We report our experience with a case of urethrolysis using a transvaginal suprameatal approach without lateral perforation of the urethropelvic ligament. A 43-year-old woman suffered from voiding difficulties such as hesitancy, frequency, urgency, decreased urinary flow, residual urine sensation after Marshall-Marchetti-Krantz operation concurrent with hysterectomy. The results of multidisciplinary work-ups of urethral obstruction such as history, vaginal examination, voiding cystourethrography, urodynamic study, showed that she had urethral obstruction due to a previous operation. Since clean intermittent catheterization and alpha-blocker therapy did not improve her symptoms, suprameatal transvaginal urethrolysis was performed to resolve the symptoms. Postoperative follow-up for 5 months showed that the patient remained free from voiding difficulty in their life. We believe that suprameatal transvaginal urethrolysis is worth attempting for urethral obstruction associated with anti-incontinence surgery.
Adult ; Female ; Follow-Up Studies ; Gynecological Examination ; Humans ; Hysterectomy ; Intermittent Urethral Catheterization ; Ligaments ; Sensation ; Urethral Obstruction* ; Urodynamics

Ulcerative colitis (UC) is a chronic inflammatory disorder of the gastrointestinal tract that affects the large bowel. Its etiology remains controversial. However, an infectious or immunologic origin is considered the primary cause. The onset of UC is typically slow and insidious, but some patients may present acutely with symptoms mimicking infectious colitis. We report a case of ulcerative colitis mimicking acute hemorrhagic colitis at initial presentation. A 60-year-old man was referred to Yeungnam University Hospital for bloody diarrhea and abdominal pain. Sigmoidoscopy revealed mildly edematous mucosa in the rectum and hyperemic mucosa with petechiae in the sigmoid colon. The patient was treated with antibiotics for several days, and his symptoms improved. However, after one month, his bloody diarrhea relapsed. Follow-up sigmoidoscopy revealed mucosal friability in the rectum and sigmoid colon. He was diagnosed with ulcerative colitis, and his symptoms were improved with mesalazine and a steroid enema.
Abdominal Pain ; Anti-Bacterial Agents ; Colitis ; Colitis, Ulcerative ; Colon, Sigmoid ; Diarrhea ; Follow-Up Studies ; Gastrointestinal Tract ; Humans ; Mesalamine ; Middle Aged ; Mucous Membrane ; Purpura ; Rectum ; Sigmoidoscopy ; Ulcer

Central venous catheterization via an internal jugular vein or subclavian vein has become a common procedure in monitoring CVP and managing severely ill patients. However, there have beennumerous reports of complications associated with central venous catheterization. These include vessel injury, pneumothorax, hemothorax, nerve injury, arrhythmias, arteriovenous thrombosis, pulmonary embolism, and infection at the insertion site. We report a case of hemothorax after subclavian vein catheterization failure, along with successful treatment.
Arrhythmias, Cardiac ; Catheterization ; Catheterization, Central Venous ; Catheters ; Central Venous Catheters ; Glycosaminoglycans ; Hemothorax ; Humans ; Jugular Veins ; Pneumothorax ; Pulmonary Embolism ; Subclavian Vein ; Thrombosis

We report an unusual case of a sigmoid colon perforation after ventriculoperitoneal shunt surgery. Distal catheters are known to cause perforation in the setting of colonoscopy. The exact pathogenesis of this complication is not clear, but it can cause serious complications. Hence, patients require prompt and aggressive management, including laparotomy with bowel wall repair, catheter removal, and antibiotic therapy.
Catheters ; Colon, Sigmoid ; Colonoscopy ; Humans ; Hydrocephalus ; Intestinal Perforation ; Laparotomy ; Ventriculoperitoneal Shunt

The incidence of hepatocellular carcinoma presenting as obstructive jaundice is 0.7~9%. The mechanisms of obstructive jaundice include bile duct invasion by tumor, tumor thrombi, blood clots, direct bile duct compression by tumor, and intraductal tumor growth. We report a rare case of hepatocellular carcinoma with intraductal growth. A 46-year-old woman was admitted due to colicky right upper abdominal pain and jaundice for 4 days. Computed tomography showed dilatation of the left intrahepatic duct, and endoscopic retrograde cholangiography showed a filling defect in the left main intrahepatic duct. We performed a left lobectomy with a Roux-en-Y hepaticojejunostomy. The tumor was diagnosed as a hepatocellular carcinoma with intraductal growth.
Abdominal Pain ; Bile Ducts ; Carcinoma, Hepatocellular ; Cholangiography ; Dilatation ; Female ; Humans ; Incidence ; Jaundice ; Jaundice, Obstructive ; Middle Aged

