• Title/Summary/Keyword: 내시경 검사

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Recurrent Acute Pancreatitis Associated with Sphincter of Oddi Dysfunction in a Child (오디 괄약근 기능 이상으로 인한 소아의 재발 급성 췌장염 1예)

  • Choi, Byung-Ho;Park, Sun-Min;Kim, Ho-Gak;Kim, Jung-Mi;Hong, Suk-Jin;Kim, Jung-Ok;Cho, Min-Hyun;Choe, Byung-Ho
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.11 no.2
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    • pp.193-197
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    • 2008
  • Recent studies suggest that sphincter of Oddi dysfunction (SOD) is one of the possible causes of unexplained recurrent acute pancreatitis in children. A 14-year-old boy who had suffered from idiopathic recurrent acute pancreatitis was diagnosed with SOD. Abdominal ultrasonography, computerized tomography, and magnetic resonance cholangiopancreatography revealed no evidence of stone, tumor, or pancreatic ductal anomaly. Endoscopic retrograde cholangiopancreatography (ERCP) and sphincter of Oddi manometry (SOM) revealed elevated basal pressure and tachyoddia consistent with SOD. Hence, an endoscopic pancreatic sphincterotomy was performed. We report a case of recurrent acute pancreatitis associated with SOD in a child. ERCP and SOM may be considered in patients with multiple unexplained attacks of pancreatic pain and negative abdominal imaging.

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A Case of Massive Hemoptysis due to Dieulafoy's Disease of the Bronchus (기관지 Dieulafoy 질환에 의한 대량 객혈 1예)

  • Kang, Yeh Rim;Lee, Jung Woo;Jeon, Hee Jung;Lee, Shin Yeop;Cha, Seung Ick;Park, Tae Ihn;Park, Jae Yong;Jung, Tae Hoon;Kim, Chang Ho
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.1
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    • pp.58-61
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    • 2009
  • Dieulafoy's disease of the bronchus is rare but potentially life-threatening, and should be considered in patients with massive hemoptysis, especially from unknown etiology. We report a case of a patient with massive hemoptysis due to bronchial Dieulafoy's disease. He underwent bronchial artery embolization and surgical resection, and the post-operative specimen revealed dilated and tortuous arteries in the submucosa that presented as Dieulafoy's disease of the bronchus.

Excision of Malignant Gastrointestinal Stromal Tumor of Distal Esophagus and Stomach using Thoracoabdominal Incision (흉복부 절개를 이용한 식도와 위에 발생한 거대 악성 위장관 간질 종양의 절제)

  • Hwang Jin Wook;Son Ho Sung;Jo Jong Ho;Park Sung Min;Lee Song Am;Sun Kyung;Kim Kwang Taik
    • Journal of Chest Surgery
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    • v.38 no.7 s.252
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    • pp.514-517
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    • 2005
  • Gastrointestinal stromal tumor is documented on every part of the gastrointestinal tract. It develops in the stomach and the small intestine most commonly, and also in the esophagus. A 44 year-old male patient was admitted due to dysphagia and weight loss. Chest CT showed about $15\times11\times11cm$ sized, well-defined, and lobulated soft tissue mass with central necrosis was noted in the posterior wall of lower esophagus throughout the lesser curvature of upper stomach. We performed the distal esophagectomy and total gastrectomy using thoracoabdominal incision. The tumor was positive at CD117 (c-kit) and CD 34, and was diagnosed as malignant GIST of the distal esophagus and upper stomach. The patient is on routine follow up at the out patient department for nineteen months up to now.

A Case of Trichosporon beigelii Esophagitis Presenting Hematemesis with a Large Amorphous Material (토혈과 원통 모양의 토물을 주소로 내원한 Trichosporon beigelii 식도염 1례)

  • Park, Eun-Jung;Hwang, Jin-Bok;Ahn, Wook-Su;Jun, Chang-Ho;Kim, Yong-Jin
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.2 no.1
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    • pp.74-79
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    • 1999
  • We experienced a case of Trichosporon beigelii esophagitis in a 16-month-old boy who was presented with hematemesis with a large amorphous material. A spit-out material was silky, $10{\times}1.2\;cm$ in size and like a part of hollow viscus organ. Emergent gastrofiberscopy revealed that this silky material was teared up from upper and to lower esophagus and was threw with hematemesis. It was suggested that pseudomembrane on esophagus was peeled off followed by mucosal bleeding. Pathologic study revealed this material was pseudomembrane with esophageal mucosa of T. beigelii esophagitis and was teared at lamina propria level from submucosa.

