• Title/Summary/Keyword: 췌장염

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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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Recurrence of Choledocholith in the Common Bile Duct after Cholecystectomy in a Dog (개에서 담낭절제술 후 총담관에 재발한 총담관결석증)

  • Chang, Jin-Hwa;Yun, Seok-Ju;Kim, Ju-Hyung;Kang, Ji-Houn;Kim, Gon-Hyung;Na, Ki-Jeong;Chang, Dong-Woo
    • Journal of Veterinary Clinics
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    • v.27 no.5
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    • pp.605-609
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    • 2010
  • A 10-year-old spayed female Yorkshire terrier presented with vomiting, and anorexia. Obstructive choledocholith with concurrent pancreatitis and hepatorenal syndrome was diagnosed based on analyses of the blood profiles, abdominal radiographs, ultrasonography and CT. Choledoliths were removed from the common bile duct, yet the patient died suddenly 10 days after surgery. Recurrent choledolithiasis has not been reported in a cholecystectomized dog and this report focuses on the imaging features of ultrasonography and CT of recurrent choledoliths.

Pictorial Review of Rare Pancreatic Tumors and Tumor-Like Lesions (췌장에서 생기는 희귀 종양 및 종양 유사 병변들의 영상 소견)

  • Seung Jae Lee;Sang Soo Shin;Suk Hee Heo;Yong Yeon Jeong
    • Journal of the Korean Society of Radiology
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    • v.81 no.5
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    • pp.1134-1150
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    • 2020
  • Various types of tumors and tumor-like lesions may affect the pancreas. Among them, pancreatic ductal adenocarcinoma is the most common and is generally referred to as "pancreatic cancer." Recently, the detection rates of rare pancreatic tumors and tumor-like lesions have increased owing to technological advancements and increased frequency of imaging tests. Considering that rare pancreatic tumors and tumor-like lesions differ from pancreatic ductal adenocarcinoma in terms of the treatment plan and prognosis, the differential diagnosis of these diseases is clinically relevant. Various imaging tests play an important role in the differential diagnoses of rare tumors, such as acinar cell carcinoma and schwannoma, tumor-like lesions, such as autoimmune pancreatitis and inflammatory pseudotumor, and pancreatic ductal adenocarcinoma, but accurately distinguishing these diseases solely based on imaging findings is difficult. The aim of this pictorial review was to present the imaging findings of rare pancreatic tumors and tumor-like lesions and discuss important points for the differential diagnosis.

Splanchnicotomy and Thoracic Sympathicotomy for Control of Intractable Abdominal Pain -One Case Report- (내장신경 절단 및 흉부교감신경 절단을 통한 난치성 복통의 치료 -1례 보고-)

  • 황정주;김재영;이두연
    • Journal of Chest Surgery
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    • v.33 no.12
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    • pp.995-997
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    • 2000
  • 내장의 통증은 교감신경을 통하여 척수로 전달된다고 알려져있다. 특히 췌장염이나 췌장암의 통증에 관해서 Mallet-Guy 등이 1943년 큰내장신경 및 요교감신경절 절제술을 시행한 이래로 상기 방법이 이용되어 왔다. 내장신경 절제술은 효과에 비해 수술이 커지고, 긴 바늘을 이용한 복강신경총 차단술이 발달하면서 사장된 방법으로 여겨졌다. 그러나, 최근에 흉강경을 이용한 수술방법이 발달하면서 간단히 큰내장신경 절제술이 가능해져 흉강경을 이용한 큰내장신경 절단술은 난치성 복통치료의 좋은 방법으로 받아 들여지고 있다.

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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.

Clinical Reference of the Maximum Standardized Uptake Values to the Pancreatic Cancer, Pancreatitis and Normal Pancreas in the 18F-FDG PET-CT (18F-FDG PET-CT 검사에서 췌장암, 췌장염, 정상 췌장에 대한 최대 표준섭취계수의 임상적 기준 설정)

  • Lee, Jae-Seung;Kweon, Dae Cheol
    • Journal of Biomedical Engineering Research
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    • v.39 no.2
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    • pp.80-86
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    • 2018
  • The aim of this study were to establish the clinical references and guidelines for the maximum standardized uptake ($SUV_{max}$) value of pancreatic cancer, pancreatitis, and normal pancreas in $^{18}F-FDG$ PET-CT examinations for pancreatic disease. For this purpose, we performed the statistical analysis on the descriptive statistics, percentiles and inter quartiles range (IQR), normal distribution, and using the probability density function for pancreatic cancer, pancreatitis, and normal pancreas. As a result, the clinical reference of $SUV_{max}$ for the pancreatic cancer, pancreatitis, and normal pancreas was more than 3.45, 1.91 to 2.62, and less than 1.91, respectively. Also, optimal cut-off value for applying the dual time point PET-CT examination was determined to be 2.62. The results of this study are summarized as follows: first, we suggests the clinical reference and guideline for the pancreatic cancer, pancreatitis, and normal pancreas, and second, suggests a scientific approach to improve diagnostic accuracy of pancreatic disease by deviating from an approximate experience approach.

