• Title/Summary/Keyword: 췌장

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Autoimmune Pancreatitis Featuring a Pseudocyst Requiring Drainage despite Steroid Therapy (스테로이드 치료에도 불구하고 낭종 배액술이 필요하였던 가성낭종을 동반한 자가면역 췌장염)

  • Park, Jae Cheol;Im, Hyeon-Su;Kang, Yewon;Son, Hyo-Ju;Jung, Kyung Hwa;Han, Jisoo;Kim, Myung-Hwan
    • The Korean Journal of Medicine
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    • v.93 no.6
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    • pp.560-564
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    • 2018
  • Autoimmune pancreatitis (AIP) is rarely associated with pancreatic pseudocysts. AIP-associated pseudocysts requiring drainage despite steroid therapy are rather rare. We report a case of AIP with an infected pseudocyst requiring drainage despite steroid therapy. A 68-year-old male was diagnosed with AIP via pancreatic imaging, a high serum immunoglobulin G4 level, and steroid responsiveness. The AIP was accompanied by a pancreatic pseudocyst. Steroid therapy was prescribed, but the pancreatic pseudocyst became aggravated during steroid tapering. Endoscopic ultrasonography-guided cyst drainage was required; the pseudocyst then became completely resolved.

A Case of Isolated Acute Pancreatitis Presenting With Epigastric Pain in an 8-Year-Old Child Infected With COVID-19 (명치 통증으로 내원한 COVID-19에 감염된 8세 소아의 단독 급성 췌장염 1례)

  • Joo Ok Jin;Se Ri Jeong;Byung Ok Kwak;Sook Min Hwang;Ky Young Cho
    • Pediatric Infection and Vaccine
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    • v.30 no.2
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    • pp.104-110
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    • 2023
  • Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) mainly causes respiratory symptoms such as fever, cough, sputum, and rhinorrhea, as well as digestive symptoms such as diarrhea, vomiting, and abdominal pain in children. In this report, we describe a case of a child with a SARS-CoV-2 infection who presented with epigastric pain and was subsequently diagnosed with acute pancreatitis without any concomitant infections in other organs. The epigastric pain was relieved with goal-directed vigorous fluid therapy for acute pancreatitis for 24 hours, and the serological and radiological findings normalized after two months. Acute pancreatitis should be considered as a differential diagnosis when a child with a history of COVID-19 visits the hospital with epigastric pain.

Case Reports of Intravascular Treatment for Gastrointestinal Bleeding Associated with Pancreatitis: Hemosuccus Pancreaticus and Pancreaticocolic Fistula (췌장염에 합병된 위장관 출혈의 혈관내 치료에 대한 증례 보고: Hemosuccus Pancreaticus와 췌장대장루)

  • Seong Jae Bae;Sangjoon Lee;Yong Hwan Jeon;Go Eun Yang;Sung-Joon Park;Hyoung Nam Lee;Youngjong Cho
    • Journal of the Korean Society of Radiology
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    • v.83 no.6
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    • pp.1418-1425
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    • 2022
  • Elderly patients with a history of chronic alcoholism presented to our hospital with episodes of melena, abdominal pain, and anemia. During admission, hemorrhagic cystic lesion at the pancreas was observed on abdominal CT. Transcatheter angiography confirmed active bleeding foci and arterial embolization was performed. After the procedure, the bleeding was resolved. The authors report two cases of hemosuccus pancreaticus and pancreaticocolic fistula associated with pancreatitis, a rare cause of gastrointestinal bleeding, treated with vascular intervention.

Safety and Efficacy of Ultrasound-Guided Percutaneous Core Needle Biopsy of Pancreatic and Peripancreatic Lesions Adjacent to Critical Vessels (주요 혈관 근처의 췌장 또는 췌장 주위 병변에 대한 초음파 유도하 경피적 중심 바늘 생검의 안전성과 효율성)

  • Sun Hwa Chung;Hyun Ji Kang;Hyo Jeong Lee;Jin Sil Kim;Jeong Kyong Lee
    • Journal of the Korean Society of Radiology
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    • v.82 no.5
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    • pp.1207-1217
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    • 2021
  • Purpose To evaluate the safety and efficacy of ultrasound-guided percutaneous core needle biopsy (USPCB) of pancreatic and peripancreatic lesions adjacent to critical vessels. Materials and Methods Data were collected retrospectively from 162 patients who underwent USPCB of the pancreas (n = 98), the peripancreatic area adjacent to the portal vein, the paraaortic area adjacent to pancreatic uncinate (n = 34), and lesions on the third duodenal portion (n = 30) during a 10-year period. An automated biopsy gun with an 18-gauge needle was used for biopsies under US guidance. The USPCB results were compared with those of the final follow-up imaging performed postoperatively. The diagnostic accuracy and major complication rate of the USPCB were calculated. Multiple factors were evaluated for the prediction of successful biopsies using univariate and multivariate analyses. Results The histopathologic diagnosis from USPCB was correct in 149 (92%) patients. The major complication rate was 3%. Four cases of mesenteric hematomas and one intramural hematoma of the duodenum occurred during the study period. The following factors were significantly associated with successful biopsies: a transmesenteric biopsy route rather than a transgastric or transenteric route; good visualization of targets; and evaluation of the entire US pathway. In addition, the number of biopsies required was less when the biopsy was successful. Conclusion USPCB demonstrated high diagnostic accuracy and a low complication rate for the histopathologic diagnosis of pancreatic and peripancreatic lesions adjacent to critical vessels.

