• Title/Summary/Keyword: 폐색전

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Two Different Causes of Intestinal Obstruction in Lung Cancer (폐암 환자에서 발생한 장 폐색 2예)

  • Han, Min Sung;Koh, Kyung Won;Kim, Yeo Myung;Kang, Min Soo;Choe, Du Hwan;Kim, Hye-Ryoun;Kim, Cheol Hyeon;Lee, Jae Cheol
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.5
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    • pp.365-369
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    • 2009
  • Prompt and proper discovery of cause is important in lung cancer patients with signs and symptoms of intestinal obstruction because approach for treatment may differ according to its etiology and emergency operation can often be required to prevent more severe complications. In this report, we present two different causes of intestinal obstruction in lung cancer. Physicians need to be aware of these possibilities to differentiate the cause of intestinal obstruction in patients with lung cancer.

Cerebrovascular Reservoir and Arterial Transit Time Changes Assessed by Acetazolamide-Challenged Multi-Phase Arterial Spin Labeling Perfusion MRI in Chronic Cerebrovascular Steno-Occlusive Disease (만성 뇌혈관 협착폐색증에서 아세타졸아미드 부하 다상 동맥스핀표지 자기공명관류영상으로 평가한 뇌혈류 예비능과 동맥 통과 시간의 변화)

  • Inpyeong Hwang;Chul-Ho Sohn;Keun-Hwa Jung;Eung Koo Yeon;Ji Ye Lee;Roh-Eul Yoo;Koung Mi Kang;Tae Jin Yun;Seung Hong Choi;Ji-hoon Kim
    • Journal of the Korean Society of Radiology
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    • v.82 no.3
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    • pp.626-637
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    • 2021
  • Purpose To explore cerebrovascular reservoir (CVR) and arterial transit time (ATT) changes using acetazolamide-challenged multi-phase arterial spin labeling (MP-ASL) perfusion-weighted MRI in chronic cerebrovascular steno-occlusive disease. Materials and Methods This retrospective study enrolled patients with chronic steno-occlusion who underwent acetazolamide-challenged MP-ASL between June 2019 and October 2020. Cerebral blood flow, CVR, basal ATT, and ATT changes associated with severe stenosis, total occlusion, and chronic infarction lesions were compared. Results There were 32 patients (5 with bilateral steno-occlusion) in our study sample. The CVR was significantly reduced during total occlusion compared with severe stenosis (26.2% ± 28.8% vs. 41.4% ± 34.1%, respectively, p = 0.004). The ATT changes were not significantly different (p = 0.717). The CVR was marginally lower in patients with chronic infarction (29.6% ± 39.1% vs. 38.9% ± 28.7%, respectively, p = 0.076). However, the ATT was less shortened in patients with chronic infarction (-54 ± 135 vs. -117 ± 128 ms, respectively, p = 0.013). Conclusion Acetazolamide-challenged MP-ASL provides an MRI-based CVR evaluation tool for chronic steno-occlusive disease.

Meconium Obstruction in Very Low Birth Weight Infants (극소저출생체중아에서 태변에 의한 장폐색에 관한 연구)

  • Hong, Ki-Bae;Seong, In-Chang;Lee, Kun-Song;Chang, Young-Pyo;Song, Hee-Seung
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.14 no.1
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    • pp.52-58
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    • 2011
  • Purpose: Mecnoium obstruction in very low birth weight infants (VLBWI), which delays enteral feeding and is one of the major causes of bowel obstruction, can be diagnosed and treated with hyperosmolar water-soluble contrast enema. The purpose of this study was to observe the clinical findings of meconium obstruction, the improvement of small bowel obstruction after contrast enema, and the complications related to the enema. Methods: Hypersolmolar water-soluble contrast enemas were performed in 14 VLBWIs with meconium obstruction. Clinical findings, radiologic findings, feeding intolerance, effectiveness, and complications of enemas were observed. Also, clinical findings related to meconium obstruction were compared with 18 VLBWIs without meconium obstruction. Results: 1) Fourteen VLBWIs with meconium obstruction had significantly lower 5 minutes Apgar scores than 18 VLBWIs without meconium obstruction (p<0.05). Moreover, the day of last meconium passing, and the day of the first trial and full enteral feeding were delayed significantly. 2) A total of 18 enemas were performed in the 14 infants. The contrast medium passed the ileocecal valve and reached the terminal ileus in 12 enemas. Of the 12 enemas, 11 were successful, but 1 infant underwent an ileotomy, even though the contrast medium reached the terminal ileum. 3) Intestinal obstruction was not relieved in three of five infants, in whom the contrast medium failed to pass the ileocecal valve. Obstruction was relieved after repeated enemas in which the contrast medium reached the terminal ileum. 4) No complications associated with water-soluble contrast enemas were observed. Conclusion: Hyperosmolar water-soluble contrast enema is considered to be safe and therapeutic for meconium obstruction in VLBWIs.

