KEY WORDS: intussusception; sigmoid lipoma; mimicking carcinoma.Colonic lipomas are the most common nonepithelial tumor, and they are the third most common tumor, after hyperplastic and adenomatous polyps (1). The majority of colonic lipomas are small and asymptomatic (2). Large lesions may be significant because of their related symptoms, and especially, intussuscepted colonic lipomas are often confused with malignant tumors, so that most of them are diagnosed after intervention (3). We present a case of an intussuscepted lipoma mimicking a malignant tumor in a 62-year-old man. Intussuscepted colonic lipoma is uncommon, and a right-side intussuscepted colonic lipoma is especially rare. The malignant transformation of lipoma is extremely rare, and recurrent lipoma has never been reported. Nonetheless, operative or endoscopic intervention may be required to differentiate this lesion from a malignant or premalignant lesion. This case is very unique in the aspects of the lipoma's shape and size and the location in which it was found. CASE REPORTA 62-year-old man was admitted to the hospital because of left lower quadrant abdominal pain that had lasted for 1 month, with intermittent hematochezia. The patient said he did not have any fever or weight loss. Upon physical examination, he had pale conjunctiva, and there was left lower quadrant tenderness without rebound tenderness. There was also a relatively highpitched sound on abdominal examination. The rectal examination showed dark blood-tinged stool. The other findings from the physical examination were normal. The results of laboratory investigation, including the level of carcinoembrionic anti-

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.

Background/Aims: Cystic lymphangioma is an uncommon disease, and rarely develops in the intraabdomen. The aim of this article was to discuss about clinical characteristics of intraabdominal cystic lymphangioma developed in Korea. Methods: Age, sex, symptoms, locations and size of the lesions, diagnostic methods, treatments, complications and recurrence were analyzed in 13 pathologically confirmed cases of intraabdominal cystic lymphangioma and 18 cases of literature consideration reported in Korea. Results: Intraabdominal cystic lymphangioma commonly developed in adults compared to the other lymphangioma, and frequently located in the mesentery. Abdominal pain was the most common symptom, but it was a non-specific finding. Tenderness and abdominal mass were not significantly associated. The size of mass was diverse. Abdominal ultrasonography and abdominal CT were diagnostic tools most commonly used, but preoperative diagnosis was possible only in 22.6%. All patients were discharged without any complications, and no recurrence was reported. Conclusions: Preoperative diagnosis of intraabdominal cystic lymphangioma is difficult and symptoms and signs are not specific. Intraabdominal cystic lymphangioma should be suspected in patients with non specific abdominal pain and intraabdominal mass and active diagnostic evaluation is mandatory. (Korean J Gastroenterol 2010;56:353-358)

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.

We present the case of a liver abscess that formed secondary to foreign bodies and formed a fistula the ascending colon and was successfully treated with percutaneous abscess drainage and colonoscopic removal of foreign bodies. A 64-year-old man presented with right upper and lower quadrant pain of 2 weeks' duration. Abdominal computed tomography was performed, demonstrating a single 3.5 x 1.9-cm abscess of the liver's right lobe and eccentric thickening of the colon wall at hepatic flexure. A percutaneous hepatic drainage catheter was placed under ultrasound guidance. Colonoscopic examination revealed multiple diverticula of the ascending colon and two 1.5-cm long fish bones at the ascending colon near the hepatic flexure. One end of each fish bone had impacted the edematous colonic mucosa and was surrounded by exudate polypoid inflammatory tissue. The fish bones were extracted with forceps. The patient was feeling well and was discharged after 12 days of treatment.