Small bowel obstruction is a clinical condition commonly caused by postoperative adhesion, volvulus, intussusceptions, and hernia. Small bowel obstruction due to bezoars is clinically uncommon, accounting for approximately 2-4% of all obstructions. Computed tomography (CT) is a useful method in diagnosing the cause of small bowel obstruction. However, small bowel obstruction caused by bezoars may not be detected by an abdominal CT examination. Herein, we report a rare case of small bowel obstruction by Aloe vera bezoars, which were undetected by an abdominal CT. Phytobezoars should be included in the differential diagnosis of small bowel obstruction in patients with predisposing factors, such as excessive consumption of high-fiber food and diabetes.
Aloe* ; Bezoars* ; Causality ; Diagnosis, Differential ; Hernia ; Humans ; Intestinal Obstruction ; Intestinal Volvulus ; Intestine, Small ; Intussusception ; Methods ; Tomography, X-Ray Computed

Patients with inflammatory bowel disease (IBD) have an elevated risk of venous thromboembolism compared with the general population. The most common sites of venous thromboembolism in IBD patients are the deep veins of the legs, the pulmonary system, and portal and mesenteric veins. However, cerebral venous thrombosis is rarely associated with IBD. This report describes a case of cerebral venous thrombosis in a patient with Crohn's disease. A 17-year-old girl, diagnosed 4 years earlier with Crohn's disease, presented with headache and vomiting. Magnetic resonance imaging of the brain with venography showed venous thrombosis in the cortical veins, superior sagittal sinus, right transverse sinus, and right internal jugular vein. The patient immediately started anticoagulation therapy with intravenous heparin infusion followed by daily oral rivaroxaban 10 mg. Follow-up imaging after 2 weeks showed resolution of the thrombosis, with recanalization of the cortical veins, superior sagittal sinus, right transverse sinus, and right internal jugular vein. She continued rivaroxaban therapy for 6 months, and remained well, without neurologic sequelae. A high level of concern for cerebral venous thrombosis may be important when treating active IBD patients, because anticoagulation treatment can prevent fatal complications.
Adolescent ; Brain ; Crohn Disease* ; Female ; Follow-Up Studies ; Headache ; Heparin ; Humans ; Inflammatory Bowel Diseases ; Jugular Veins ; Leg ; Magnetic Resonance Imaging ; Mesenteric Veins ; Phlebography ; Rivaroxaban ; Superior Sagittal Sinus ; Thrombosis ; Veins ; Venous Thromboembolism ; Venous Thrombosis* ; Vomiting

Lymphangioma is a benign vascular lesion with characteristics of subepithelial tumor which can proliferate in the lymphatic system. Lymphangioma of the small-bowel mesentery is rare, having been reported in less than 2% of all lymphangiomas. Lymphangioma does not require any specific treatment because it is absolutely a benign tumor. However, surgical exploration is rarely required for cases with disease-related symptoms or complications, or for those misdiagnosed as a malignant lesion. We recently experienced a case of mesenteric cavernous lymphangomas in a 53-year-old female who was misdiagnosed as having a liposarcoma. The final diagnosis was confirmed by a pathologic examination of the specimen that was obtained via laparoscopic exploration. Herein, we report a very rare case of mesenteric cavernous lymphangioma along with a brief review of relevant literature.
Female ; Humans ; Intestine, Small/pathology ; Laparoscopy ; Lymphangioma/*diagnosis/pathology/surgery ; Mesentery/pathology ; Middle Aged ; Peritoneal Neoplasms/*diagnosis/pathology/surgery ; Tomography, X-Ray Computed

PURPOSE: To evaluate the safety and feasibility of a simplified zero ischemia technique using kidney donor computed tomographic (CT) angiography and conventional laparoscopic bulldog clamps. MATERIALS AND METHODS: We conducted a review of seven robot-assisted partial nephrectomies (RAPNs) performed by a single surgeon from January 2012 to May 2012. Using a simplified protocol of 3-dimentional reconstruction, tertiary arterial branches supplying the tumor were selectively clamped prior to resection. We used conventional laparoscopic bulldog clamps instead of microsurgical vessel clamps. The patients' demographic information, perioperative outcomes, pathologic outcomes and pre- and postoperative renal functions up to 3 months follow-up were analyzed. RESULTS: RAPN were successfully performed for seven complex renal hilar tumors. There were no significant differences in the total operation time, estimated blood loss or postoperative outcomes compared with published literature on standard RAPN. Negative surgical margins were reported in all cases. CONCLUSIONS: We presented a simplified-zero ischemia technique using kidney Donor CT angiography and conventional laparoscopic bulldog clamps. We have also demonstrated its safety and feasibility in patients with complex renal hilar tumors. This modified technique can be easily adopted by most surgeons who are currently performing RAPN.
Angiography ; Follow-Up Studies ; Glycosaminoglycans ; Humans ; Imaging, Three-Dimensional ; Ischemia ; Kidney ; Kidney Neoplasms ; Nephrectomy ; Robotics ; Tissue Donors