Isolated Small Bowel Metastasis of Endometrial Carcinoma with Resultant Jejunojejunal Intussusception: A Case Report (자궁내막암의 단독 소장 전이로 인해 유발된 공장-공장 장중첩증: 증례 보고)

  • Yeon Jang;Dong Hee Park;Joon Seog Kong
    • Journal of the Korean Society of Radiology
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    • v.83 no.6
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    • pp.1380-1384
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    • 2022
  • Endometrial carcinoma is a common gynecologic malignancy; however, metastasis to the small bowel is rare. Metastatic endometrial carcinoma usually occurs through local extension rather than distant metastasis. Isolated small bowel metastasis is extremely rare; further, intussusception with resultant intestinal obstruction is not common. We report the imaging findings of a patient with isolated small bowel metastasis of endometrial carcinoma with resultant jejunojejunal intussusception.

A Case of Massive Pulmonary Thromboembolism in a Young Man Attribute to Computer Gaming (젊은 남자에서 장시간의 컴퓨터게임 후 발생한 대량 폐색전증 1예)

  • Kim, Hyun;Choe, Kang Hyeon;Lee, Ki Man;Shin, Yoon Mi
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.3
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    • pp.211-215
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    • 2009
  • Pulmonary thromboembolism occurs in old patients with risk factors, such as, immobilization, chronic medical disease, trauma, a hereditary hypercoagulable state, and others. However, we experienced a young man with a massive pulmonary thromboembolism attributed to immobilization due to computer gaming. The patient had been playing computer games in a seated position for at least five hour continually, and for twelve hours per day over a two-week period. The 36-year-old patient was transferred to our institute rule out the possibility of an acute myocardial infarction. Computer tomography revealed intraluminal filling defects in the distal main pulmonary artery and the left popliteal vein. He received thrombolytic therapy and subsequently recovered without complications. This case raises the possibility that prolonged computer gaming is a risk factor of thromboembolism in young adults.

Extrahepatic Biliary Obstruction Secondary to Traumatic Diaphragmatic Hernia in Dog (개에서의 횡격막 탈장에 의한 간외담도폐색)

  • Yoon, Young-Min;Jeong, Dong-In;Yeon, Seong-Chan;Lee, Hee-Chun
    • Journal of Veterinary Clinics
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    • v.31 no.6
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    • pp.531-534
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    • 2014
  • A 3-year-old intact mixed hunting dog was referred to Gyeongsang Animal Medical Center with the clinical signs of vomiting, dyspnea, anorexia. The dogs had traumatic history that wounded at abdominal wall during the wild boar hunting 2 week ago. The dogs was diagnosed as extrahepatic biliary tract obstruction (EHBO) secondary to traumatic hernia. Diagnosis was based on radiographic features of a diaphragmatic hernia on survey radiography, dilated bile duct in abdominal ultrasonography and complete recovery due to the return of displaced organs into the peritoneal cavity and repair of the diaphragmatic rent. Diagnostic imaging and surgical intervention may result in a favorable outcome in dog with post hepatic obstruction secondary to diaphragmatic hernia. This case emphasizes the strangulation of bile duct by diaphragmatic rupture could be the cause of EHBO.

Hydraulic Characteristic Analysis for Prevention of River Disaster at Estuary in the Eastern Coast of Korea (동해안 하천 하구부의 하천재해 방지를 위한 수리특성 분석)

  • Choi, Jong-Ho;Jun, Kye-Won;Yoon, Yong-Ho
    • Journal of Korean Society of Disaster and Security
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    • v.11 no.2
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    • pp.83-89
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    • 2018
  • The significant sedimentation at the estuary in the eastern coast of Korea frequently causes river mouth occlusion where disconnection between the river and sea is observed. River mouth occlusion causing watershed retention raises the environmental risk of the area as it impairs water quality and threatens the area's safety in the event of floods. This study proposes a plan to maintain stability of river channel and flow of flood discharge at the estuary with loss of its function for disaster prevention. To this end, the study tries to change the location and width of stream path, focusing on the center line of stream near the sand bar of river mouth. This allows to identify a shape of stream path that leads the most stable flow. To review the result, this study uses the SRH-2D, a model for two-dimensional hydraulic analysis, and conduct numeric simulation. The simulation result showed that the most effective plan for maintaining the stable flow of running water without having the area sensitive to changes in hydraulic characteristics is to lower the overall river bed height of the sand bar near the center line of stream to a equal level.

