• Title/Summary/Keyword: 상부위장관 내시경

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Clinical Study of Childhood Accidents from a Hospital Over Ten Years with Regard to Foreign Body Aspiration (단일병원에서 관찰한 최근 10년간의 소아 우발사고에 관한 연구 : 이물흡인을 중심으로)

  • Kim, Cheol-Min;Song, Jun-Young;Kim, Ja Hyung;Kim, Ki Soo;Hong, Soo-Jong
    • Clinical and Experimental Pediatrics
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    • v.45 no.9
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    • pp.1134-1140
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    • 2002
  • Purpose : Childhood accidents have been increasing recently. Accidents rank as the leading cause of childhood mortality and morbidity. We performed this study to evaluate the causes of childhood accidents. Methods : The authors analysed retrospectively the medical records of 6,410 cases of childhood accidental injuries who visited the emergency room of Asan Medical Center from January 1990 to December 1999. Results : The most common type of accidents was trauma which accounted for 5,038 cases of the total accidents, followed by falls, burns, foreign body aspiration, and poisoning. The most common age of foreign body aspiration was under two years old and the male to female ratio was 2 to 1. The most common site of foreign body aspiration was the esophagus and the stomach, followed by the respiratory tract. In airways, the right and left main bronchus were the most common site for foreign body aspiration and were accompanied by the highest mortality. The most common foreign body in the gastrointestinal tract and respiratory tract were coins and peanuts, respectively. Conclusion : The most common cause of accidents was trauma, followed by falls, burns, foreign body aspiration, and poisoning. The incidence of foreign body aspiration and poisoning is increasing in infants. In cases of foreign bodies in airways, proper management is needed because of the high mortality rate.

A Case of Gastric Anisakiasis with Recurrent Abdominal Pain in a Child (소아에서 반복성 복통을 동반한 위 아니사키스증 1례)

  • Kwon, Jae Hun;Uhm, Ji Hyun;Chung, Ki Sup
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.1
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    • pp.74-77
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    • 2004
  • Anisakiasis is a accidental parasitic infection caused by nematode larvae belonging to the subfamily Anisakinae when a raw or inadequately cooked fish is ingested. The common clinical symptoms are severe colicky abdominal pain or epigastric full sensation, nausea, vomiting and fever, but hematemesis or melena is very rare. We report a case of a 11-year-old female child who developed severe epigastric pain recurrently for 2 months, and recalled that she had eaten the raw flesh of an Astroconger myriaster. Endoscopic examination showed the whitish worm invading the stomach wall. Clinical symptoms disappeared after endoscopic removal. This study may be the first pediatric case of gastric anisakiasis in korea.

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Performance analysis of deep learning-based automatic classification of upper endoscopic images according to data construction (딥러닝 기반 상부위장관 내시경 이미지 자동분류의 데이터 구성별 성능 분석 연구)

  • Seo, Jeong Min;Lim, Sang Heon;Kim, Yung Jae;Chung, Jun Won;Kim, Kwang Gi
    • Journal of Korea Multimedia Society
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    • v.25 no.3
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    • pp.451-460
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    • 2022
  • Recently, several deep learning studies have been reported to automatically identify the location of diagnostic devices using endoscopic data. In previous studies, there was no design to determine whether the configuration of the dataset resulted in differences in the accuracy in which artificial intelligence models perform image classification. Studies that are based on large amounts of data are likely to have different results depending on the composition of the dataset or its proportion. In this study, we intended to determine the existence and extent of accuracy according to the composition of the dataset by compiling it into three main types using larynx, esophagus, gastroscopy, and laryngeal endoscopy images.