THE OCCURRENCE OF GIANT BETA ISLETS IN THE PANCREAS OF THE CALF (자우췌장(仔牛膵臟)의 거대(巨大) beta 도서(島嶼)에 관(關)한 연구(硏究))

  • Kim, Sang Nam
    • Korean Journal of Veterinary Research
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    • v.2 no.1
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    • pp.1-13
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    • 1962
  • 10두(頭)의 홀스타인 자우(仔牛)에 glucagon, insulin 등 홀몬과 reserpine 및 nicotine을 투여(投與)하여 그들이 췌장(膵臟)의 Langerhans 도서(島嶼)에 미치는 세포학적(細胞學的) 영향을 전자현미경(電子顯微鏡)에 의해서 연구하는 도중 거대(巨大)한 크기의 도서(島嶼)를 관찰하였다. 이 거대도서(巨大島嶼)들은 상기(上記)한 약품투여에 영향을 받지 않으며 거의 beta 세포(細胞)들로만 되어 있으므로 보통 크기의 도서(島嶼)들과의 혼동을 피하기 위하여서는 그 분포상태(分布狀態)와 세포학적(細胞學的) 및 조직학적(組織學的) 특징(特徵)을 구명(究明)하는 것이 필요하게 되어 본연구(本硏究)에 착수하였든 것이며 아울러 췌장(膵臟) 각부분(各部分)에 함유되는 Langerhans 도서수(島嶼數)의 평균치(平均値)를 산출(算出)하였다. Langerhans 도서(島嶼)는 편의상 그 크기에 따라서 직경(直徑) $200{\mu}$이하(以下)의 것을 "Regular islets" $200{\sim}500{\mu}$까지의 것을 "Intermediate islets" 그리고 $500{\mu}$ 이상(以上)의 것을 "Giant islets"라 이름지어서 구별하였다. 지금까지 알려진 최대(最大)의 도서(島嶼)는 개에서 관찰된 $333{\mu}$의 도서(島嶼)이었는데 필자는 본연구(本硏究)에서 직경 $1.395{\mu}$에 달하는 것과 기리 $2,700{\mu}$에 달하는 거대(巨大)한 도서(島嶼)들을 관찰하였다. 본연구(本硏究)의 결과(結果)를 요약(要約)하면 다음과 같다. 1. 자우췌장(仔牛膵腸) 50평방(平方)mm 면적(面積)내에 함유되는 Langerhans 도서(島嶼)의 수(數)는 평균(平均) 191개로서 다른 연구자에 의해서 보고된 수치(數値)보다 훨씬 많은 것이었다. 2. 거대도서(巨大島嶼)의 크기는 직경(直徑) $200{\sim}1,400{\mu}$이며 그 분포상태(分布狀態)는 보통 크기의 도서(島嶼)와 마찬가지로 췌장(膵臟)의 십이지장부(十二指腸部) 중간부(中間部) 및 췌장부(膵臟部)의 순서(順序)로 많이 함유되고 있다. 즉 십이지장부(十二指腸部)에는 2% 중간부(中間部) 1.8% 췌장부(膵臟部)에는 0.8%의 거대도서(巨大島嶼)가 함유되어 있으며 직경(直徑) $200{\mu}$이상(以上)의 도서평균치(島嶼平均値)는 1.53%이었다. 3. 중간대(中間大)의 도서(島嶼)와 거대도서(巨大島嶼)들은 거의 beta 세포(細胞)들로서만 되어있음으로 "중간대(中間大) beta 도서(島嶼)" 및 "거대(巨大) beta 도서(島嶼)"라고 각 각 명명하였으며 alpha세포(細胞)들이 있는 경우에는 작은 세포집합체(細胞集合體)를 이루고 도서전반(島嶼全般)에 걸쳐서 산재(散在)한다. 4. 췌장(膵臟)에 함유되고 있는 거대(巨大) beta 도서(島嶼)의 수(數)는 적지마는 보통 크기의 도서(島嶼)와 비교할때 그 용량(容量)은 막대한 것이며 따라서 insulin 분비량(分泌量)도 많을것이므로 우췌장(牛膵臟)의 insulin 분비(分泌)를 연구할 때에는 반듯이 이 사실(事實)을 고려해야 할 것이다. 5. 불규칙한 색상(索狀)의 실질세포(實質細胞)들로된 거대(巨大) beta 도서(島嶼)에는 간질결합조직(間質結合組織)이 풍부하며 그 간질(間質) 속에는 비교적 큰 혈관(血管)과 개재관양(介在管樣) 구조물(構造物)이 들어있다. 거대(巨大) beta 도서(島嶼)는 출생(出生)후 도서내외(島嶼內外)에 산재(散在)하고 있는 외분비도관세포(外分泌導管細胞)들의 증식(增殖)에 의해서 발생(發生)하며 그 크기도 증대(增大)하는 것으로 믿어진다. 6. 거대(巨大) beta 도서(島嶼)의 beta 세포(細胞)들은 현저한 Golgi 장치(裝置)와 비대(肥大)한 핵소체(核小體) 및 포상핵(胞狀核)등의 세포학적(細胞學的) 특징을 가지며 이것은 거대(巨大) beta 도서(島嶼)가 보통 크기의 Langerhans 도서(島嶼)에 비하여 더 활발하게 insulin을 분비(分泌)한다는 것을 시사(示唆)하는 것이다.

