• Title/Summary/Keyword: 급성 췌장염

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Colonic Complication of Acute Necrotizing Pancreatitis - a Case Report - (급성 괴사성 췌장염에서 발생한 결장 합병증 -1 예 보고-)

  • Sohn, Bo-Sung;Jung, Jae-Hee;Song, Young-Tack
    • Advances in pediatric surgery
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    • v.9 no.2
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    • pp.113-116
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    • 2003
  • We present a case of a colonic involvement associated with necrotizing pancreatitis, with a review of the literature. A 10 year old boy had an appendectomy at the local clinic ten days ago. On admission, he complained nausea, vomiting and severe constipation. His abdomen was distended and he had tenderness on the left abdomen. Laboratory and radiologic studies revealed findings consistent with acute pancreatitis with colonic complication. He was treated conservatively for 30 days but did not improve. On hospital 30th day, abdominal pain developed and his vital sign changed. Abdominal CT suggested ischemic change of the transverse colon. At laparotomy, the left colon showed stenosis. The greatly distended transverse colon was resected and a transverse end colostomy was done. He was discharged at postoperative 45th day with improvement and colostomy closure was performed 8 months later.

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Primary Hyperparathyroidism Presenting as Acute Pancreatitis (급성 췌장염으로 발현된 일차성 부갑상선 기능항진증 1예)

  • Kim Sung-Do;Chang Hang-Seok;Chung Woung-Yoon;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.15 no.1
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    • pp.76-79
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    • 1999
  • The relationship between acute pancreatitis and hyperparathyroidism has been described extensively in the past. Despite the rarity, the clinical progression of pancreatitis associated with hyperparathyroidism has been known to be so rapid and severe that it may cause death. When, furthermore, the pancreatitis is caused by hyperparathyroidism, the recovery from disease can be hardly expected unless the hyperparathyroidism is corrected. We present a case of acute pancreatitis in a 68-year-old man that have been caused by primary hyperparathyroidism. The clues of hyperparathyrodism were hypercalcemia and elevated parathyroid hormone, but he showed subtle or negative symptoms of hypercalcemia. After the excision of parathyroid adenoma, serum calcium level returned to normal and the symptoms and function of pancreas were recovered.

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A Case of Acute Pancreatitis Complicated with Allergic Purpura (Allergic Purpura에 합병된 Acute Pancreatitis 1례)

  • Lee, Sung-Chul;Kim, Hwa-Ja;Tchah, Hann;Park, Ho-Jin
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.2 no.1
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    • pp.116-122
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    • 1999
  • Allergic (Henoch-Schonlein) purpura is a nonthrombocytopenic purpura that affects small nonmuscular vessels with involvement of skin, gastrointestinal tract, joint, and kidney. Pancreatitis has rarely been reported as a complication of H-S purpura. In 1965, hemorrhagic pancreatitis as a complication of H-S purpura was reported by Toskin. We experienced one case of pancreatitis complicated with H-S purpura: pancreatic head enlargement was noted in small bowel series and abdominal sonogram with increased serum amylase level (160 U/dL) in a 6-year-old female child who complained of abdominal pain, vomiting, bloody stool, and petechiae on lower extremities.

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Clinical Practice Guidelines for Acute Pancreatitis (급성 췌장염 진료 권고안)

  • Koh, Dong Hee
    • The Korean Journal of Gastroenterology
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    • v.72 no.6
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    • pp.281-285
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    • 2018
  • Acute pancreatitis is a common gastrointestinal disease that is associated with significant morbidity and consumes enormous health care resources. As such, it requires up-to-date evidence-based diagnosis and standard treatment guidelines with broad support from the clinician. Korean Pancreatobiliary Association has developed clinical practice guidelines for the diagnosis and treatment of acute pancreatitis to provide a framework for clinicians to manage acute pancreatitis and to improve national health care. The guidelines were divided into four parts: the diagnosis of acute pancreatitis, the assessment of the severity, the initial management, and the treatment of necrotizing pancreatitis and local complications of acute pancreatitis. In this article, we summarize and present the diagnosis and treatment guidelines for acute pancreatitis established in Korea.

