Journal of Yeungnam Medical Science

Case Reports

Non-cirrhotic portal hypertension in an ankylosing spondylitis patient: Sukki Park, Ji Hyun Lee, Joon Sul Choi, Hyun Woo Kim, Beom Jin Shim, Won Kyu Choi, Sang Hyun Kim; Yeungnam Univ J Med. 2018;35(1):89-93. Published online June 30, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.1.89

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Abstract PDF: Idiopathic non-cirrhotic portal hypertension (INCPH) is a disease with an uncertain etiology consisting of non-cirrhotic portal hypertension and portal pressure increase in the absence of liver cirrhosis. In INCPH, patients exhibit normal liver functions and structures. The factors associated with INCPH include the following: Umbilical/portal pyremia, bacterial diseases, prothrombic states, chronic exposure to arsenic, vinyl chloride monomers, genetic disorders, and autoimmune diseases. Approximately 70% of patients present a history of major variceal bleeding, and treatment relies on the prevention of complications related to portal hypertension. Autoimmune disorders associated with INCPH are mainly systemic sclerosis, systemic lupus erythematosus and rheumatoid arthritis. To the best of our knowledge, a case of ankylosing spondylitis (AS) associated with INCPH has not been reported thus far. Therfore, we report our experience of a patient with AS accompanied by INCPH, who showed perisplenic varices with patent spleno-portal axis and hepatic veins along with no evidence of cirrhosis on liver biopsy, and provide a brief literature review.

Mediastinal pancreatic pseudocyst naturally drained by esophageal fistula: Soo Ho Park, Seung Keun Park, Sang Hyun Kim, Won Kyu Choi, Beom Jin Shim, Hee Ug Park, Chan Woo Jung, Jae Won Choi; Yeungnam Univ J Med. 2017;34(2):254-259. Published online December 31, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.2.254

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Mediastinal pancreatic pseudocyst is a rare complication of acute or chronic pancreatitis. Pleural effusion and pneumonia are two of the most common thoracic complications from pancreatic disease, while pancreaticopleural fistula with massive pleural effusion and extension of pseudocyst into the mediastinum is a rare complication of the thorax from pancreatic disease. To the best of our knowledge, there have been no case reports of mediastinal pancreatic pseudocyst-induced esophageal fistula in Korea to date. Here in, we report a case about 43-year-old man of mediastinal pancreatic pseudocyst-induced esophageal fistula presenting with chest pain radiating toward the back and progressive dysphagia. The diagnosis was confirmed by an esophagogastroduodenoscopy and abdomen computed tomography (CT). The patient was treated immediately using a conservative method; subsequently, within 3 days from treatment initiation, symptoms-chest pain and dysphagia-disappeared. In a follow-up gastroscopy 7 days later and abdomen CT 12 days later, mediastinal pancreatic pseudocyst showed signs of improvement, and esophageal fistula disappeared without any complications.

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Pseudocyst of the pancreas masquerading as spontaneous pneumomediastinum
John D L Brookes, Manish Mathew, Charlene P Munasinghe, John C Gribbin, David A Devonshire, Prashant Joshi, Andrew D Cochrane
Journal of Surgical Case Reports.2019;[Epub] CrossRef

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