• Title/Summary/Keyword: 위장관 질환

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Endoscopic Findings of Upper GI Bleedings in Full Term Newborn Infants (만삭아에서 발생한 상부 위장관 출혈의 내시경적 진단과 치료)

  • Rhim, Suk-Ho;Lee, Hye-Kyung;Min, Yong-Sik;Kim, Han-Jin;Kim, Young-Chang
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.4 no.2
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    • pp.142-147
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    • 2001
  • Purpose: We are going to establish the efficacy of endoscopic examinations in diagnosing and treating upper GI bleeding in full term neonates. Methods: We retrospectively reviewed newborns who underwent endoscopic examination because of hematemesis from July 1998 to April 2001. Results: Gestational ages were between 38 and 41weeks, and birth weights were between 2,730 and 3,400 gm. Total of 9 patients were reviewed. Endoscopic examination revealed gastric ulcer in 6 cases, multiple erosions in 2 cases and negative finding in 1 case. All 6 gastric ulcers were multiple and among them 2 patients endoscopic hemostatic therapy. No complication due to the procedure was noticed. Five patients recieved transfusions. All 9 cases were cured through conservative and endoscopic therapy without recurrence. Conclusion: The common cause of upper GI hemorrhage in newborns with no preceding disease turns out to be multiple gastric ulcers and the prognosis is good. The endoscopic approach is useful in diagnosing and treating upper GI bleeding in newborns.

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ESOPHAGEAL FOREIGN BODY REMOVAL WITH FIBEROPTIC ESOPHAGOSCOPY (식도이물의 굴곡형 내시경을 이용한 치료)

  • 박수헌
    • Korean Journal of Bronchoesophagology
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    • v.2 no.2
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    • pp.182-193
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    • 1996
  • 식도내 이물은 종종 어린이나 식도질환을 가진 환자, 죄수들, 정신박약자 및 정신질환자등의 위험성이 높은 성인에서 흔히 발생한다. 그러나 대부분의 이물은 저절로 위장관을 통과하나 날카롭고 뾰족하며 긴 이물은 위장관의 천공이나 혈관과 누공형성 및 다른 합병증을 초래할 수도 있다. 이물의 섭취는 대개 환자나 다른 목격자에 의하여 복용한 병력으로 진단할 수 있다. 그러나 어린이나 정신박약자는 병력을 얻을 수 없기 때문에 우선 의심하는 것이 중요한 진단방법이 될 수밖에 없다. 연하곤란과 연하통은 식도이물의 통상적인 증상이다. 주변기도의 압박으로 인한 호흡기 증상은 어린이에 흔하며 종종 성인에서도 관찰된다. 식도내 이물을 제거하는데 많이 사용되는 방법은 굴곡형내시경을 사용하여 제거하는 것이다. 이방법은 성인이나 어린이에서 전신마취없이 기존의 진정제 투여방법으로 시술할 수 있다. 이물제거에 사용되는 파지겸자와 올가미는 내시경이물제거술을 가능하게 하였고 굴곡형내시경에 사용되는 overtube는 기존의 강직 형내시경의 장점을 얻을 수 있어 뽀족하거나 날카로운 이물을 제거하는데 사용하게 되었다. 이런 내시경적이물제거 원칙을 잘 지키고 적절한 준비가 된다면 합병증이 거의 없이 98% 정도의 이물을 제거할 수 있다. 내시경을 사용하지 않는 여러 가지 방법은 천공의 위험성이 높고 흡인성폐렴을 유발할 수 있기 때문에 사용하지 않는 것이 낫다. 수술적인 처치는 천공이 되었거나 다른 이물로 인한 합병증이 있는 경우에만 드물게 적용된다.

