Euyi Hyeog Im

Pancreatic Metastasis and Obstructive Jaundice in Small Cell Lung Carcinoma

Primary lung cancer frequently metastasizes to distant organs. The pancreas is a relatively infrequent site of metastasis. Furthermore, obstructive jaundice resulting from pancreatic metastasis is extremely rare. This paper examines the case of a 65-year-old woman with small cell lung cancer initially presenting with extrahepatic biliary obstruction. The patient underwent percutaneous transhepatic biliary drainage. The obstruction was relieved with a stent placement, then the woman was treated with combination chemotherapy (irinotecan, cisplatin) and a complete remission achieved in six months.

Spontaneous rupture of the lateral thoracic artery in patients with liver cirrhosis

Bleeding in patients with liver cirrhosis is primarily caused by gastroesophageal varix in association with extensive collateral circulation, portal hypertensive gastropathy, a Mallory-Weiss tear and peptic ulcer disease. The spontaneous rupture of an artery, as a result of coagulopathy, is extremely rare in patients with liver cirrhosis; however, we recently observed a case of a spontaneous rupture of the lateral thoracic artery in a 47 year-old male patient with alcoholic liver cirrhosis. The patient expired despite repeated transcatheter arterial embolization of the lateral thoracic artery and best supportive care. This is, to our knowledge, the first documented case of the spontaneous rupture of the lateral thoracic artery in a patient with liver cirrhosis.

Cecal Fecaloma Due to Intestinal Tuberculosis: Endoscopic Treatment

Colorectal fecaloma is a mass of accumulated feces that is much harder in consistency than a fecal impactation. The rectosigmoid area is the common site for fecalomas and the cecum is the most unusual site. Diagnosis is usually made by distinctive radiographic findings of a mobile intraluminal mass with a smooth outline and no mucosal attachment. Most of the fecalomas are successfully treated by conservative methods such as laxatives, enemas and rectal evacuation. When conservative treatments have failed, endoscopic procedures or a surgical intervention may be needed. We report here that a cecal fecaloma caused by intestinal tuberculosis scar was successfully removed by endoscopic procedures.

T1084 Is the Conventional 7-Day Triple Therapy Sufficient for Eradication of Helicobacter pylori?

BACKGROUND/AIM: The eradication rates attained by the PPI-based triple therapy were first reported to be around 85~91%. Not only bacterial resistance to anti-microbial agents but also insufficient acid inhibition during the eradication treatment causes eradication failure. Thus, there has recently been much debate on whether the currently used standard seven days triple therapy is sufficient for Helicobacter pylori eradication. The authors undertook the study to find out whether the currently implemented seven day treatment is pertinent. Methods: From January 2006 through October 2008, eight hundred fifty nine patients with Helicobacter pylori positive peptic ulcer disease or chronic gastritis who received first line therapy with esomeprazol 20mg, amoxicillin 1000mg and clarithromycin 500mg bid for 7 days were prospectively evaluated. Successful eradication therapy was defined as a negative 13C-urea breath test 6 to 8 weeks after the completion of the treatment. Result: There were 565 male and 294 female. Mean age was 56.3 years. Of all the subjects, 77.4% (665/859) showed negative 13C-urea breath test results. There were no difference in the eradication rate of Helicobacter pylori between people living in urban and rural areas (78.4% vs 76.4%). There were no differences in eradication rate based on the age of the patient group. However, women had a considerably lower eradication rate for Helicobacter pylori (80.9% vs 70.7%, P< 0.001). This was even more evident in the 40s (86.2% vs 69.4%, P= 0.002) and 50s (80.9% vs 67.47%, P= 0.022). Conclusion: The eradication rate ofHelicobacter pylori has reduced compared to the past. There is no difference between the people living in rural and urban areas though medical facilities were different. However the eradication rate is significantly lower in women aged 40s and 50s; for those groups, it should be considered to use regimens longer than 7 days or increase the dose of the drugs.