• Title/Summary/Keyword: Esophageal ulcer

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Three Cases of Tetracyclines Induced Esophageal Ulcer (Tetracyclines이 원인으로 생각되는 약제성 식도궤양 3례)

  • Lee, Heon-Ju;Chung, Moon-Kwan;Kim, Chong-Suhl
    • Journal of Yeungnam Medical Science
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    • v.1 no.1
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    • pp.179-183
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    • 1984
  • In recent years, an increasing number of drugs have been reported to cause direct esophageal damage. More than 30 cases on tetracyclines induced esophageal ulcer have been reported since the first description of tetracycline induced esophageal ulcer by Bokey and Hugh in 1975. In Korea, only one case of doxycycline-induced esophageal ulcer has been reported. Authors have experienced 3 cases of esophageal ulcer probably caused by tetracyclines. The patients had taken their capsules just before going to bed with little fluid intake. About 6-8 hours later they had felt substernal burning sensation and epigastric discomfort. Gastrofiberscopy revealed relatively well demarcated circular ulcers on the mid esophagus. An esophagogram showed no apparent abnormality. Patients's symptomas became negligible with antacid treatment within 2-5 days. One of the causes of the esophageal ulcer is thought to be the delay in transit time of drugs and direct esophageal damage from mucosal contact when tablets are ingested in the recumbent position without an accompanying proper quantity of fluid. If only physicians endow patients with more concern about drug induced esophageal ulcer, they could find out more increasing number of drug induced esophageal ulcers by gastroscopic examination and thereby could prevent tetracycline induced esophageal ulcer.

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Cytomegalovirus-associated esophageal ulcer in an immunocompetent infant: When should ganciclovir be administered?

  • Jang, Hyo-Jeong;Kim, Ae Suk;Hwang, Jin-Bok
    • Clinical and Experimental Pediatrics
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    • v.55 no.12
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    • pp.491-493
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    • 2012
  • Cytomegalovirus (CMV)-associated esophageal ulcer is rare in immunocompetent infants. The presence of inclusion bodies and immunohistochemical staining for CMV in biopsy specimens obtained during esophagogastroduodenoscopy (EGD) indicate that such ulcers occur because of CMV infection. A 7-week-old female infant who experienced frequent vomiting and feeding intolerance was diagnosed with a massive CMV-associated ulcer in the distal esophagus. The ulcer improved after conservative treatment using proton-pump inhibitors; however, ganciclovir was not administered. In a follow-up EGD biopsy specimen, no CMV inclusion bodies were present, and immunohistochemical staining results for this virus were negative. The presence of CMV inclusion bodies indicates active viral replication. If persistent inclusion bodies or positive immunohistochemical staining for CMV is observed in follow-up biopsy specimens, ganciclovir may be used to treat CMV-associated esophageal ulcers.

A Case Report of Esophageal Ulceration after Taking Doxycycline (독시사이클린 복용 후 발생한 식도궤양형성 사례)

  • Kim, Ga Yeon;Lee, Chan Hee;Lee, Jeong Woo;Lee, Jung-Min;Lee, Mo-Se;Ji, Eunhee
    • Korean Journal of Clinical Pharmacy
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    • v.29 no.3
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    • pp.209-214
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    • 2019
  • Doxycycline is frequently prescribed to treat urogenital infections or acne vulgaris. A 39-year-old man was prescribed doxycycline as a treatment for his skin infection. He took each tablet on an empty stomach in the morning, and just before going to bed with insufficient water. After taking the prescribed medication for approximately 3 weeks, he was diagnosed with esophageal ulcer. He had not experienced these symptoms before, and the drug label says that doxycycline rarely causes esophageal ulcer. After discontinuing the medication, the symptoms disappeared. Using the World Health Organization-Uppsala Monitoring Center criteria, the causality for doxycycline-induced esophageal ulcer was evaluated as "possible." Additionally, using the Naranjo scale and Korean causality assessment algorithm (Ver. 2), the causality was evaluated as "probable." Previous reports have stated that most patients who took doxycycline with insufficient water just before going to bed or in the supine position developed esophageal ulcer. Therefore, all patients taking doxycycline must be provided with detailed instructions about the appropriate administration methods.

Sliding esophageal hernia associated with hemorrhagic gastric ulcer-A case report- (출혈성 위궤양이 병발한 식도열공 허니아의 치험례)

  • 정원상
    • Journal of Chest Surgery
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    • v.16 no.3
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    • pp.386-390
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    • 1983
  • One case of surgically treated sliding esophageal hiatal hernia associated with bleeding gastric ulcer is presented. The patient was 73 years-old woman who had suffered from epigastric heartburn, indigestion, and melena since 3 months prior to admission. Esophageal hiatal hernia was suspected on the simple chest film and the diagnosis was confirmed by tetralogic barium study of the gastrointestinal tract. Hematemesis and melena were persisted so emergent thoracotomy and abdominal exploration were undertaken. Repair of hiatal hernia by constricting suture around relaxed esophageal hiatus was made and plication sutures were Inserted between esophagogastric junction and median arcuate ligament of diaphragm. Concomittently, subtotal gastrectomy with Billroth II procedure was performed to removal of large bleeding ulcer on the lesser curvature of the stomach antrum. Postoperative course was uneventful.