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식도 천공의 외과적 치료

  • 이재익
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 2003.09a
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    • pp.108-108
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    • 2003
  • 식도 천공의 치료는 최근 치료법의 발전에도 불구하고 여전히 난해한 문제이다. 이 환자들은 천공의 원인이나 위치, 심한 정도가 다양한 이질적인 군이며, 반수 이상이 이미 식도에 기존의 질환을 가지고 있어 문제를 더욱 복잡하게 한다. 따라서 절대적이고 획일적인 치료방법은 아직 확립되어 있지 않으며 많은 다양한 방법들이 제시되고 있다. 2002년 11월부터 2003년 7월까지 총 8명의 환자가 식도 천공으로 동아대학교병원 흥부외과에서 치료를 받았으며, 원인별로는 의인성(iatrogenic) 손상이 6례, 자발성(spontaneous) 손상이 2례였고 부위별로는 경부가 3례, 흥부가 5례였다. 의인성 손상에는 내시경 검사중 정상 경부 식도에 발생한 1례, 부식성 식도협착 환자의 풍선 확장술과 스텐트 삽입시 흉부 식도에 발생한 경우가 각각 1례씩, 외상성 경추손상의 수술시 정상 경부 식도에 발생한 경우가 2례, 선천성 식도폐쇄증(esophageal atresia)의 술후 문합부 누출이 생긴 경우가 1례 있었으며, 자발성 손상에는 하부식도에 발생한 기압성(barogenic) 손상 1례와 상흉부 식도암 천공 1례가 있었다. 경부 식도 천공 3례는 모두 경부 배액(drainage)과 식이용 장루술(feeding jejunostomy)을 시행하였고, 부식성 식도협착이 있던 환자 2례는 식도절제술과 흉부내 식도-위 문합을 시행하였으며, Boerhaave씨 증후군 환자는 1차 봉합술, 술후 문합부 유출이 있었던 환자와 식도암 천공이 있었던 환자는 식도절제 및 경부 식도루(esophagostomy), 배액용 위루(gastrostomy), 식이용 장루술을 시행하였다. 모든 환자는 패혈증 등의 심각한 합병증으로의 진행 없이 회복되었다. 현재 위장관의 연속성이 유지 혹은 복원된 환자는 경구식이 중이며 그 외의 환자들은 장루를 통해 영양을 공급하며 식도재건술을 기다리고 있다. 식도 천공은 최근 항생제의 사용, 과영양요법(hyperalimentation), 술후 환자관리의 개선 등으로 치료에 많은 발전이 있었으나, 치료 방침에 있어서는 여전히 논란이 있으며 높은 사망률을 보이는 난제로 남아있다. 비록 일반적인 지침이 도움이 되겠지만, 치료 방침은 환자 개개인의 상황에 따라 적절하게 선택해야 하며, 임상경과에 따라 언제라도 방침을 변경할 수 있는 유연함이 필요하리라 생각한다.

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Endoscopic Ultrasound-Guided Fine Needle Aspiration Cytology in the Diagnosis of a Gastrointestinal Stromal Tumor of the Stomach -A Case Report - (내시경 초음파 유도하에 세침흡인 세포검사로 진단한 위의 위장관 기질 종앙 1예 보고)

  • Kim, Lucia;Kim, Hyung-Gil;Chu, Young-Chae;Park, In-Suh;Choi, Suk-Jin;Han, Jee-Young;Kim, Sun-Hee;Lee, Don-Haeng;Kim, Joon-Mee
    • The Korean Journal of Cytopathology
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    • v.19 no.2
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    • pp.178-182
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    • 2008
  • We report here a case of a gastrointestinal stromal tumor (GIST) in the stomach that was diagnosed by endoscopic ultrasound-guided fine needle aspiration cytology (EUS-FNA). A 67 year old male patient underwent regular check-ups for five years due to the presence of a submucosal tumor that was found in the fundus of the stomach incidentally. EUS-FNA was performed to evaluate the tumor, which had increased in size from 1 cm to 2.8cm. A cytologic smear revealed cohesive sheets or clusters of spindle cells with elongated nuclei. Immunohistochemical staining revealed a strong positive reaction for c-kit and CD34, without any reaction for smooth muscle actin and Ki-67. Therefore, a diagnosis of GIST was made.

