Chief Complaint Laterally spreading tumor c diverticulum, S-colon Present Illness 45/M, 타병원에서 건강검진으로 시행한 위, 대장 내시경 상 colon 의 Laterally spreading tumor c diverticulum 소견으로 절제 시술 위해 입원함. Case 김 O 훈 (M/45) Admission date :

Past-medical history DM / HTN / Tb / Hepatitis ( - / + / - / - ) Op Hx. (-) Personal history Alcohol(+): 주 3 회 x 소주 2 병 Smoking(+): 25PY

Work Up Endoscopy colonoscopy Image study None

S Diagnosis : A. Colon, sigmoid, 29cm from anal verge, colonoscopic biopsy: Hyperplastic polyp B. Colon, sigmoid, 28cm from anal verge, colonoscopic biopsy: Hyperplastic polyp Pathologic finding

Diagnosis Hyperplastic polyp c diverticulum, colon

Chief Complaint RLQ pain onset> 1 month ago Present Illness 18/M, Crohn’s disease(2010 년 1 월 ) s/p remicade #31( 까지 ), s/p Humira( ~) 투약 중으로 1 달 전부터 RLQ pain 발생하여 11/24 abd-CT 촬영 후 terminal ileum 에 4x4 sized mass 관찰되어 자세한 검사 위해 IG 입원하여 항생제 치료 후 GS 로 전과되어 Rt. Hemicolectomy 시행함. Case 전 O 중 (M/18) Admission date :

Past-medical history DM / HTN / Tb / Hepatitis ( - / - / - / - ) Alcohol(-) Smoking (-) Op Hx (+) : Lap. partial cecectomy d/t fistular formation from the cecum( ) Personal history Alcohol (-) Smoking (-)

Work Up Endoscopy EGD, CFS ( 진단 당시 ) sigmoidoscopy Image study AP-CT entero MR AP-CT AP-CT

Operation Rt. Hemicolectomy

S Diagnosis : Ileum and colon, right hemicolectomy: 1. Transmural inflammation and fissuring with non-caseating granulomas, consistent with Crohn's disease (Post partial cecectomy status) 2. Fibromatosis (Desmoid tumor, size: 4.5x3.3x3.0 cm) 3. Reactive lymph nodes (0/24) Small bowel, segmentectomy: Transmural inflammation and subserosal fibrosis, consistent with Crohn's disease Pathologic finding

Diagnosis Refractory crohn’s disease c desmoid tumor

Chief Complaint Lower abdominal pain onset> 1 mo ago Present Illness 49/F, IDA 로 본원 IH 진단, 고려대병원 IH f/u 하는 자, 반복적인 Infectious colitis 입원 치료 받은 바 ( , ) 있으며, 중순부터 fever(upto 37.8 도 ), 하복부의 통증 발생, 이후 고려대학교 외 래에서 WBC 증가, Hb 감소 동반되어 외래 내원함. Case 최 O 인 (F/49) OPD date :

Past-medical history DM / HTN / Tb / Hepatitis ( - / - / -/ - ) IDA 2014/3/24~4/3, 2015/2/3~2/9 Infectious colitis 로 본원 IG 입원 Op Hx (-) Personal history Alcohol (-) Smoking(-)

Work Up Endoscopy Colonoscopy, Gastroscopy Sigmoidoscopy Colonoscopy, Gastroscopy Image study AP-CT GB&billiary-CT

S , S Diagnosis : A. Terminal ileum, colonoscopic biopsy: Chronic inflammation with erosion B. Colon, ascending, colonoscopic biopsy: Acute and chronic inflammation with lymphoid aggregates and erosion C. Colon, transverse, colonoscopic biopsy: Acute and chronic inflammation with lymphoid aggregates D. Colon, descending, colonoscopic biopsy: Acute and chronic inflammation with cryptitis E. Colon, sigmoid, colonoscopic biopsy: Acute and chronic inflammation with cryptitis F. Rectum, colonoscopic biopsy: Chronic inflammation Pathologic finding