The Usefulness of MRCP in the Evaluation of Pancreaticobiliary Diseases in Children (소아에서 담췌관 질환에 대한 자기공명 담췌관조영술의 진단적 유용성)

  • Uhm, Ji Hyun;Lee, Seung Yeon;Chung, Ki Sup
    • Clinical and Experimental Pediatrics
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    • v.45 no.11
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    • pp.1381-1388
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    • 2002
  • Purpose : Magnetic resonance cholangiopancreatography(MRCP) is a noninvasive method for imaging the pancreaticobiliary tree. The aim of this study was to evalute the usefulness of MRCP for the diagnosis of pancreaticobiliary diseases in children. Methods : From October 1996 to May 2001, 67 patients with obstructive jaundice and three patients with chronic recurrent pancreatitis were evaluated with abdominal ultrasonography and MRCP. The final diagnosis was based on the operative and pathologic findings with biopsy specimen including clinical and laboratory findings. Results : A total of 70 patients, consisting of 31 males and 39 females, with a mean age of $2.6{\pm}3.3$ years were studied. The final diagnosis was biliary atresia in 25, neonatal cholestasis in 18, choledochal cyst without anomalous pancreatobiliary duct union(APBDU) in nine, choledochal cyst with APBDU in seven, cholestatic hepatitis in five, chronic recurrent pancreatitis in three, sclerosing cholangitis in two, and secondary biliary cirrhosis in one case. The overall diagnostic accuracy of abdominal ultrasonography was 75.7% and that of MRCP was 97.1%. The sensitivity and specificity of MRCP were 100% and 98% for biliary atresia, 87.5% and 100% for choledochal cyst with APBDU, 100% and 100% for choledochal cyst without APBDU, sclerosing cholangitis and chronic recurrent pancreatitis, respectively. Conclusion : MRCP is a fast, non-invasive and reliable method for diagnosing pancreaticobiliary diseases in children and will be the standard diagnostic procedure in the future.

Two Cases of Pancreatitis in Children with Hemolytic Uremic Syndrome (용혈성 요독 증후군에서 발생한 췌장염 2례)

  • Park Jee-Min;Kim Ki-Sung;Nam Young-Mi;Kim Eun-Soo;Ahn Sun-Young;Shin Jae-Il;Lee Jae-Seung
    • Childhood Kidney Diseases
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    • v.7 no.2
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    • pp.211-216
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    • 2003
  • An epidemic outbreak of food poisoning due to enterohemorrhagic Escherichia coli(EHEC) occurred throughout Korea from May to September, 2003. Patients infected via contaminated school lunch foods were found mainly in Seoul and Gyeonggi province. As a result of this food poisoning, 36 patients were diagnosed as hemolytic uremic syndrome(HUS) up to mid-September, 2003 and five of them visited our hospital. Before the outbreak this year, we had experienced only 23 cases of HUS, including diarrhea associated (D+) and atypical (D-) forms, for the last 14 years, and there had been no case with pancreatic enzyme elevation. Unlike the past HUS cases, those of this year presented with severe abdominal pain and spiking elevation of pancreatic enzyme levels in 2 cases. We report 2 cases of transient pancreatitis combined with HUS in children during the epidemic outbreak in 2003 with a brief review of related literatures.

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생활습관병 예방 프로젝트 4 실천 List - 규칙적으로 천천히 오래~오래

  • Kim, Eun-Gyeong
    • 건강소식
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    • v.37 no.2
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    • pp.14-15
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    • 2013
  • 과식과 폭식은 건강의 적이다. 소화불량, 역류성 식도염, 복통, 복부팽만감, 설사 등 위장 장애를 일으킬 뿐만 아니라 급성장염이나 드물지만 급성췌장염 등의 심각한 병으로까지 발전할 수 있기 때문이다. 현대인들의 만병의 근원인 비만의 원인이 되기도 한다. 특히 설과 같은 명절기간엔 평소보다 튀김이나 전, 잡채 등과 같은 기름기와 지방이 많은 음식을 더 많이 섭취하기 때문에 각별한 주의가 필요하다. 건강한 설을 보낼 수 있는 식습관에 대해 알아보자.

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Pancreatic Exocrine Adenocarcinoma in a Cat (고양이에서 발생한 췌장 외분비 선암종 1례)

  • Park, Noh-Won;Lee, Seung-Yeoun;Lee, So-Yun;Song, Sun-Hye;Choi, Yang-Kyu;Eom, Ki-Dong
    • Journal of Veterinary Clinics
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    • v.30 no.3
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    • pp.189-192
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    • 2013
  • An 8-year-old, neutered female Korean short hair cat was referred with severe vomiting and anorexia. Abdominal mass effect was seen in the cranial abdomen on radiographs, and a mass with a heterogeneous echogenic pattern was observed medial to the right kidney on ultrasonography. On computed tomography, a large mass with soft tissue attenuation and a contrast-enhanced capsule was seen. In histopathological findings, the acinar structures were lined with irregular cuboidal cells that have pale eosinophilic cytoplasm and round to oval nuclei. Based on these diagnostic imaging and histopathological findings, the mass was diagnosed as pancreatic exocrine adenocarcinoma.