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Experimental Studies on Pharmacological Action of the Banhahubagtang, A Combined Preparation of Oriental Medicine (반하후박탕(半夏厚朴湯)의 실험약리학적(實驗藥理學的) 연구(硏究))

  • Lee, Bum-Koo;Cho, Tae-Soon
    • Korean Journal of Pharmacognosy
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    • v.18 no.1
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    • pp.14-25
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    • 1987
  • The effects of the water extract of 'Banhahubagtang', the combined herbal medicine, on the low esophageal sphincter, stomach, small intestine and CNS were investigated, and the results were as follows: The hexobarbital induced sleeping time was prolonged in female mice. The convulsion induced by electric shock was suppressed and analgesic action was recognized in mice. The extract inhibited intestinal propulsion of barium sulfate in mice. The extract inhibited free acid secretion and showed remarkable suppression of gastric ulcer in rats. Relaxation induced by isoproterenol and norepinephrine in low esophageal sphincter(L.E.S.) of rabbit was potentiated by addition of the extract. In conclusion, the Banhahubagtang exhibited anticonvulsive, sedative and L.E.S. inhibitory activities. These experimental results might indicate to be coincided with the indications for neuro-esophago-stenosis, esophagitis, esophagia, gastralgia, and neurosis which are well referred to the literature of oriental medicine.

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Gastro-Cavenous Fistula Developed after Esophagectomy(Ivor Lewis Operation) Due to Active Gastric Ulcer in Esophageal Cancer (식도암 환자에서 식도암적출술후 활동성 위궤양에 의해 발생한 위-공동 누공)

  • 김성철;심영목;김관민;김진국
    • Journal of Chest Surgery
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    • v.32 no.1
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    • pp.49-52
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    • 1999
  • A 58-year-old male patient visited our hospital for epigastric discomfort and dysphagia which had developed 5 months earlier. He was diagnosed with esophageal cancer at the mid-thoracic level based on radiologic, endoscopic, and histologic examinations. An esophagectomy(Ivor Lewis technique) was done to treat the esophageal cancer. He was doing well until the 20th postoperative day when he began to complain of cough, sputum, fever and chills, Subsequently, thereafter, abdominal pain and generalized abdominal tenderness developed on the 22nd postoperative day. Upon gastrofiberscopy and esophagographic examinations, he was diagnosed with gastrobronchial fistula and an emergency operation was performed. On operative findings, the gastric fundus was perforated and directly connected to the abscessed cavity of the right upper lobe due to a gastric ulcer. We, herewith, report this case after review of the literature.

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Surgical Treatment of Benign Esophageal Stricture (양성 식도 협착의 외과적 치료)

  • 박창권
    • Journal of Chest Surgery
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    • v.23 no.1
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    • pp.107-114
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    • 1990
  • During a ten-year period from August, 1978 to September, 1989 45 patients with benign esophageal stricture were surgically evaluated. The results are as follows; l. Out of 45 patients, there were 26 males and 19 females ranging from 2 to 70 years of age with a mean of 31.9 years. 2. The most common cause of benign esophageal stricture was corrosive burn due to caustic agents[40 cases, 88.9 %]. Corrosive agents were 15 cases of lye, 22 cases of acid and 3 cases of other agents. Other causes were two cases of esophageal web and each one case of previous surgical result, inflammation and idiopathic mediastinal fibrosis respectively. 3. The most frequent stricture site was whole esophagus as 21 cases[46.7 %] and the next was lower a third thoracic esophagus[10 cases, 25.0%]. 4. In 33 of total 45 cases, colon interposition with right colon was performed without resection of the strictured esophagus except one case which was complicated esophageal cancer. Other procedures were 4 cases esophagogastrostomy with segmental resection, 2 cases of plastic repair and so on. 5. Major postoperative complications which were needed for secondary operation were 5 cases[11.1 %]. [2 cases of stenosis, ileus and ulcer bleeding respectively] Overall mortality rate was 4.4 %.