Macroamylasemia in a 4-year-old girl with abdominal pain (복통을 주소로 내원한 4세 여아에서 진단된 마크로아밀라제혈증 1예)

  • Ko, Jeong Hee;Lee, Dae Hyoung
    • Clinical and Experimental Pediatrics
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    • v.52 no.11
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    • pp.1283-1285
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    • 2009
  • Macroamylasemia is a benign condition characterized by abnormally large-sized serum amylase; it has been reported to occur in 1-2% of the population. In macroamylasemia, a macromolecular complex consisting of amylase linked to immunoglobulins circulates in the plasma and usually causes hyperamylasemia with low or normal amylasuria. Macroamylasemia is extremely rare in children. We report a case of a 4-year-old girl with abdominal pain and macroamylasemia, who was initially misdiagnosed as having acute pancreatitis. Failure to immediately identify macroamylase as the cause of the unexplained but benign hyperamylasemia can lead to the misdiagnosis of the condition, necessitating costly analyses for ruling out pancreatic disease and unnecessary prescriptions such as fasting and intravenous replacement therapies, as was observed in our patient.

Study on clinico-pathological and ultrasonographic changes for experimental induced-acute pancreatitis in dogs (개에서 실험적으로 유발시킨 급성 췌장염에 있어서 혈액화학치와 췌장의 초음파학적 변화)

  • Yun, Young-min;Park, Su-jin;Yoon, Jung-hee;Youn, Hwa-young;Choi, Hee-in
    • Korean Journal of Veterinary Research
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    • v.38 no.2
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    • pp.423-435
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    • 1998
  • In acute pancreatitis group, all the dogs are showed increase of amylase and lipase after the 1st day of surgery, and amylase and lipase activity were significantly more increased than those of control group. The methemalbumin was increased significantly after the 2nd day of surgery in the acute pancreatitis group. In pancreatitis group, ultrasonographic findings included thickened duodenal wall and poorly circumscribed hyperechoic lesion of pancreatic mass after the 2nd day of surgery. And the lesion was exacerbated until the 4th day and reduced after the 6th day of surgery. To identify the lesion of pancreas, it is considered that transverse view is more useful Than sagittal view. Gross findings showed increase of pancreatic parenchymal consistency, surface nodule, and extensive pancreatic necrosis. Necrosis of peripancreatic fat tissue was also a prominent feature. The microscopic appearance of the pancreas was characterized by pancreatic acinar cell necrosis, hemorrhage, infiltration of the inflammatory cell and fat necrosis and saponification were also observed.

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Transcholecystic Duodenal Drainage as an Alternative Decompression Method for Afferent Loop Syndrome: Two Case Reports (들장관증후군의 대체 감압 치료로서 경담낭 십이지장 배액술: 두 건의 증례 보고)

  • Jihoon Hong;Gab Chul Kim;Jung Guen Cha;Jongmin Park;Byunggeon Park;Seo Young Park;Sang Un Kim
    • Journal of the Korean Society of Radiology
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    • v.85 no.3
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    • pp.661-667
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    • 2024
  • Afferent loop syndrome (ALS) is a rare complication of gastrectomies and gastrointestinal reconstruction. This can predispose patients to fatal conditions, such as cholangitis, pancreatitis, and duodenal perforation with peritonitis. Therefore, emergency decompression is necessary to prevent these complications. Herein, we report two cases in which transcholecystic duodenal drainage, an alternative decompression treatment, was performed in ALS patients without bile duct dilatation. Two patients who underwent distal gastrectomy with Billroth II anastomosis sought consultation in an emergency department for epigastric pain and vomiting. On CT, ALS with acute pancreatitis was diagnosed. However, biliary access could not be achieved because of the absence of bile duct dilatation. To overcome this problem, a duodenal drainage catheter was placed to decompress the afferent loop after traversing the cystic duct via a transcholecystic approach. The patients were discharged without additional surgical treatment 2 weeks and 1 month after drainage.