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Gastrointestinal Foreign Bodies in Children -Experiences of 60 Cases in Kangwon, Korea- (소아 위장관 이물 -강원지역 소아 60례-)

  • Lee, Young-Sub;Kang, Kae-Wool;Choi, Won-Kyu
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.4 no.2
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    • pp.148-154
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    • 2001
  • Purpose: Ingested foreign bodies present a common clinical problem. It is well known that most of them pass uninterrupted through the gastrointestinal tract. We evaluated the role of endoscopy and Foley catheter for removal of foreign bodies in the gastrointestinal tract. Methods: We investigated retrospectively 60 cases with foreign bodies in the gastrointestinal tract. They had been treated at Wonju Christian Hospital, Yonsei University of Korea, from January, 1996 through December, 1999. Results: The age of the patients ranged from 7 months to 13 years. Patients under 5 years were 57 cases (97%) and there was no significant difference in sex (M : F=1.07 : 1). 45 cases of the patients had no symptom. The most common foreign bodies were coins (43 cases). The most common location was esophagus (31 cases). The number of foreign body removal using flexible endoscopy and Foley catheter was 22 (36.7%) and 18 (30.0%) cases, respectively. In 18 cases (30.0%), foreign bodies passed spontaneously. Only 1 case (1.7%), curtain pin impaction at ileocecal region, required surgery. Conclusion: Early foreign body removal from esophagus and stomach is recommended to lessen the morbidity and complication. Fluoroscopic foley catheter technique and flexible endoscopy for removal of esophageal foreign bodies in children is safe and effective.

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Prokinetic Activities of Extracts from the Dried Rhizomes and Roots of Gentiana scabra Bunge in Mice (용담 추출물의 위장관 운동 촉진 활성)

  • Lee, Hyun-Tai
    • Journal of Life Science
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    • v.29 no.6
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    • pp.735-739
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    • 2019
  • The dried rhizomes and roots of Gentiana scabra (GS) have been frequently prescribed as a traditional folk medicine in East Asia (including China, Japan, and Korea) for the treatment of various pathophy-siological conditions, such as inflammatory skin diseases, anorexia, indigestion, gastric infections, and diabetes mellitus. In the present study, the effects of aqueous (GS-W) and ethanolic (GS-E) extracts of GS on gastrointestinal (GI) motor function were investigated by measuring the in vivo gastric emptying rate (GER) and the intestinal transit rate (ITR) in mice. The GER was significantly increased by GS-W at a dose of 1 g/kg. The ITR was significantly increased by GS-W (at doses of 0.1 and 1 g/kg) or GS-E (at a dose of 1 g/kg) in a dose-dependent manner. Furthermore, the ITR value of GS-W (at a dose of 1 g/kg) appeared to be higher than that of cisapride, which was the most prominent prokinetic agent in the 1900s but was removed from the market in 2000 due to its fatal side effects. The above results suggest that GS-W might be a potential prokinetic agent to replace cisapride.

Identifying Small Bowel Gastrointestinal Stromal Tumor as the Culprit Lesion in Obscure Gastrointestinal Bleeding: Emphasis on Angiographic Findings (원인불명의 위장관 출혈을 보인 소장 위장관 기질종양 식별: 혈관조영술 소견의 강조)

  • Hyung In Choi;Min Jeong Choi;Bong Man Kim;Hwan Namgung;Seung Kyu Choi
    • Journal of the Korean Society of Radiology
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    • v.83 no.2
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    • pp.400-405
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    • 2022
  • Gastrointestinal stromal tumors (GISTs) are not uncommon and often cause gastrointestinal bleeding. GISTs occurring in the small intestine are occasionally difficult to identify by endoscopy and CT. In this case, the patient underwent CT three times before surgery, and the lesion was found to be located in a different area of the abdominal cavity on each CT scan. Moreover, the lesion was missed in the first two CT images because it was difficult to distinguish it from the nearby collapsed small intestine. The lesion was eventually detected through angiography; however, the correct diagnosis and treatment were delayed for 3 years because it was mistaken for a vascular malformation, which is the most common cause of obscure GI bleeding in elderly patients. This report emphasizes the need for interventional radiologists to be updated and vigilant of the angiographic features of GISTs to make an accurate diagnosis and establish a management strategy.