Endoscopic Management with Ethanol Injection in a Child with Gastric Dieulafoy Lesion (Dieulafoy 병변 소아의 내시경적 치료 1례)

  • Kim, Hyun-Jin;Shin, Jee-Seon;Seo, Jeong-Wan
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.6 no.2
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    • pp.187-191
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    • 2003
  • The Dieulafoy's lesion is a rare cause of recurrent massive gastrointestinal bleeding in children. The bleeding results from an abnormally large submucosal artery that protrudes through a small mucosal defect. The lesion is commonly found on proximal stomach. Surgical intervention was believed to be the best treatment in the past, but recent advancement in endoscopy has made effective hemostasis possible. We report a case of a 9-year-old boy with underlying mycoplasma pneumonia with effusion who presented with massive upper gastrointestinal bleeding. Bleeding was controlled with endoscopic treatment by epinephrine and ethanol injection and the patient was successfully treated.

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The Usefulness of Capsule Endoscopy in Diagnosis of Small Bowel Diseases (소장질환의 진단에 캡슐내시경 검사의 유용성)

  • Eun, Jong-Ryul;Jang, Byung-Ik
    • Journal of Yeungnam Medical Science
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    • v.23 no.1
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    • pp.45-51
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    • 2006
  • Background: This study was conducted to evaluate the usefulness of capsule endoscopy (CE) for the diagnosis of small bowel diseases. Materials and Methods: We reviewed the medical records of 66 patients (mean age: 52.1 years, male/female: 39/27), who underwent CE at Yeungnam University Hospital from August 2003 to March 2006. Results: Suspicious gastrointestinal (GI) bleeding presenting as anemia or history of gross bleeding was the most common reason to perform CE (71.2%). Other indications included GI symptoms (21.2%) such as abdominal pain/discomfort, nausea, diarrhea, and others (7.6%). In studies performed for GI bleeding (n=47), ulcer/erosion was the most common finding (n=22, 46.8%) followed by tumor (n=5, 10.6%), angiodysplasia (n=3, 6.4%), polyp (n=3, 6.4%), active bleeding (n=1, 2.1 %), ulcer with stenosis (n=1, 2.1%), and normal findings (n=12, 25.5%). Of these, a bleeding focus was detected in 32 cases (68.1%) undergoing CE studies. Among 14 patients with GI symptoms, only two patients had typical findings related with symptoms. Surgical resection was performed in five cases with tumor. Of these, four were diagnosed as gastrointestinal stromal tumor and the other one was a lymphangioma. There were no complications associated with the CE procedure. Conclusion: Capsule endoscopy is a safe, noninvasive diagnostic tool for small bowel diseases and may be useful for the diagnosis of small bowel hemorrhage including obscure bleeding. However, further studies are needed to confirm its utility for abdominal symptoms other than hemorrhage because of the low diagnostic yield.

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A Case of Adenomyoma of the Stomach in a Child Presenting Epigastric Pain (심와부 복통으로 내원한 5세 소아에서의 위 선근종 1례)

  • Heo, Mi-Young;Jung, Ji-A;Choi, Kum-Ja;Sung, Sun-Hee;Seo, Jeong-Wan
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.4 no.1
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    • pp.99-103
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    • 2001
  • Adenomyomas of the stomach are rare tumors characterised by duct/gland-like structures embedded within a smooth muscle stroma. A 5-year-old female patient was admitted to the department of Pediatrics, Ewha Womans University MokDong Hospital with the history of severe epigastric pain and vomiting for 1 day. Esophagogastroduodenoscopy showed bridging fold with central dimpling on posterior wall of prepyloric antrum. Endoscopic biopsy was nondiagnostic. The patient complained epigastric pain continuously and underwent wedge resection. Pathologic examination showed an adenomyoma of the prepyloric antrum. After wedge resection, the patient did not complain epigastric pain during the postoperative follow-up. We report an unusual case of an adenomyoma of stomach.