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A Study on the concept of Ulkyuk and Banui (열격${\cdot}$반위의 개념에 대한 소고)

  • 김지미
    • Journal of Life Science
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    • v.7 no.3
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    • pp.241-252
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    • 1997
  • Having examined the literatures on the terminologies. UlkyuK and Banui, the following results were obtained. 1. since Ul accompanies the symptom of dysphagia. it is thoughr ro indicate the disease and ailment in the larynx and pharynx. and the esphangus. 2. Kuyk is used in the contextof Kyuksak. Kyukjung. Bikyuk. Ulsakamnd Ulkyuk. and since it also includes the meaning of Ul. it is thought that disease and ailment in the esophagus. stomach and duodenum are included in this category. 3. Although Ul and Kyuk are differentiated. since they appear in conjunction with the other clinically. they can be refferred to as Ulkyuk. 4. Banui represents the phenomenon of vomiting. because it is oresent in a bad case of Ulkyuk. it can be seen to be included in Ulkyuk. Thus. Ulkyuk and Banui can be refferred to as one. 5.Although the name of an ailments in oriental medicine and that in the western medicine can not be in perfect match. Ulkyuk is refferred to as ailments in esophagus such as esophagitis. esophageal ulcer, esophageal deverticulum and esophageal cancer. while Banui is refferred to asailments in stomanch and duodenum such as stomach cancer. chtonic spasmic gastritis. it is reasonable to differentiate the two in general. As seen above, since the concept of the terminologies. Ulkyuk and Banui are somewhat different among Oriental medicine doctors. a consensus is needed to come up with terms that all can agree on.

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The Protective Effect of Arecae Semen and Coptidis Rhizoma in a Chronic Reflux Esophagitis Rat Model (만성 역류성 식도염 모델에서 빈랑(檳榔)와 황련(黃連) 복합물의 보호 효과)

  • Lee, Se Hui;Lee, Jin A;Shin, Mi-Rae;Lee, Ji Hye;Roh, Seong-Soo
    • The Journal of Internal Korean Medicine
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    • v.42 no.1
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    • pp.11-24
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    • 2021
  • Objective: Chronic reflux esophagitis (CRE), characterized by esophageal mucosa ulcer, is caused by continuous backflow of gastric acid and consequent inflammation due to unstable gastroesophageal sphincter. The aim of the present study was to clarify the effect of an Arecae Semen and Coptidis Rhizoma mixture (AC-mix) on CRE. Methods: CRE was surgically induced in SD rats with three experimental groups used: normal; CRE control; and CRE treatment (200 mg/kg AC-mix). Blood and esophageal tissue were collected after two weeks of drug administration. The anti-oxidant activity of the AC-mix was measured by total polyphenol and total flavonoid contents as well as by radical scavenging activity with protein levels evaluated using western blotting. Results: CRE damage to the esophageal mucosa was significantly reduced in the AC-mix group as compared with the controls, and administration of the AC-mix was seen to inhibit NF-κBp65 activity. Consequently, the inactivation of NF-κBp65 significantly inhibited inflammatory mediators such as COX-2 and iNOS. Moreover, the anti-oxidant enzyme HO-1 significantly increased through activation of the Nrf2-Keap1 pathway. Matrix metalloproteinase-2 (MMP-2), which can break down collagen from the basement membrane and extracellular matrix, was decreased following AC-mix treatment, and elevated levels of MMP-2 were regulated by its tissue inhibitor. Conclusions: These results show that AC-mix can alleviate esophageal mucosa ulcer though inhibition of the NF-κBp65 inflammatory pathway and enhancement of the anti-oxidant Nrf2-Keap1 pathway.

Clinical Study of Duodenal Ulcer (십이지장 궤양의 임상적 고찰)

  • Im, Nam-Sung;Moon, Soo-Hyung;Lee, Jai-Hoang;Kim, Kang-Sueck
    • The Journal of the Korean life insurance medical association
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    • v.9
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    • pp.130-137
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    • 1990
  • We'd performed the upper gastrointestinal study for a total of 10,047 insureds-male 5,919 female 4,128 persons-who were examined at medical department of Dae Han Kyoyuk Insurance Co., from August, 1986 to December, 1989. The results on duodenal ulcer were as follows; 1) Duodenal ulcer was found in 138 cases(1.37%) among the 10,047 insureds. 2) In all 138 cases who have duodenal ulcer, duodenal ulcer was found in 112 cases(1.89%) among the 5,919 insureds of male and in 26 cases(0.63%) among the 4,128 insureds of female. The incidence of duodenal ulcer in male was higher than in female. 3) The possessing rate of duodenal ulcer is 1.28% in 20 yrs, 1.24% in 30 yrs, 1.72% in 40 yrs, 1.21% in 50 yrs, 0.48% in 60 yrs. 4) The possessing rate of duodenal ulcer in male is 2.24% in 20 yrs, 1.78% in 30 yrs, 1.99% in 40 yrs, 2.05% in 50 yrs, 0.91% in 60 yrs and in female, 0.52% in 20 yrs, 0.48% in 30 yrs, 1.20% in 40 yrs, 0.2% in 50 yrs. 5) Coexistent lesion with duodenal ulcer were found in 19 cases; one case of esophageal diverticulum, one case of gastric diverticulum, one case of duodenal diverticulum, tow cases of gastric ulcer, six cases of gastritis, five cases of duodenitis, two cases of gastroduodenitis, one case of pseudodiverticulum.

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