A Case of the Large Colon Impaction in an Adult Donkey (성숙한 당나귀의 큰잘록창자 폐색 증례)

  • Yang, J.;Park, Y.S.
    • Journal of Practical Agriculture & Fisheries Research
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    • v.20 no.2
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    • pp.117-123
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    • 2018
  • The purpose of this report is to describe the diagnosed case of a large colonic impaction in an adult donkey. An adult female donkey (Equus africanus asinus; 6-years-old) was admitted to the Equine Hospital of Jeju Race Park with signs of anorexia, which had started 1 day previously. Clinical examination revealed: weak gut sounds, dehydration, and severe abdominal distension, but normal respiratory and heart rates and no signs of pain. Transrectal palpation identified an impaction in the colon. The patient was treated with nasogastric siphonage, fluid therapy, and nonsteroidal anti-inflammatory drugs. Over the course of a day, her condition worsened; she started trembling, could not stand, and 2 hours later she died. Upon necropsy, a vast amount of ingesta was found in the large colon, particularly in the left ventral colon. The cecum and small colon were normal. Eleven days prior to presentation, the stable management and diet of the donkey had changed. We suspect that the change of feed, reduced water consumption, and lack of exercise precipitated the illness. However, the exact cause of the sudden death of the donkey requires further investigation.

Malignant Bowel Obstruction in Terminal Cancer Patients (말기암 환자의 악성 장 폐색)

  • Moon, Do-Ho;Choe, Wha-Sook
    • Journal of Hospice and Palliative Care
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    • v.7 no.2
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    • pp.214-220
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    • 2004
  • Purpose: As for the malignant bowel obstruction of terminal cancer patient, a prognosis is relatively bad. Physicians consider palliative procedures or surgery for the quality of life, but sometimes it is hard to decide. After diagnosis of a malignant bowel obstruction in terminal cancer patients, we investigated the clinical characteristics, the prognostic factors and the survival of patients with palliative procedures or surgery. Methods: we retrospectively reviewed the medical records in 40 malignant bowel obstruction patients who had been diagnosed as terminal cancer from May in 2002 to May in 2004. Results: There were 21 males (53%) and 19 females (47%), and median age of patients was $64.1{\pm}1.58$ years. The most common cause of malignant bowel obstruction was colorectal cancer (18 patients, 45%), followed by stomach cancer (11, 28%), pancreatic cancer (4, 10%), others (7, 19%). Metastases were carcinomatosis peritonei (14 patients, 35%), liver (13, 33%). During a bowel obstruction, symptoms were vomiting (15 patients, 38%), abdominal pain (10, 25%), constipation (6, 15%), abdominal distension (5, 13%). Performance status (ECOG) was 2 score (16 patients, 40%), 3 score (20, 50%), 4 score (4, 10%). Palliative procedure group were 30 patients, the others 10. Median survival in palliative procedure group was 142 days, that of no palliation group 30. Median survival time of palliative procedure group from palliative procedures or surgery were significantly higher than that of no palliation group from diagnosis of malignant bowel obstruction. Prognostic factors of palliative procedure group were PS, site of obstruction and primary cancer. Median survival in PS 2, lower GI obstruction and colorectal cancer was higher than PS 3, upper GI obstruction and others, respectively. Conclusion: we recommend aggressively palliative procedures or surgery in malignant bowel obstruction patients diagnosed with terminal cancer if palliative procedures or surgery could be performed effectively.

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Palliative Management of Gastric Cancer with Outlet Obstruction: Stent versus Bypass (위배출구 폐색을 동반한 위암환자의 치료)

  • Kim, Hyung-Ho
    • Journal of Gastric Cancer
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    • v.9 no.1
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    • pp.6-9
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    • 2009
  • Gastric cancer with gastric outlet obstruction has a high incidence of direct invasion into neighboring organs, with a low resection rate and a poor prognosis. Traditionally, open gastrojejunostomy has been the standard palliative treatment in these patients. Recently, endoscopic self-expanding metal stents have been used increasingly for the palliative treatment of malignant gastric outlet obstruction, but the choice of modality to treat the obstruction caused by gastric cancer is still controversial. Many studies have shown that endoscopic stenting is less invasive and offers not only a shorter time to oral intake and length of hospital stay, but also less frequent complications compared to open gastrojejunostomy. However, recurrent obstruction by tumor overgrowth and ingrowth occur more frequently and re-intervention for recurrent obstructive symptoms are more frequently performed after stent placement than after gastrojejunostomy. Thus, stent placement may be associated with more favorable results in patients with a relatively short life expectancy, while gastrojejunostomy is preferable in patients with a more prolonged prognosis. Also, open surgery affords a greater chance for curative surgery. However, most underlying diseases analyzed in previous studies were pancreaticobiliary malignancies, and there have been few prospective studies specific for patients with gastric cancer. Additional randomized controlled trials with larger sample sizes are expected to decide the treatment modality for unresectable gastric cancer with gastric outlet obstruction.

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