We present an incidentally detected case of bilateral sub-internal limiting membrane (ILM) hemorrhage secondary to typical hemolytic uremic syndrome (HUS) along with a literature review. A 4-year-old girl presented to our emergency department with bloody diarrhea, abdominal pain, fever, and oliguria. HUS was suspected based on clinical symptoms and laboratory findings suggestive of hemolytic anemia, thrombocytopenia, and acute kidney injury. Supportive management, including intermittent dialysis, was provided during admission. However, the patient exhibited central nervous system involvement and presented with a seizure. Despite the absence of visual symptoms, a fundus examination revealed unexpected bilateral sub-ILM hemorrhages and a cotton wool spot in the right eye. Blood dyscrasia improved with repeated hemodialysis and red blood cell transfusions. The sub-ILM hemorrhage gradually resolved, as observed on consecutive fundus photographs. Multimodal retinal imaging revealed healthy capillary structures without evidence of macular ischemia or fibrosis. Typical HUS can be accompanied by a sub-ILM hemorrhage without preceding symptoms. The absence of visual symptoms, despite significant retinal abnormalities, emphasizes the importance of immediate and routine fundus examinations in patients with typical HUS. This proactive approach improves early detection of ocular involvement, enabling prompt intervention to manage potential visual complications, and ultimately improving patient outcomes.

We present an incidentally detected case of bilateral sub-internal limiting membrane (ILM) hemorrhage secondary to typical hemolytic uremic syndrome (HUS) along with a literature review. A 4-year-old girl presented to our emergency department with bloody diarrhea, abdominal pain, fever, and oliguria. HUS was suspected based on clinical symptoms and laboratory findings suggestive of hemolytic anemia, thrombocytopenia, and acute kidney injury. Supportive management, including intermittent dialysis, was provided during admission. However, the patient exhibited central nervous system involvement and presented with a seizure. Despite the absence of visual symptoms, a fundus examination revealed unexpected bilateral sub-ILM hemorrhages and a cotton wool spot in the right eye. Blood dyscrasia improved with repeated hemodialysis and red blood cell transfusions. The sub-ILM hemorrhage gradually resolved, as observed on consecutive fundus photographs. Multimodal retinal imaging revealed healthy capillary structures without evidence of macular ischemia or fibrosis. Typical HUS can be accompanied by a sub-ILM hemorrhage without preceding symptoms. The absence of visual symptoms, despite significant retinal abnormalities, emphasizes the importance of immediate and routine fundus examinations in patients with typical HUS. This proactive approach improves early detection of ocular involvement, enabling prompt intervention to manage potential visual complications, and ultimately improving patient outcomes.

Purpose: This study evaluated the postoperative quality of life (QoL) after various types of gastrectomy for gastric cancer. Materials and Methods: A multicenter prospective observational study was conducted in Korea using the Korean Quality of Life in Stomach Cancer Patients Study (KOQUSS)-40, a new QoL assessment tool focusing on postgastrectomy syndrome. Overall, 496 patients with gastric cancer were enrolled, and QoL was assessed at 5 time points: preoperatively and at 1, 3, 6, and 12 months after surgery. Results: Distal gastrectomy (DG) and pylorus-preserving gastrectomy (PPG) showed significantly better outcomes than total gastrectomy (TG) and proximal gastrectomy (PG) with regard to total score, indigestion, and dysphagia. DG, PPG, and TG also showed significantly better outcomes than PG in terms of dumping syndrome and worry about cancer. Postoperative QoL did not differ significantly according to anastomosis type in DG, except for Billroth I anastomosis, which achieved better bowel habit change scores than the others. No domains differed significantly when comparing double tract reconstruction and esophagogastrostomy after PG. The total QoL score correlated significantly with postoperative body weight loss (more than 10%) and extent of resection (P<0.05 for both).Reflux as assessed by KOQUSS-40 did not correlate significantly with reflux observed on gastroscopy 1 year postoperatively (P=0.064). Conclusions Our prospective observation using KOQUSS-40 revealed that DG and PPG lead to better QoL than TG and PG. Further study is needed to compare postoperative QoL according to anastomosis type in DG and PG.

We present an incidentally detected case of bilateral sub-internal limiting membrane (ILM) hemorrhage secondary to typical hemolytic uremic syndrome (HUS) along with a literature review. A 4-year-old girl presented to our emergency department with bloody diarrhea, abdominal pain, fever, and oliguria. HUS was suspected based on clinical symptoms and laboratory findings suggestive of hemolytic anemia, thrombocytopenia, and acute kidney injury. Supportive management, including intermittent dialysis, was provided during admission. However, the patient exhibited central nervous system involvement and presented with a seizure. Despite the absence of visual symptoms, a fundus examination revealed unexpected bilateral sub-ILM hemorrhages and a cotton wool spot in the right eye. Blood dyscrasia improved with repeated hemodialysis and red blood cell transfusions. The sub-ILM hemorrhage gradually resolved, as observed on consecutive fundus photographs. Multimodal retinal imaging revealed healthy capillary structures without evidence of macular ischemia or fibrosis. Typical HUS can be accompanied by a sub-ILM hemorrhage without preceding symptoms. The absence of visual symptoms, despite significant retinal abnormalities, emphasizes the importance of immediate and routine fundus examinations in patients with typical HUS. This proactive approach improves early detection of ocular involvement, enabling prompt intervention to manage potential visual complications, and ultimately improving patient outcomes.

