected a toothpick and removed it using grasping forceps. The final diagnosis was an intramural gastric abscess caused by a toothpick.
Abscess* ; Diagnosis ; Endoscopy, Digestive System ; Endosonography ; Female ; Foreign Bodies ; Gastroenterology ; Hand Strength ; Humans ; Lymph Nodes ; Middle Aged ; Surgical Instruments

Endoscopic submucosal dissection has been a useful treatment of selected colorectal neoplasia cases. The incidence of perforation related to colorectal endoscopic submucosal dissection is 5-20%. However, while there have been numerous reports regarding retroperitoneal, mediastinal, pleural and subcutaneous emphysema after therapeutic colonoscopy, pneumoscrotum is a relatively rare manifestation of perforation associated with colorectal endoscopic submucosal dissection. In particular, pneumorrhachis, or air within the spinal cord, following therapeutic colonoscopy, is extremely rare. Herein, we report a conservatively treated perforation case as having pneumorrhachis, penumoscrotum, and pneumoperitoneum after colorectal endoscopic submucosal dissection.
Colon ; Colonoscopy ; Incidence ; Pneumoperitoneum ; Pneumorrhachis ; Spinal Cord ; Subcutaneous Emphysema