The peritoneum is one of the common extrapulmonary sites of tuberculosis infection. Patients with underlying end-stage renal or liver disease are frequently complicated by tuberculous peritonitis; however, the diagnosis of the tuberculous peritonitis is difficult due to its insidious nature, well as its variability in presentation and limitation of available diagnostic tests. Once diagnosed, the preferred treatment is usually antituberculous therapy in uncomplicated cases. However, surgical treatment may also be required for complicated cases, such as small bowel obstruction or perforation. An 85-year-old woman was referred our hospital for abdominal pain with ileus. Despite medical therapy, prolonged ileus and progression to sepsis were shown, she underwent surgery to confirm the diagnosis and relief of mechanical ileus. Intraoperative peritoneal biopsy and macroscopic findings confirmed tuberculous peritonitis. Therefore, physicians should consider the possibility of tuberculous peritonitis in patients with unexplained small bowel obstruction. (Korean J Gastroenterol 2017;69:308-311)

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ObjectivesSmall cell lung cancer is sensitive to chemotherapy and radiotherapy. Nevertheless, responses are still short-lived and apparent cure remains for only limited disease patients.MethodsWe combined cyclophosphamide (750mg/m2 by intravenous infusion at first day) vincristine (2mg intravenously at third day), cisplatin (20mg/m2 intravenously for 3 days), and etoposide (100mg/m2 intravenously for 3 days) with radiotherapy (total 300cGy over 4 weeks in 17 fractions) and treated 39 patients with small cell lung cancer who had received no prior systemic chemotherapy and radiotherapy.ResultsThirty-nine patients (limited disease: 17 patients, extensive disease 22 patients) were treated and 35 patients were evaluable for response. Overall response rate was 82.8% (complete response 28.6%, partial response 54.2%)The median survival was 52 weeks for all patients and 58 weeks for limited disease and 45 weeks for extensive disease. There was no statically significant survival difference between the two patient groups. The median relapse-free survival time was 48 weeks.Overall, treatment was well tolerated, with granulocytopenia being the most frequent toxicity.ConclusionsCombination chemotherapy with COPE regimen combined with radiation therapy was effective as a first line therapy for SCLC.

Gastroparesis is a syndrome characterized by delayed gastric emptying in the absence of mechanical obstruction of the stomach. Approximately 20∼40% of patients with a long course of diabetes mellitus and/or other complications, especially neurologic dysfunction, develop diabetic gastroparesis. Diabetic gastroparesis has been thoroughly investigated; however, few reports have considered an associated episodic cyclic vomiting pattern. We present a literature review and report the case of our recent experience with a 29-year-old male patient who presented with a cyclic vomiting pattern associated with diabetic gastroparesis.