Usefulness of Ultrasonographic Examination by a Pediatrician in Children with Abdominal Pain (소아 복통에서 소아과 의사에 의한 초음파 검사의 유용성)

  • Park, Hyun-Seok;We, Ju-Hee;Park, Jae-Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.14 no.2
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    • pp.141-147
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    • 2011
  • Purpose: Ultrasonography (US) is widely used as a screening test in patients with abdominal pain (AP). We investigated the usefulness of US by a pediatrician in children with AP. Methods: We retrospectively analysed the medical records of children with AP who undertook US from December, 2008 to July, 2010. Results: A total of 628 patients (325 male, 303 female) were enrolled in this study. The mean age of patients was $8.08{\pm}4.61$ years. Duration of AP was acute in 427 and chronic in 201 patients. Localization of AP was diffuse (36.9%), periumbilical (24.4%), epigastric (21.0%), and right lower quadrant (8.1%). On the examination, there were no abnormal findings in 327 patients (52.1%). Abnormal ultrasonographic findings were mesenteric lymphadenitis (27.1%), intestinal mural thickening (10.0%), intussusception (3.0%), appendicitis (2.6%), choledochal cyst (1.6%), and pancreatitis (0.3%). We performed additional imaging studies such as computed tomography (CT) or magnetic resonance imaging (MRI) in 39 patients who showed obscure findings on the US. In 33 patients (84.6%), the same results were obtained from CT or MRI. Two cases of appendicitis, one case of pancreatitis and one case of Henoch-Sh$\ddot{o}$nlein purpura were diagnosed by the CT examination. However, there were two cases of appendicitis diagnosed by US thathad no evidence of appendicitis on the CT. Diagnostic accuracy of initial US in children with abdominal pain was 99.4%. Conclusion: US by a pediatrician as a screening test in children with AP provides a rapid and accurate diagnostic indication and has non-invasive and radiation-free advantages.

Mumps meningoencephalitis without parotitis, after secondary vaccination of Measles-Mumps-Rubella (MMR) : A Case Report (MMR 2차 예방접종을 받은 후 이하선염 없이 발생한 볼거리 뇌염 1례)

  • Choi, Pahn Kyu;Kang, Hyun Goo
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.9
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    • pp.123-126
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    • 2017
  • Mumps, which are also known as epidemic parotitis,lead to viral infectious diseases that can cause complication such as pancreatitis, orchitis, hearing impairments, oophoritis, parotitis and meningitis. Central nervous system involvement has been reported in up to 65% of mumps patients, with most of these including meningitis. Meningoencephalitis is a rare central nervous system (CNS) complication of the mumps. Measles-Mumps-Rubella (MMR) vaccination has been reported protective effect against clinical complications and hospitalization. Here, we describe acute mumps meningoencephalitis in a 24-year-old female without parotitis who had received the MMR vaccination by age related schedule. She initially visited our hospital with aggravated cognition and confusion. After conservative viral treatment, she recovered cognitive function rapidly and complication was not remained. We report here a case of a patient with good recovery of mumps meningoencephalitis without parotitis after secondary vaccination for MMR.

The Comparison Between Single And Yimyosan in Acute Pancreatitis : Atractylodes chinensis(AC) and Phellodendron amurense Ruprecht(PAR) (이묘산(二妙散)과 구성약재(構成藥材)의 효능(效能) 비교(급성(急性) 췌장염(膵臟炎)을 중심으로))

  • Lim, Young-Hwan;Kook, Yoon-Bum
    • Herbal Formula Science
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    • v.19 no.2
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    • pp.23-38
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    • 2011
  • Objectives : Atractylodes chinensis(AC) and Phellodendron amurense Ruprecht(PAR) have been used as anti-inflammatory medicines. However, the effects of AC, PAR and Yimyosan on AP were not examined. To prove this, We decocted the dried prescription of AC and PAR with boiling distilled water and freeze-dried to be powdered. AC, PAR and Yimyosan was administrated intraperitoneally. Methods : 1h after administration, cerulein was injected hourly six times. 6hrs after last cerulein injection, mice were sacrificed, then the pancreas and blood were harvested. Serum amylase and lipase, neutrophil infiltration, pancreatic cytokines were used as the parameter of severity of AP. Results : As a result of assessment the parameters of AP, AC alone treatment did not inhibit the severity of AP, however PAR treatment inhibited the severity of AP significantly. Yimyosan also showed the protective effects against AP at lower doses, however AC alone plus PAR alone extract did not show the protective effects significantly. Conclusions : In conclusion, PAR extract has a protective effects on AP, and the effects could be increased by co-treatment with AC.