Knowledge, Attitudes and Practices in Health Care Professionals and Awareness in the Public toward Propofol (프로포폴에 대한 의료인의 지식, 태도, 실천 및 일반인의 인식정도)

  • Ryoo, Eon-Na;Ha, Eun-Ho;Cho, Jin-Young
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.1
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    • pp.275-284
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    • 2013
  • With the propofol-induced accident such as adverse effects, abuse, death is becoming to the fore as a social issue, there is an increasingly loud call for self-examination about excessive propofol use. The purpose of this study was to identify the knowledge, attitudes and practices in health care professionals and awareness in the public toward propofol. Participants in this study were 359 health care professionals, and 682 publics who is going to undergo endoscopy. The collected data was analyzed using t-test, ANOVA, Scheffe for knowledge, attitude, and practice toward propofol in health care professionals, Pearson Correlation for its correlation. and frequencies, %, mean for others. Scores of knowledge, attitudes, and practices were 7.16 (11), 3.26 (5), 3.95 (5) respectively. Nurses' attitudes toward propofol was much more higher than doctors', doctors' practice toward propofol was higher than nurses'. There was a correlation among knowledge, attitudes, and practices toward propofol. 53.4% of the publics answered that never heard what is propofol. Considering these results, regular customized and standardized-education strategies for both groups need to be developed for the purpose of proper use and management of propofol.

Granular Cell Tumor Arising from the Left Main Bronchus - A case report- (좌측 주기관지에서 발생한 과립 세포종 -1예 보고-)

  • Sea Yeon Ho;Kim Kyung Hwa;Kim Nan Yeol;Kuh Ja Hong
    • Journal of Chest Surgery
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    • v.39 no.3 s.260
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    • pp.244-247
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    • 2006
  • Granular cell tumors (GCT) are uncommon benign neoplasms. Their location is mostly in the the skin, tongue, and breast; appearance in other parts of the body is rare, but it has been reported. They have also been reported to occur synchronously in multiple organs and metachronously in a single organ. The incidence of GCTs in the tracheobronchial tree is unknown and pulmonary GCTs are uncommon, with approximately 100 reported cases in the literature. We present the case of a 33-year-old man with a granular cell tumor of the left main bronchus. The tumor was found at bronchoscopy performed to exclude suspected endobronchial mass with symptoms of pneumonia. Biopsies revealed the histological pattern of a benign granular cell tumor. He underwent resection of the left main bronchus followed by end to end anastomosis of left main bronchus. He has not had any recurrence of the tumor during the 1 year follow-up.

Broncholithiasis Caused by Actinomycosis (방선균에 의해 발생된 기관지 결석증)

  • Park, Jeong-Ok;Park, Seong-Sik;Kim, Sam-Hyun;Seo, Pil-Won;Ryu, Jae-Wook
    • Journal of Chest Surgery
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    • v.39 no.3 s.260
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    • pp.236-239
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    • 2006
  • A 32 year-old man was transferred to our hospital due to blood-tinged sputum for 15 days. He had been treated at a private hospital for recurrent pneumonia. The chest X-ray showed an atelectasis on the right middle lobe. Computed tomography of the chest demonstrated a broncholith on right middle lobar bronchus with lobar atelectasis of the right middle lobe. We tried to remove the broncholith through fiberoptic bronchoscopy, but could not remove it. Therefore, we performed surgical removal of broncholith and the right middle lobectomy. The cause of broncholith was identified as actinomycosis by pathologic examination. The broncholith caused by actinomycosis is rare. We report a rare case of broncholithiasis with recurrent obstructive pneumonia caused by actinomycosis, which was treated by surgical operation.

A Case Report: A Rare Case of Extraocular Sebaceous Carcinoma on the Chin in 22-Year-old Asian Young Man (증례보고: 22세의 젊은 아시아인의 턱에서 진단된 안구외부위 피지샘암종의 진단 1례)

  • Hong, Joon Shik;Shin, HeaKyeong;Jung, Gyu Yong;Lee, Joon Ho
    • Korean Journal of Head & Neck Oncology
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    • v.37 no.1
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    • pp.53-56
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    • 2021
  • Sebaceous carcinoma (SC) is a rare malignant tumor, with an estimated incidence of approximately 1 to 2 per 1,000,000 per year. Approximately 75% of SCs are reported to occur in eyelids. Most of these tumors are diagnosed at age 40 or over and exhibit a wide variety of patterns in addition to the general appearance previously reported. SC is difficult to diagnose clinically, but can be diagnosed by accompanying biopsy. In cases of SC, additional examinations, such as endoscopy and computed tomography, may be necessary because of its association with Muir-Torre Syndrome. We present the case of a 22-year-old Asian man who complained of a rapidly growing chin tumor. The tumor was treated by surgical resection and adjuvant radiation therapy.