S Diagnosis : Colon, colonoscopic biopsy: Acute and chronic inflammation S Diagnosis : Colon, sigmoid, colonoscopic biopsy: Acute and chronic inflammation with superficial cryptitis Pathologic finding

S Diagnosis : A. Cecum, colonoscopic biopsy: Ulcer with acute and chronic inflammation, consistent with infectious colitis B. Colon, transverse, colonoscopic biopsy: Ulcer with acute and chronic inflammation, consistent with infectious colitis C. Rectum, colonoscopic biopsy: Acute and chronic inflammation, consistent with infectious colitis Immunohistochemical finding (S , 2): CD3 (+), CD20 (+), Cytomegalovirus (-) EBV finding(S , 2): negative Pathologic finding

Diagnosis Indeterminated colitis

Chief Complaint RLQ pain onset> 1 month ago Present Illness 52/F, Tb peritonitis c multiple Tb abscess 로 부터 항결핵제 투여중인 자, 외래에서 시행한 small bowel CT 에서 multiple intra-abdominal abscess 있어 IG 입원하여 결핵약제 투여하다 GS 로 전과되어 Lap. LN biopsy c ileostomy 시행함. Case 이 O 자 (F/52) Admission date :

Past-medical history DM / HTN / Tb / Hepatitis ( - / - / - / - ) Alcohol (-) Smoking (-) Op Hx (+) : C-sec(1987) Personal history Alcohol (-) Smoking(-)

Work Up Endoscopy CFS CFS Image study Abd-CT AP-CT small bowel CT Abd-CT Abd-CT Abd-CT

Operation Lap. biopsy c ileostomy

S Diagnosis : Peritoneum, biopsy: Chronic granulomatous inflammation, consistent with Tuberculosis Small intestine, biopsy: Chronic granulomatous inflammation, consistent with Tuberculosis Special stain finding (S , 1 and 2): A.F.B (1:-, 2: -) Pathologic finding

S Diagnosis : A. Colon, ascending, proximal, colonoscopic biopsy: Chronic inflammation B. Colon, transverse, proximal, colonoscopic biopsy: Chronic inflammation S Diagnosis : A. Terminal ileum, colonoscopic biopsy: Ulceration and chronic granulomatous inflammation B. Colon, ascending, proximal, colonoscopic biopsy: Ulceration and chronic granulomatous inflammation C. Rectum, polypectomy: Tubular adenoma with low grade dysplasia Pathologic finding

S Diagnosis : A. Cecum, colonoscopic biopsy: Ulcer with acute and chronic inflammation, consistent with infectious colitis B. Colon, transverse, colonoscopic biopsy: Ulcer with acute and chronic inflammation, consistent with infectious colitis C. Rectum, colonoscopic biopsy: Acute and chronic inflammation, consistent with infectious colitis Immunohistochemical finding (S , 2): CD3 (+), CD20 (+), Cytomegalovirus (-) EBV finding(S , 2): negative Pathologic finding

Diagnosis TB peritonitis and multiple Tb abscess

Chief Complaint Lower abdominal pain onset> 2 weeks ago Present Illness 17/F, Crohn's disease c anal fistula (2014’-5 송도병원 ) mesalazine 복용하던 환자, 2 주 전부터 lower abdomen 의 쑤시는 듯한 통증 발생, pelvic abscess 소견으로 전원됨. Case 김 O 림 (F/17) Admission date :

Past-medical history DM / HTN / Tb / Hepatitis ( - / - / - / - ) Alcohol (-) Smoking (-) Op Hx (-) Personal history Alcohol(-) Smoking(-)

Work Up Endoscopy None Image study Abd-CT AP-CT AP-CT AP-CT

S Diagnosis : A. Colon, sigmoid, 29cm from anal verge, colonoscopic biopsy: Hyperplastic polyp B. Colon, sigmoid, 28cm from anal verge, colonoscopic biopsy: Hyperplastic polyp Pathologic finding

Diagnosis Crohn's disease c pelvic abscess