Pseudoaneurysm formation in the pulmonary vasculature is a rare but fatal condition. Several etiologies have been described including trauma, complication after cardiac or other surgeries, tuberculosis, necrotizing pneumonia, congestive heart disease, atherosclerosis, cancer and vasculitis. We report a case of pseudoaneurysm found in a patient being treated with status asthmaticus, who developed complications of pneumonia and brain abscess secondary to sepsis.
Aneurysm, False ; Atherosclerosis ; Brain Abscess ; Estrogens, Conjugated (USP) ; Heart Diseases ; Humans ; Pneumonia ; Sepsis ; Status Asthmaticus ; Tuberculosis ; Vasculitis

Coblation devices are now widely used in arthroscopic surgery and they show a very low incidence of intraoperative complications. We experienced a case where the tip of the wand separated and migrated into the posterior knee compartment in an arthrofibrotic knee. The free wand tip was identified and then extricated from the popliteal hiatus of the knee with using C-arm fluoroscopic control. To the best of our knowledge, this is the first report of its kind involving coblation wands. We describe this complication to show that the use of coblation devices can lead to unexpected problems and it is imperative to inspect all instruments before and after each surgical use.
Arthroscopy/adverse effects/*instrumentation ; Catheter Ablation/adverse effects/*instrumentation ; *Equipment Failure ; Humans ; *Intraoperative Complications ; Knee Joint/*surgery ; Male ; Middle Aged

Tumor lysis syndrome (TLS) is an oncologic emergency that is characterized by numerous metabolic abnormalities, including hyperuricemic nephropathy, hyperphosphatemia, hypocalcemia, hyperkalemia and increased serum creatinine. This syndrome is common for tumors with rapid cell turnover and growth rates, and for bulky tumors with high sensitivity to anti-neoplastic treatments. Hence, TLS is a well-recognized clinical problem in hematologic malignancies. TLS is rarely observed to be induced in solid tumors by chemotherapy. Herein we present the second case of TLS that developed during radiotherapy in a patient with non-small cell lung cancer.
Carcinoma, Non-Small-Cell Lung ; Creatinine ; Emergencies ; Hematologic Neoplasms ; Humans ; Hyperkalemia ; Hyperphosphatemia ; Hypocalcemia ; Tumor Lysis Syndrome

Chemical pneumonitis induced by hydrocarbon aspiration is rare in Korea. Kerosene is a petroleum distillate with low viscosity and high volatility. We report two adult cases of chemical pneumonitis caused by the accidental aspiration of kerosene. They were treated successfully with antibiotics and systemic corticosteroids, and recovered without complications.
Adrenal Cortex Hormones ; Adult ; Anti-Bacterial Agents ; Humans ; Kerosene ; Korea ; Petroleum ; Pneumonia ; Viscosity ; Volatilization

Fingerprints remain the most important methodology of personal identification in the field of scene investigation despite of outstanding current DNA typing technique. Restoration of fingerprints may be, however, difficult or impossible in cases of severely putrefied or dried bodies. Several methods have been used in fingerprints recovery but they are somewhat easy and costly. We introduce a new practical method that is reconditioning of friction ridge skin with rehydration, which can obtain a good quality for comparison and identification via the automated fingerprint identification system. We think this method is easy to use and could contribute to restoring fingerprints of dead bodies with severe postmortem change.
Dermatoglyphics ; DNA Fingerprinting ; Fluid Therapy ; Friction ; Humans ; Skin

OBJECTIVE: To compare the surgical outcomes between laparoscopy-assisted vaginal hysterectomy (LAVH) and total laparoscopic hysterectomy (TLH). METHODS: The data were collected retrospectively from hospital records. Between September 2006 and August 2007, Patients undergone with LAVH (93 cases) and TLH (142 cases) with pathologic reports of leiomyoma or adenomyosis were enrolled. The characteristics and surgical results were compared according to the operation type. The correlations among the variables were analyzed with multiple linear regression. RESULTS: Between two groups, the characteristics of patients were similar such as age, body mass index, surgical history, and pathologic findings. In the univariate analysis, the differences of operation duration and blood loss between LAVH (129.0+/-34.5 min, 385.5+/-296.1 mL) and TLH (123.6+/-40.8 min, 294.7+/-285.4 mL) were significant (P<0.050). Specimen weight was slightly heavier in LAVH (378.7+/-211.7 g vs. 316.9+/-170.1 g, P=0.060), Admission duration (5.63+/-1.61 day vs. 5.71+/-1.61 day) and the incidence of complications (10.8% vs. 14.0%) were indifferent to the groups (LAVH vs. TLH, P>0.050). In multivariate analysis, blood loss was correlated with operation duration and specimen weight (P=0.000) but not with operation type (P=0.213). CONCLUSIONS: LAVH tends to be selected in larger uteri and results in more blood loss and longer operation duration. Operation type (LAVH or TLH) does not affect blood loss which is related with operation duration and uterine weight.
Adenomyosis ; Body Mass Index ; Female ; Hospital Records ; Humans ; Hysterectomy ; Hysterectomy, Vaginal ; Incidence ; Laparoscopy ; Leiomyoma ; Multivariate Analysis ; Retrospective Studies ; Uterus