Clinical Evaluation and Diagnosis of Children with Chest Pain (흉부 통증을 호소한 소아에서의 임상적 고찰 및 검사)

  • Shin, Su A;Kim, Yong Joo;Lee, Jae Whan;Kim, Nam Su;Moon, Soo Ji
    • Clinical and Experimental Pediatrics
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    • v.46 no.12
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    • pp.1248-1252
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    • 2003
  • Purpose : Chest pain in the pediatric population is not rare and mostly benign. Causes of chest pain are diverse, and differential diagnosis is not easy. Chest pain in children is less likely to be cardiac in origin. Furthermore, chest pain in the pediatric population is rarely associated with life-threatening disease. This study was designed to evaluate children with chest pain and the usefulness of several diagnostic examinations. Methods : Between March 2001 and August 2002, 33 patients(15 boys and 18 girls, aged four to 15 years) presented with chronic chest pain. The records of these patients were reviewed. Chest radiography and electrocardiogram were performed in all patients. Cardiologic and gastrointestinal evaluations were carried out when considered necessary. Results : Chest pain was most common in the age group of 10 to 12 years old, and the four to six years old group. The most common diagnostic findings of chest pain were idiopathic(15 cases, 45.5 %), heart disease(9 cases, 27.3%), upper gastrointestinal disease(6 cases, 18.2%), respiratory disease (2 cases, 6%) and trauma(1 case, 3%). In children with abnormal results of cardiologic evaluation, these findings are not major etiologic categories of chest pain. Through history taking and physical examinations, six cases were evaluated concerning gastrointestinal disease and all of them showed gastrointestinal diseases(esophagitis, gastroesophageal reflux disease, nodular gastritis and chronic superficial gastritis). Conclusion : Chest pain is usually benign in children but the possibility of cardiovascular or gastrointestinal disease is considered. Careful history taking, physical examination and proper clinical examinations are usually required to find out the rare life-threatening causes of chest pain.

Synchronous Occurrence of a Gastric Adenocarcinoma and a GIST (Gastrointestinal Stromal Tumor): A Case Report (위에 동시성으로 발생한 조기위암 및 위장관간질종양)

  • Jee, Sung-Bae;Seo, Kyung-Jin;Heo, Hun;Jeon, Hae-Myung
    • Journal of Gastric Cancer
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    • v.7 no.4
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    • pp.261-264
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    • 2007
  • A gastric adenocarcinoma is the second most common cause of cancer deaths worldwide, but there are some geographical differences in its incidence. A gastrointestinal tumor is an uncommon disease with a wide spectrum of aggressive behavior. These two tumors have a distinct pathogenesis, and synchronous occurrence of an adenocarcinoma and a GIST (gastrointestinal stromal tumor) in the stomach is very rare. We report a case of synchronous occurrence of a gastric adenocarcinoma and GIST in a 64-year-old man. We performed the following tests: barium swallowing test, gastroduodenoscopy, and CT scanning. We performed a total gastrectomy, and a 9 em-sized GIST at the fundus and a small early gastric cancer at the antrum were confirmed pathologically. Some explanations for this rare case exist, but in our opinion, the synchronous occurrence is a rare but probable event that can happen in an endemic area. We describe a case of synchronous occurrence of a gastric adenocarcinoma and GIST in the stomach, with a review of the literature.

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Building a Diagnosis Process and Ontology Based on Differentiation Rule of Crohn's Disease (궤양성 대장질환-크론병 감별 규칙 기반 진단 프로세스 및 온톨로지 구축)

