• Journal of Yeungnam Medical Science
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• 제33권1호
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• pp.29-32
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• 2016

Most ingested foreign bodies pass readily throughout intestinal tract if they reach the stomach. In some cases, foreign bodies may be impacted behind a luminal constriction but are rare in colon. Here, we report the case of a 59-year-old man who did laparoscopic anterior resection due to sigmoid colon cancer 2 years ago and ischemic colitis was repeated on the anastomosis site. He initially presented with symptoms of abdominal pain 3 months before and melena 1 day before admission. Abdomen computerized tomography showed a 3.2 cm segment of luminal narrowing of the proximal colon involving upstream foreign material stasis. Sigmoidoscopic approaches revealed near complete obstruction on the anal verge of 20 cm and scope passing failed. Balloon dilatations were done on the obstruction site four times all and a foreign body impacted above the obstruction site was removed by an alligator without any complications. The foreign body removed looks like plastic or a shell, about 20 mm in size.

• Journal of Yeungnam Medical Science
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• 제11권2호
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• pp.381-387
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• 1994

저자틀은 53세 여자로써 연하곤란, 철 결핍성 빈혈, 구각순증, 설염, 스푼형 조갑과 경부식도 막양구조를 특징으로 하고, 내시경적 풍선확장술에 의한 막양구조의 제거와 경구 철제 투여 후 현저한 증상의 호전을 보인 전형적인 Plummer-Vinson 증후군 환자를 경험하였다. 병력상 연하곤란이 나타나기 전부터 빈혈이 발견되었고, 철제 투여 후 피부와 점막의 병변도 호전된 점등을 고려해 볼 때 철 결핍이 본 질환의 발생에 중요한 역할을 한 것으로 추측할 수 있었다.

• Journal of Yeungnam Medical Science
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• 제39권2호
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• pp.161-167
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• 2022

Congenital web formations are extremely rare anomalies of the extrahepatic biliary tree. We herein report a case of common bile duct septum combined with multiple intrahepatic bile duct strictures in a 74-year-old female patient who was successfully treated with radiological intervention. The patient initially visited the hospital because of upper abdominal pain. Imaging studies revealed multifocal strictures with dilatation in both intra- and extrahepatic ducts; the final clinical diagnosis was congenital common bile duct web combined with multiple intrahepatic duct strictures. Surgical treatment was not indicated because multiple biliary strictures were untreatable, and the disease was clinically diagnosed as benign. The multiple strictures were extensively dilated twice through bilateral percutaneous transhepatic biliary drainage (PTBD) for 2 months. After 1 month of observation, PTBD catheters were successfully removed. The patient is doing well at 6 months after completion of the radiological intervention, with the maintenance of normal liver function. Congenital web of the bile duct is very rare, and its treatment may vary depending on the patterns of biliary stenosis. In cases where surgical intervention is not indicated for congenital web and its associated disease, radiological intervention with balloon dilatation can be a viable therapeutic option.

• Clinical Endoscopy
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• 제56권6호
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• pp.726-734
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• 2023

Background/Aims: Endoscopic stenting for stricturing Crohn's disease (CD) is an emerging treatment that achieves more persistent dilatation of the stricture over time than endoscopic balloon dilatation (EBD). We aimed to explore the efficacy and safety of stenting for the treatment of CD strictures. Methods: A systematic electronic literature search was performed (PROSPERO; no. CRD42022308033). The primary outcomes were technical success, efficacy, complication rate, and the need for further interventions due to reobstruction. The outcomes of partially covered self-expanding metal stents (PCSEMS) with scheduled retrieval after seven days were also analyzed. Results: Eleven eligible studies were included in the review. Overall, 173 patients with CD were included in this study. Mean percentage of technical success was 95% (range, 80%-100%), short-term efficacy was 100% in all studies, and long-term efficacy was 56% (range, 25%-90%). In patients with a scheduled PCSEMS retrieval, the long-term efficacy was 76% (range, 59%-90%), the mean complication rate was 35% (range, 15%-57%), and the major complication rate was 11% (range, 0%-29%). Conclusions: Endoscopic stenting with scheduled PCSEMS retrieval may be considered a feasible second-line treatment for short CD strictures to postpone surgery. However, larger head-to-head prospective studies are needed to understand the role of stenting as an alternative or additional treatment to EBD in CD.

• Journal of Korean Neurosurgical Society
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• 제30권sup1호
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• pp.165-169
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• 2001

Apatient, 51 years old woman, had suffered form headache and decrease of visual acuity. She had $3{\times}3cm$ sized giant aneurysm originated in cavernous and clinoid portion of left ICA(C4,C5) in the cerebral angiography. Before craniotomy, left CCA was exposed and 6F double lumen catheter was inserted in left ICA through the sheath. Pre-operative angiography was done. balloon catheter was positioned at the petrous portion of ICA. Eyebrow approach was done and giant aneurysm was exposed. The proximal blood flow was controlled with balloon dilatation and suction and decompression was tried, then multiple clips were applied. The loss of distal blood flow under intra-operative angiography was notified after clipping. The position of clips were repositioned to preserve blood flow & the rich flow was confirmed at distal part of clipping. In the post-operative cerebral angiography, the same finding was shown.

