Li-Jung Tseng

Esophageal Intramural Pseudodiverticulosis Complicated with Stricture

We report a rare case of diffuse esophageal intramural pseudodiverticulosis in a 35-year-old man complaining of severe dysphagia and vomiting for several months. The advanced morphological change in the esophagus caused irregular track formation, mimicking an ulcerative lesion on esophagogram. Endoscopic examination revealed an esophageal stricture with intact mucosa. Endoscopic ultrasonography and chest computed tomography showed multiple hyperechoic lesions of unknown nature and multiple air collection sites in the esophageal wall, respectively, making diagnosis difficult. The patient finally received a subtotal esophagectomy because of severe symptoms. The lesion was pathologically proven to be intramural pseudodiverticulosis with marked submucosal fibrosis. Our experience suggests that awareness of this rare pathology and the related image changes will be helpful for early diagnosis and treatment in the future.

Colonic Obstruction Induced by Phytobezoar: Report of a Case

Bezoars are foreign that are formed by concretions of undigested food particles, masses of foreign bodies and undigested seeds and fibers of fruits that impact in the gastrointestinal tract, with the stomach being the most common site. They usually result in intestinal obstruction, ulcer formation, hemorrhage and perforation. Management of bezoars is usually surgical with fragmentation and milking it cephalad or caudad depending on its location and level of obstruction. A colonic bezoar causing bowel obstruction is a very rare occurrence. Experiencing it twice in a lifetime at the same location is even a rarer occurrence. We present a case of a recurrent colonic phytobezoar, secondary to habitual chewing and ingestion of betel nut fiber, which was successfully managed surgically. To the best of knowledge, a recurrent obstructing colonic bezoar related to betel nut chewing has never been reported before in literature.

Small Cell Carcinoma of Rectum: Report of a case

Small cell carcinoma of rectum is a rare tumor， since the majority of small cell carcinomas are of primary pulmonary origin. This tumor manifested highly aggressive behavior. We reported a 63 year-old male patient who had bloody stool. Colonoscopy revealed a rectal mass with ulcerated surface. Endoscopic ultrasound miniprobe image showed a homogenous, hypoechoic rectal tumor invading into the muscularis propria layer. The diagnosis of small cell carcinoma was made after colonoscopic biopsy, and patient received surgical resection of tumor, followed by chemotherapy and radiotherapy.