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Complications Following and Supplementary Procedures for a Pancreas-preserving Total Gastrectomy (위 전절제술에서 췌장보존 비장적출술의 합병증 및 보완술식)

  • Lee, Moon Soo;Kang, Gil Ho;Cho, Gyu Seok;Kim, Yong Jin;Kim, Sung Yong;Baek, Moo Jun;Kim, Chang Ho;Cho, Moo Sik
    • Journal of Gastric Cancer
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    • v.7 no.1
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    • pp.31-37
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    • 2007
  • Purpose: A pancreas-preserving total gastrectomy (PPTG) was introduced to decrease the postoperative complications due to pancreatic resection. However, some complications, such as leakage of pancreatic juice, are still reported. Thus, the purpose of this study was to propose a supplementary procedure based on the results of treatment for gastric cancer at our hospital. Materials and Methods: From Jan. 1997 to Dec. 2004, the cases of 141 patients who underwent a PPTG for gastric cancer were reviewed retrospectively. The patients were divided into Group A (38 cases), patients who were treated using a conventional PPTG, and Group B (103 cases), patients who were treated using a new and improved PPTG. Their postoperative complications were compared. Results: No statistically significant differences in clinicopathologic data were noted between the two groups. The comparison of complications showed for groups A and B, respectively, 4 and 0 cases of pancreatic fistula, 1 and 0 cases of intraabdominal abscess, 2 and 0 cases of intraoperative pancreatic necrosis, and 2 and 2 cases of minor leakage. The difference in the prevalence of complications between the two groups was statistically significant (P=0.0001). Conclusion: In order to reduce the risk of PPTG-related complications, we used vascular clamps to observe the necrosis of the pancreatic tail before dividing the splenic artery, and this method resulted in a significant decrease in postoperative complications. Thus, we conclude that our use of vascular clamps in a PPTG is a simple and useful method for preventing postoperative complications.

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췌장암

  • 한호성
    • The Monthly Diabetes
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    • s.97
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    • pp.26-28
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    • 1997
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Immunohistochemical study of pancreatic poly-peptide-immunoreactive cells in the pancreas of the Korean native goat (Capra hircus) during developmental stages (발생단계에 따른 한국재래산양 췌장에서 pancreatic polypeptide 면역반응세포에 대한 면역조직화학적 연구)

  • Ham, Tae-su
    • Korean Journal of Veterinary Research
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    • v.40 no.3
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    • pp.421-430
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    • 2000
  • The regional distribution and relative frequency of the pancreatic polypeptide (PP)-immunoreactive cells in the pancreas of the Korean native goat (Capra hircus) were studied by immunohistochemical methods (PAP methods) using specific antisera against to PP during developmental stage, fetus, neonate, 1-month-old, 6-month-old and adult. The different regional distribution and relative frequency of PP-immunoreactive cells in the pancreas of Korean native goat were observed during development. In the exocrine portions, they were detected in the all ages and distributed in the interacinar regions. PP-immunoreactive cells were increased from neonate to 1-month-old but thereafter decreased with developmental stage. In the pancreatic duct, PP-immunoreactive cells were demonstrated from 1-month-old but they were decreased with developmental stages in these regions. These cells were observed in the subepithelial connective tissue of the pancreatic duct with a few frequencies in 1-and 6-month-old. However, they were located in the interepithelial cells of the pancreatic duct in the adult with rare frequency. In the endocrine portion (pancreatic islets), PP-immunoreactive cells were observed from neonate, and the regional distribution of PP-immunoreactive cells from 1-month-old was divided into two patterns : dispersed 1) in the marginal regions of the pancreatic islets with moderate or a few frequencies, and 2) in the whole pancreatic islets (in a case of 1-month-old) or in the central cores (in a case of 6-month-old and adult) with numerous frequency. In conclusion, the different regional distribution and relative frequency of PP-immunoreactive cells in the pancreas of the Korean native goat were observed during development. It is suggested that the changing of feeding habits and physiological conditions during different developmental stages may cause these differences.

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