• Journal of Chest Surgery
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• 제23권2호
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• pp.396-401
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• 1990

This report is an review of 5 cases of congenital esophageal atresia associated with tracheoesophageal fistula which were treated in the Department of Thoracic and Cardiovascular Surgery, Chonnam University Hospital from January, 1987 to February, 1989. First patient that was associated with VATER’s syndrome and moderate pneumonia, i.e., Waterston Category C was treated by gastrostomy, colostomy and primary anastomosis, but expired. Second patient that was weighed 2.2 Kg, suffered from moderate pneumonia was treated by gastrostomy, but died from asphyxia. The other patients were treated by primary repair. Any anastomotic leakage or gastroesophageal reflux was not found in these cases, but mild anastomotic strictures were found in these patients by postoperative esophagography. However, esophageal dilatation of anastomotic strictures was successful using the Griintzig balloon catheter.

• Journal of Chest Surgery
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• 제25권9호
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• pp.891-899
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• 1992

Esophageal atresia with tracheoesophageal fistula may occur as separate, but usually occur in combination. First described by Thomas Gibson in 1696, esophageal atresia was not successfully treated until 1939 when the first two survivors of staged correction were described by Ladd and Leven. In 1941, Haight and Towsley performed the first successful one-stage primary repair. We report three cases of esophageal atresia with tracheoesophageal fistula of which were treated with one-stage surgical repair method. The operation was performed tra-nspleurally through right 4th intercostal space. The fistula in the trachea was closed with interrupted 5-O prolene sutures and esophagoesophageal anastomosis was performed with 3-O prolene single layer sutures in all cases. All patients tolerated the operative procedures and recovered uneventfully. On follow-up study, anastomotic stricture was developed in one patients, so esophageal dilatation was performed for it with the Griintzig balloon catheter and the result was satisfactory. The other patients were well-being without any complication.

• Journal of Chest Surgery
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• 제37권4호
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• pp.364-368
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• 2004

선천성 폐정맥 협착증은 매우 드문 기형으로 진행성 폐동맥 고혈압 및 조기 심부전으로 사망률이 높아 적극적인 내외과적 치료가 요구된다 수술적 치료법으로는 품선 확장술, 스텐트 삽입술, 전폐절제술, 폐이식술, 패취 봉합술, 그리고 무봉합 교정술 등이 있다. 본원에서는 정상적인 해부학적 연결을 가진 폐정맥 협착증에서 무봉합 교정술 및 수술 후 Sildenafil, Iloprost 그리고 NO gas등의 폐혈관 확장제를 사용하여 성공적으로 치료한 1예를 경험하여 이를 보고하고자 한다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제15권1호
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• pp.52-56
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• 2012

Congenital esophageal stenosis (CES) can be classified into three types based on the etiology of stenosis: tracheobronchial remnants (TBRs), fibromuscular hypertrophy (FMH), and membranous diaphragm (MD). It is important to make a differential diagnosis because the therapeutic plan for CES is determined by its etiology. Most cases of FMH and MD can be managed with balloon dilatation, whereas cases of TBRs require resection and anastomosis. Thus, the preoperative distinction of TBRs is critical. Recently miniprobe endoscopic ultrasonography (EUS) with a maximum diameter of 2.5 mm has been useful for distinguishing TBRs from FMH in pediatric patients with CES. EUS shows hyperechoic lesions indicating TBR cartilage. Miniprobe EUS is recommended for choosing the correct therapeutic method for CES. We report a case of CES due to TBRs in which a preoperative diagnosis was made in a child using miniprobe EUS without any difficulties.

• Journal of Chest Surgery
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• 제24권12호
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• pp.1232-1237
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• 1991

The cervical esophageal stricture has various surgical modalities and difficulties in reconstruction. We had experienced a case of successful reconstruction of the cervical esophageal restenosis using the free jejunal graft, on 30 year old man had had esophageal stricture after ingestion of lye. He had undergone colon interposition[esophagocologastrostomy] with left colon feeding gastrostomy. But restenosis was occurred just above of the cervical esophagocolostomy site several times of balloon dilatation were failed. So, we decided to use of the free jejunal graft. The free jejunal graft was isolated about 15cm length with it`s vascular arcades. The graft was irrigated with the mixed solution as isotonic saline, heparin and papaverine chloride. The artery of graft was anastomosed to the branch of the external carotid artery in end to side with continuous sutures of the 8.0 Prolene. The vein of the graft was anastomosed to the branch of the anterior facial vein in end to end with continuous sutures of the 8.0 prolene. Postoperative course was uneventful and the patient was discharged after removal of the tracheostomy cannula and gastrostomy tube.