A two-month-old girl with a history of an incidental arachnoid cyst in the prenatal period (38 weeks) presented with persistent irritability. A follow-up computed tomographic (CT) scan revealed an enlarged arachnoid cyst with hydrocephalus. We performed craniotomy and fenestration, but the cyst size did not decrease, and hydrocephalus had worsened on a follow-up CT scan performed 13 months after fenestration. The patient was treated with cystoperitoneal shunting. Follow-up magnetic resonance imaging (MRI) performed 5 years later revealed that the arachnoid cyst had decreased in size and that the hydrocephalus had resolved. Enlarging arachnoid cysts are not common, and optimal surgical treatment is uncertain. Based on the features of this case, we believe cystoperitoneal shunting is an advisable surgical intervention for patients with enlarging arachnoid cysts presenting with hydrocephalus.
Arachnoid ; Arachnoid Cysts ; Craniotomy ; Follow-Up Studies ; Humans ; Hydrocephalus ; Magnetic Resonance Imaging

Angioleiomyoma of the sinonasal tract is a rare benign tumor. We report a case of angioleiomyoma of the nasal septum in a 51-year-old woman who complained of frequent epistaxis for 3 months. Surgicalexcision was performed. The excised specimen was 0.7 x 0.5 x 0.4 cm in size, well circumscribed, grayish white, rubbery, and soft. Histological examination showed thick-walled blood vessels and smooth muscle cell proliferation. No nuclear atypia or mitoses were present.
Angiomyoma ; Blood Vessels ; Epistaxis ; Female ; Humans ; Middle Aged ; Mitosis ; Myocytes, Smooth Muscle ; Nasal Cavity ; Nasal Septum

A 67-year-old woman with severe congestive heart failure (New York Heart Association, NYHA class IV) was set to receive general anesthesia for cardiac surgery. For several months, she had been in a constant sitting position from which the slightest change evoked dyspnea. A patient in such a condition is rarely considered a candidate for general anesthesia, because such patients are never eligible for any type of surgery other than that used to fix the heart problem itself. We report this case to explain how anesthesia was induced with the patient sitting in a crouching position and discuss other methods of induction that can probably be used in similar situations.
Aged ; Anesthesia ; Anesthesia, General ; Dyspnea ; Estrogens, Conjugated (USP) ; Female ; Heart ; Heart Failure ; Humans ; Thoracic Surgery

Osteomas are benign osteoblastic tumors that occur mainly in the fronto-ethmoid areas ofthe head and neck region. When they occasionally occur in the temporal bone, the external auditory canal is the most common site of origin; they rarely occur in the mastoid region. Moreover, mastoid osteoma with mastoiditis is an extremely rare entity in the temporal bone. Recently, the authors experienced a case of mastoid osteoma with mastoiditis in the left temporal bone. The mastoid osteoma was completely resected itself without a mastoidectomy, only for correction of the cosmetic deformity; the mastoiditis was not treated. Hence, the authors report the first case of a mastoid osteoma with mastoiditis in Korea, along with a review of the related literature.
Cosmetics ; Ear Canal ; Head ; Korea ; Mastoid ; Mastoiditis ; Neck ; Osteoblasts ; Osteoma ; Temporal Bone

Crohn's disease is a chronic inflammatory bowel disease that mainly affects children and young adults. Its cause remains unknown. The incidence of pediatric Crohn's disease is increasing, so it is important for clinicians to be aware of the presentation of this disease in the pediatric population. The majority of patients complain of abdominal pain (72%), with only 25% presenting with the 'classical triad' of abdominal pain, weight loss, and diarrhea. Many children with Crohn's disease present in a 'non-classical' manner, with vague complaints such as lethargy or anorexia, which may be associated with only mild abdominal discomfort. Other symptoms include fever, nausea, vomiting, growth retardation, malnutrition, delayed puberty, psychiatric symptoms, arthropathy, and erythema nodosum. Severe constipation and abdominal distension are uncommon symptoms at diagnosis. We report a case of pediatric Crohn's disease, which was diagnosed after the patient presented with severe constipation and abdominal distension.
Abdominal Pain ; Anorexia ; Child ; Constipation ; Crohn Disease ; Diarrhea ; Erythema Nodosum ; Fever ; Humans ; Incidence ; Inflammatory Bowel Diseases ; Lethargy ; Malnutrition ; Nausea ; Puberty, Delayed ; Vomiting ; Weight Loss ; Young Adult