  • Yoo, Dong-Yeon;Park, Ye-Seul;Lee, Jung-Won
    • Proceedings of the Korea Information Processing Society Conference
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    • 2018.05a
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    • pp.373-376
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    • 2018
  • 만성 염증성 장질환인 크론병은 위장관 전체에서 발병할 수 있으며, 국내에서도 발병률이 증가하고 있다. 특히, 크론병은 다른 궤양성 대장질환과 유사한 증상을 보일 수 있어 크론병을 진단하는데 어려움이 있다. 이로 인해 크론병 진단 가이드라인이나 크론병과 유사한 증상을 보이는 질병 감별에 대한 연구가 진행되고 있다. 하지만 기존 연구에는 크론병에 대한 절차적인 진단 과정이 기술되지 않아, 크론병 진단을 위한 검사 과정에서 과다한 검사가 시행될 우려가 있다. 따라서 본 논문에서는 크론병과 유사한 증상을 보이는 궤양성 대장질환을 감별하기 위해 중복성 및 절차적인 연관성, 질병의 진단 조건을 분석하여 감별 규칙으로 정의하고, 이를 기반으로 크론병 진단 프로세스를 제안한다. 제안하는 프로세스를 체계적으로 정의하고 온톨로지로 시각화함으로써 크론병과 유사한 증상을 보이든 대장질환올 감별하고, 효과적으로 크론병을 진단하는데 도움을 줄 수 있다.

Intestinal Ultrasonographic and Endoscopic Findings in Pediatric Patients with Henoch-Sch$\"{o}$nlein Purpura and Gastrointestinal Symptoms (위장관 증상을 동반한 Henoch-Sch$\"{o}$nlein Purpura 환아의 장관 초음파 소견 및 내시경 소견)

  • Noh, Yun-Il;Ryu, Min-Hyuk;Jung, Chul-Zoo;Lee, Dong-Jin;Kwon, Jung-Hyeok
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.4 no.2
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    • pp.181-190
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    • 2001
  • Purpose: The aim of this study is to investigate the usefulness of intestinal ultrasonography (US) and upper gastrointestinal endoscopy in the early diagnosis of Henoch-Sch$\"{o}$nlein purpura (HSP) with the gastrointestinal (GI) symptoms preceding the emergence of the skin lesion. Methods: The clinical, intestinal US and upper gastrointestinal endoscopic records of 85 patients (88 cases) with GI symptoms relating to HSP presenting between January 1999 and April 2001 were reviewed. Results: 1) GI symptoms were observed in 52 cases (59%) and skin, joint, renal and scrotal manifestations were observed in 88 (100%), 64 (73%), 15 (17%), 3 cases (3%) respectively. 2) Out of 52 cases with GI symptoms, abdominal pain was observed in all cases (100%). Positive stool occult blood, nausea and vomiting, abdominal tenderness, melena or tarry stool, diarrhea, hematemesis, rebound tenderness and rigidity were observed in 28 (50%), 17 (33%), 17 (33%), 12 (23%), 6 (12%), 4 (8%), 1 (2%) and 1 case (2%) respectively in order of frequency. 3) Intestinal US examination was performed in 27 cases with HSP and GI symptoms (52 cases). Out of 27 sonographic examinations 22 showed abnormal findings. Thickening of the duodeno-jejunal wall was observed in 16 cases (73%). Free peritoneal fluid, enlarged mesenteric lymph node, ileus and abnormal gall bladder were seen in 8 (36%), 8 (36%), 4 (18%) and 1 case (5%) respectively. In three cases of HSP without GI symptoms, those changes were absent. 4) In all of five cases with HSP and GI symptoms, endoscopic study showed mucosal edema and multiple hemorrhagic erosions especially at the second portion of the duodenum. Biopsy specimens from the duodenum of 2 cases out of 5 endoscopic examinations showed acute inflammatory infiltrates in the mucosa with hemorrhage. 5) Both intestinal US and endoscopic studies were performed in 4 cases with HSP and GI symptoms simultaneously. Out of 4 those cases, 3 cases showed the thickened duodeno-jejunal wall on the intestinal US, which suggested erosive hemorrhagic duodenitis by endoscopic findings. Conclusion: The typical but nonpathognomonic intestinal US findings including the thickening of the duodeno-jejunal wall and upper gastrointestinal endoscopic findings including hemorrhagicerosive duodenitis, in children with GI symptoms, should be considered a manifestation of HSP, even in the absence of skin lesion.

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