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Effect of One- or Two-Week Triple Therapy with Omeprazole, Amoxicillin, and Clarithromycin on Eradication of Helicobacter pylori Infection in Children (소아에서 Omeprazole, Amoxicillin, Clarithromycin 삼제 병합 요법의 치료기간별 Helicobacter pylori 제균율)

  • Choi, In-Kyoung;Lee, Seung-Yun;Chung, Ki-Sup
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.5 no.1
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    • pp.19-25
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    • 2002
  • Purpose: The triple therapy with proton pump inhibitor (PPI) has been recognized as the treatment of choice in Helicobacter pylori (H. pylori) infection in adults. However, the effect of triple therapy with omeprazole, amoxicillin and clarithromycin (OAC) on eradication of H. pylori infection in children has not been established yet. This study was performed to evaluate the efficacy of OAC triple therapy and to compare the effect of one-week with two-week therapy on H. pylori eradication. Methods: From July 1998 to July 2000, 34 children with upper gastrointestinal symptoms, who underwent upper gastrointestinal endoscopy with biopsy at entry and 4 or more weeks after therapy, were enrolled in this study. H. pylori infection was assessed by CLO test and histologic examination (Hematoxylin-Eosin stain or Alcian yellow stain) with biopsy specimens. The regimen consisted of omeprazole (0.7 mg/kg/day), amoxicillin (50 mg/kg/day), and clarithromycin (25 mg/kg/day) for 1 week (n=21) or 2 weeks (n=13). Eradication of H. pylori was determined after the termination of treatment by the CLO test and histologic examination. Results: One-week treatment group consisted of 21 children (11 male, 10 female) with a mean age of $9.5{\pm}3.0$ years. Two-week group consisted of 13 children (4 male, 9 female) with a mean age of $9.9{\pm}4.0$ years. The endoscopic diagnoses included nodular gastritis in 19 cases, superficial gastritis in 7 cases, gastric ulcer in 4 cases, purpuric duodenitis in 2 cases, and normal in 2 cases. H. pylori was eradicated in 28 of total 34 children (82.4%). In 1-week group, H. pylori was eradicated in 17 of 21 children (81%). In 2-week group, H. pylori was eradicated in 11 of 13 children (84.6%). In remaining 6 cases in whom H. pylori had not been eradicated with OAC regimen, H. pylori infection persisted despite of the treatment with additional drugs such as colloidal bismuth subcitrate ($Denol^{(R)}$) and metronidazole. Conclusion: In this study, eradication rate of H. pylori with OAC regimen was 82.4%, and the triple therapy would be highly effective as primary treatment. However, there was no significant difference in the eradication rate between the 1-week and 2-week treatment group (P=0.785).

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Clinical Features of Henoch-Schönlein Purpura Gastroenteropathy without Purpura before Diagnosis (진단 전에 자반이 동반되지 않았던 Henoch-Schönlein 자반 위장병증의 임상적 고찰)

  • Oh, Jae Min;Park, Jae Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.1
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    • pp.54-60
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    • 2004
  • Purpose: Henoch-$Sch{\ddot{o}}nlein$ purpura (HSP) is a small-vessel vasculitic disease that most often affects the skin. Abdominal symptoms precede the typical purpuric rash of HSP in 14~36%. It is a challenge to diagnose HSP in the absence of a rash, because there are no biologic tests that can identify HSP with certainty, so we tried to find out the characteristic features of HSP gastroenteropathy without purpura before diagnosis. Methods: This study included 82 children with HSP who had been admitted or visited outward of the Department of Pediatrics, Pusan National University Hospital from 1995 to 2000. The cases that the onset of purpura preceded or coincided that of abdominal pain were defined as purpura-positive group. The cases that the onset of abdominal pain preceded purpura more than 1 week and purpura was not presented till diagnosed as HSP gastroenteropathy were defined as purpura-negative group. We compared and analyzed the clinical features of the two groups by reviewing the medical records retrospectively. To ensure the diagnosis of HSP gastroenteropathy, we conducted upper GI series, abdominal ultrasonogram, abdominal CT, endoscopy and/or skin biopsy. Results: The number of cases of purpura-positive group and purpura-negative group were 72 and 10, respectively. There is no difference between two groups in the incidence of clinical symptoms and laboratory findings. Children with HSP gastroenteropathy had characteristic erosive or ulcerative lesions in the stomach or duodenum on esophagogastroduodenoscopy, or mural thickening of the small bowel on abdominal ultrasonogram, CT or upper GI series. Skin biopsy revealed leukocytoclastic vasculitis in 3 of them, although biopsy specimen was taken from any areas of normal- appearing skin. In purpura-negative group, 9 patients improved by steroid therapy. Conclusion: In purpura-negative group, there is no diagnostic feature on the laboratory findings and clinical features. Therefore, to diagnose HSP gastroenteropathy in patients with abdominal pain in the absence of the characteristic rash, careful observation of clinical features and laboratory data, and prompt application of available diagnostic tools such as gastrointestinal endoscopy, radiologic study and skin biopsy are recommended. Early use of corticosteroid may reduce the suffering in these patients.