Purpose: This study evaluated the postoperative quality of life (QoL) after various types of gastrectomy for gastric cancer. Materials and Methods: A multicenter prospective observational study was conducted in Korea using the Korean Quality of Life in Stomach Cancer Patients Study (KOQUSS)-40, a new QoL assessment tool focusing on postgastrectomy syndrome. Overall, 496 patients with gastric cancer were enrolled, and QoL was assessed at 5 time points: preoperatively and at 1, 3, 6, and 12 months after surgery. Results: Distal gastrectomy (DG) and pylorus-preserving gastrectomy (PPG) showed significantly better outcomes than total gastrectomy (TG) and proximal gastrectomy (PG) with regard to total score, indigestion, and dysphagia. DG, PPG, and TG also showed significantly better outcomes than PG in terms of dumping syndrome and worry about cancer. Postoperative QoL did not differ significantly according to anastomosis type in DG, except for Billroth I anastomosis, which achieved better bowel habit change scores than the others. No domains differed significantly when comparing double tract reconstruction and esophagogastrostomy after PG. The total QoL score correlated significantly with postoperative body weight loss (more than 10%) and extent of resection (P<0.05 for both).Reflux as assessed by KOQUSS-40 did not correlate significantly with reflux observed on gastroscopy 1 year postoperatively (P=0.064). Conclusions Our prospective observation using KOQUSS-40 revealed that DG and PPG lead to better QoL than TG and PG. Further study is needed to compare postoperative QoL according to anastomosis type in DG and PG.

Purpose: This study evaluated the postoperative quality of life (QoL) after various types of gastrectomy for gastric cancer. Materials and Methods: A multicenter prospective observational study was conducted in Korea using the Korean Quality of Life in Stomach Cancer Patients Study (KOQUSS)-40, a new QoL assessment tool focusing on postgastrectomy syndrome. Overall, 496 patients with gastric cancer were enrolled, and QoL was assessed at 5 time points: preoperatively and at 1, 3, 6, and 12 months after surgery. Results: Distal gastrectomy (DG) and pylorus-preserving gastrectomy (PPG) showed significantly better outcomes than total gastrectomy (TG) and proximal gastrectomy (PG) with regard to total score, indigestion, and dysphagia. DG, PPG, and TG also showed significantly better outcomes than PG in terms of dumping syndrome and worry about cancer. Postoperative QoL did not differ significantly according to anastomosis type in DG, except for Billroth I anastomosis, which achieved better bowel habit change scores than the others. No domains differed significantly when comparing double tract reconstruction and esophagogastrostomy after PG. The total QoL score correlated significantly with postoperative body weight loss (more than 10%) and extent of resection (P<0.05 for both).Reflux as assessed by KOQUSS-40 did not correlate significantly with reflux observed on gastroscopy 1 year postoperatively (P=0.064). Conclusions Our prospective observation using KOQUSS-40 revealed that DG and PPG lead to better QoL than TG and PG. Further study is needed to compare postoperative QoL according to anastomosis type in DG and PG.

Background: Various molecular methods are used to rapidly detect gastrointestinal pathogens, highlighting the importance of understanding the performance of the associated kits in detail. We comprehensively assessed the performance of Kogene PowerChek multiplex real-time PCR kits (PowerChek Bacterial/Viral Kits) with the FilmArray GI Panel. Methods: Residual stool specimens (N = 246), initially tested utilizing the FilmArray GI Panel (May 2023–Jan 2024), were reanalyzed using PowerChek Bacterial/Viral Kits. Discrepancies were resolved by performing additional molecular assays and reviewing culture results when available. True positives (TPs)/true negatives were defined by concordant results in at least two assays. We determined cycle threshold (Ct)/crossing point (Cp) distributions between the TP and false positive (FP) groups and analyzed melting curves for the FilmArray GI Panel FPs. Results: The positive-percent agreement (PPA) of the PowerChek Bacterial/Viral Kits was 50–100%, with lower values for Salmonella spp., rotavirus, and astrovirus, whereas the FilmArray GI Panel showed 100% PPA across all targets. Both platforms demonstrated > 99% negative-percent agreement, except for enteropathogenic Escherichia coli (EPEC) and adenovirus (PowerChek Bacterial/Viral Kits) or EPEC, enteroaggregative E. coli, norovirus, and Salmonella spp. (FilmArray GI Panel). The FPs showed higher Ct/Cp values with both kits, and these values were significantly higher for adenovirus (PowerChek Viral Kit), EPEC, and norovirus (FilmArray GI Panel). Melting curve analysis of four norovirus FPs (FilmArray GI Panel) revealed atypical patterns in three cases. Conclusions The FilmArray GI Panel demonstrated higher sensitivity than the PowerChek Kits. For norovirus, melting curve analysis will help avoid FPs.

Polytetrafluoroethylene (PTFE) grafts are artificial vascular grafts commonly utilized for reconstructing the middle hepatic vein during living donor liver transplantation. In this report, we present three cases of expanded PTFE (ePTFE) graft migration into the gastrointestinal tract. These migrations were incidentally discovered and later migrated grafts were successfully removed endoscopically. The first case involved a patient presenting with epigastric discomfort, with a migrated ePTFE graft observed in the duodenal lumen during esophagogastroduodenoscopy (EGD). In the second case, a patient who visited the emergency room with hematochezia was found to have a migrated ePTFE graft in the colonic lumen on colonoscopy. The third case involved a patient undergoing regular EGD after endoscopic submucosal dissection for early gastric cancer; graft migration into the duodenal lumen was documented over time through sequential surveillance EGDs. The graft was endoscopically removed after complete migration. Contrary to previous reports, the three cases presented here did not exhibit serious clinical symptoms, and they were successfully treated through endoscopic foreign body removal without complications. We believe these occasions were possible due to the slow migration of the graft and the concurrent spontaneous closure of the fistula tract.