Cat-scratch disease (CSD) is a bacterial infection which primarily transmitted to humans through scratches, bites, or licks from infected cats. Even though CSD is generally a mild condition, atypical symptoms may appear and must be distinguished from other diseases. We encountered a 57-year-old woman who presented with intermittent pain in the right upper quadrant and epigastric part of the abdomen, and had lost 11 kg within a few months. She never had a cat and did not recall being scratched by a cat. Radiologic examinations strongly suggest a malignant bile duct tumor, thus liver resection was done. However, the result of histopathology was a CSD. At follow-up, the patient was stable and also showed improvement in her general condition. Hence, proper preoperative examinations of the patients are crucial in order to avoid excessive or inadequate treatment.

수술이 불가능한 담관암에서 담관 내 고주파 열치료는 악성 담관 폐쇄를 호전시키는 실용적인 치료로 보고되고 있으나, 내시경적 역행성 담췌관조영술을 이용한 고주파 열치료는 투시조영을 통해 열을 적용하는 방법으로, 병변을 직접 시각화하지 못하는 단점이 있다. 반면에, 직접 경구 담관 내시경하 담관 내 고주파 열치료는 담관 내 병변을 시각화함으 로써 카테터의 삽입 등에 용이하며 시술로 인한 합병증을 감 소시킬 수 있을 것으로 기대되고 있다. 본 증례에서는 총담 관십이지장문합술을 시행 받은 담관암 환자에서 직접 경구 담관 내시경하 담관 내 고주파 열치료를 적용하여서 스텐트 시술 없이 담관 개존을 보존한 첫 번째 사례로서 직접 경구 담관 내시경하 담관 내 고주파 열치료의 효용성을 문헌 고찰과 함께 보고하는 바이다.

Actinomycosis is a rare disease caused by the Gram-positive anaerobic filamentous bacterium, Actinomyces israelii. Due to its unusual clinical presentation, it is mainly diagnosed postoperatively. The risk of the disease increases with the use of intrauterine contraception device (IUD). A 46-year-old female was admitted to the hospital due to diffuse lower abdominal pain and had used an IUD until two weeks ago. Findings on abdominal computed tomography showed a large mass measuring approximately 9 cm, which was suspected of urachal cancer or omental sarcoma. After wide surgical resection, pathologic finding showed severe inflammation with sulfur granule, confirming abdominal actinomycosis.