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Gastroscopic Findings of Rural Residents with Symptoms of Chronic Gastrointestinal Disorder (만성(漫性) 위장장애증상(胃腸障碍症狀)을 가진 농촌주민(農村住民)들의 위내시경(胃內視鏡) 검사소견(檢査所見))

  • Park, Jung-Han;Chun, Byung-Yeol;Lee, Dong-Koo;Choi, Yong-Whan
    • Journal of Preventive Medicine and Public Health
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    • v.19 no.1 s.19
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    • pp.85-90
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    • 1986
  • This study was conducted in July-August, 1984, to define the causes of chronic gastrointestinal symptoms in rural population and to provide data for the management of such patients. A household survey was conducted to identify all the residents of Youngchun and Sungiu counties in Kyungpook province who were over 20 years of age, had chronic upper gastrointestinal symptoms for over the last 6 months, never had medical examination for the symptoms, and volunteered to participate in the gastroscopic examination. Gastroscopy was done for 106 males and 108 females. Gastric ulcer was found in 16.8% of all the examinees, duodenal ulcer in 15.4%, gastritis in 14.0%, and gastric cancer in 3.7%. No lesion was found by gastroscopy in 52.3%. Gastric ulcer more common in male(26.4%) than in female(7.4%) (p<0.01) and the same was true for duodenal ulcer(20.8% of male, 10.2% of female). Gastric cancer was found in 7.5% of the male while none of the female had gastric cancer. A higher proportion of the female (68.5%) showed normal finding in the gastroscopy than the male(35.9%) (p<0.01). No significant association was found between the upper gastrointestinal symptoms and the gastroscopic findings. The higher prevalence rate of gastric ulcer than that of duodenal ulcer in this study which is the reverse of the study findings of urban area in Korea and western countries may be related in part with the dietary habit and social environment of the rural population. Although early diagnosis is the most important for the treatment of gastric cancer, many of the people with chronic upper gastrointestinal complaints defer the diagnosis and treatment. It is may be due to lack of the knowledge of diseases and the health care attitude of the rural people. A national program for the health education and mass screening for the gastric cancer should be developed.

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The Effect of Behavioral Relaxation Training on Distress and Cancer Screening Intention of Patients with Upper Gastrointestinal Endoscopy (행동이완훈련이 비진정 상부위장관 내시경검사자의 불편감과 수검의도에 미치는 효과)

  • Nam, Hyo Yeon;Shim, Hyung Wha
    • The Journal of Korean Academic Society of Nursing Education
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    • v.25 no.4
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    • pp.414-423
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    • 2019
  • Purpose: This study evaluates the effect of behavioral relaxation training on distress and cancer screening intention of patients with upper gastrointestinal endoscopy. Methods: The research was conducted in a non-equivalent control group posttest design. Data were collected from endoscopy subjects in B city from October to November of 2018. Fifteen minutes of behavioral relaxation training were provided to the experimental group (n=40) and traditional relaxation therapy methods were provided to the control group (n=40). Outcome measures were distress and cancer screening intention of patients with upper gastrointestinal endoscopy. Data were analyzed with a ${\chi}^2$-test, independent t-test, Fisher's exact test with SPSS/PC version 23.0. Results: The objective discomfort (t=8.81, p<.001) of the experimental group was lower than that of the control group; there were no significant differences in the subjective discomfort (t=1.73, p=.088). The cancer screening intention (t=-5.85, p<.001) of the experimental group was significantly higher than that of the control group. Conclusion: Behavioral relaxation training was effective in heightening cancer screening intention. Therefore it can be usefully applied to increase cancer screening intention.