• Title/Summary/Keyword: Upper gastrointestinal symptoms

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Korean Medicine Treatment for Dyspepsia and Constipation in a Patient with HIV: A Case Report

  • Ji-Su Ha;Han-Song Park;Hyun-Seo Park;Ka-Hyun Kim;Hae-Won Hong;In-Ae Youn
    • Journal of Acupuncture Research
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    • v.40 no.2
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    • pp.143-149
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    • 2023
  • Functional dyspepsia (FD) is a chronic and recurrent upper gastrointestinal symptom that has no organic cause. A 49-year-old male patient positive for human immunodeficiency virus (HIV) visited the clinic because of FD and constipation. He received complex Korean medicine treatment, including acupuncture and herbal medicines, from April 14 to July 18, 2022 (27 times) in the outpatient department. Gastrointestinal Symptom Rating Scale (GSRS), Nepean Dyspepsia Index (NDI), FD-related quality of life (FD-QoL), Euro QoL visual analog scale (EQ-VAS), and Numerical Rating Scale (NRS) were used as evaluation tools in this study. Symptoms were relieved after 3 months of treatment, and his QoL improved (GSRS, 15-3; NDI, 110-21; FD-QoL, 52-20 [eating status, 10-3; liveliness status, 12-8; psychological, 1-0; role-functioning status, 18-9]; EQ-VAS, 40-65; NRS, 8-4). The results revealed that complex Korean medicine treatment could alleviate FD and constipation in patients with HIV.

Prevalence of Esophageal Cancer in the Northern Part of Afghanistan

  • Hamrah, Mohammad Shoaib;Hamrah, Mohammad Hashem;Rabi, Mirwais;Wu, Hong Xian;Hao, Chang-Ning;Harun-Or-Rashid, Mohammad;Sakamoto, Junichi;Ishii, Hideki
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.24
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    • pp.10981-10984
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    • 2015
  • Background: Esophagogastroduodenoscopy (EGD) is the standard technique for diagnosis of patients presenting with upper gastrointestinal symptoms. Some reports have shown high prevalence of esophageal cancer in the northern part of Afghanistan. The aim of this study was to investigate epidemiological profile of esophageal cancer among patients in this region. Materials and Methods: We identified 364 consecutive patients that received EGD examinations to examine upper gastrointestinal tract at the endoscopy unit of Balkh regional Hospital from March 2012 to March 2013. The case subjects included both in-patients and out-patients aged 16 years or more. We evaluated the results retrospectively. Results: The cases consisted of 184 (51%) males and 180 (49%) females. The mean age was $47.3{\pm}17.8$ and the age range 17-88 years. Ninety two cases had esophageal cancer, out of which 58 (63.0%) were male. The mean age at time of diagnosis was $57.8{\pm}13.2years$. Uzbek-Turkmen peoples were more common among patients with esophageal cancer (52.2%). Dysphagia was the most frequent symptom among patients with esophageal cancer at the time of presentation, seen in 77 (84.8%) of cases. Conclusions: Our results showed high incidence of esophageal cancer in the northern part of Afghanistan, especially in the Uzbek-Turkmen ethnic group.

Suspected Upper Gastrointestinal Bleeding by Interaction of Clozapine and Buspirone (상부위장관 출혈이 의심되는 클로자핀과 부스피론의 상호작용)

  • Sung, Yu-Mi;Kim, Soo-In;Yun, Kyu-Wol;Lim, Weon-Jeong
    • Korean Journal of Psychosomatic Medicine
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    • v.14 no.1
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    • pp.62-66
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    • 2006
  • Introduction: Unexpected serious and lethal drug interactions can be occurred by polypharmacy for treatment-resistant psychiatric disorders. We report a case who has suspected upper gastrointestinal bleeding after the combination of clozapine and buspirone. Case : A 69-year-old woman with DSM-IV schizophrenia who was admitted to our hospital had no previous medical problems. Findings on physical exam, laboratory values, EEG, and a magnetic reso-nance imaging scans were no abnormality, except for slightly low level of hemoglobin at admission. Because of aggravating anxiety symptom, a trial of buspirone was begun from 15mg, in addition to olanzapine 30mg. And then olanzapine was switched to clozapine due to her treatment-refractory his-tory and poor response on this admission. Moreover, At the admission 11 weeks later, after 4 weeks of starting buspirone and clozapine, she was placed on a regimen of clozapine 300mg and buspirone 60mg. At this point, she started to complaint nonspecific abdominal pain for 4 days and then hematemesis, melena and hypotension were developed suddenly with negative findings in gastroduodenoscopy. After stopping all medication, the suspected upper gastrointestinal bleeding was subsided. After the regimen was switched back to clozapine only, psychotic symptoms were improved without the recurrence of the adverse events. Conclusion : We concluded that the upper gastrointestinal bleeding in this case was attributed to the drug interaction with clozapine and buspirone, although the definite mechanism is not clear. The clini-cians should be very cautious to prescribe the combination of clozapine and buspirone due to a possible lethal adverse effect.

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Reye syndrome after acute enteritis during the neonatal period (신생아기 장염에 의하여 발병된 Reye 증후군)

  • Bang, Jun Suck;Nam, Sang Jung;Lee, Kyung Hwa;Bae, Eun Joo;Park, Won-Il;Lee, Hyun Sook;Son, Bae Young;Choi, Hwan Suck;Lee, Hong Jin
    • Clinical and Experimental Pediatrics
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    • v.49 no.3
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    • pp.273-277
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    • 2006
  • Purpose : The prevalence of Reye syndrome has decreased since late 1980's. But we report that recently there were concentrative attacks of Reye syndrome after acute enteritis during the neonatal period. Methods : Clinical symptoms and laboratory results(quantitative organic acid analysis, routine chemistry, arterial blood gas analysis, serum ammonia) of seven patients admitted at the Samsung Medical Center, Sanggye Paik Hospital, Wonju Christian Hospital and Chuncheon Sacred Heart Hospital, referred from Jan. 2005 to Apr. 2005, were analysed retrospectively. The major clinical symptoms were derived from the patients' clinical records sended with urine samples and quantification of organic acids were done with gas chromatography and mass spectrometry. Results : The mean age of seven cases is 18 days and the major preceding symptoms were gastrointestinal symptoms(vomiting, diarrhea, refusal to feeding). The major clinical symptoms were clouded conciousness, repiratory difficulty, vomiting, seizures, and diarrhea. One patient died; that patient's serum ammonia was twenty times higher than normal. Conclusion : The seven patients were neonates. Reye syndrome has been known to be closely related with upper respiratory infections as a preceding disease and to internal use of aspirin, but in our study, the major preceding disease of the seven cases was gastrointestinal infection and none of these used aspirin.

An incidental case of human Heterophyes nocens infection diagnosed by sectional morphology in a biopsy specimen of the small intestine

  • Ryang, Yong-Suk;Lee, Chi-Young;Lee, Kyu-Jae;Lee, Soon-Hyung;Chai, Jong-Yil
    • Parasites, Hosts and Diseases
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    • v.37 no.3
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    • pp.189-194
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    • 1999
  • A case of human infection with Heterophyes nocens (Heterophyidae) was incidentally found in a biopsy specimen of the Meckel's diverticulum at the upper part of the small intestine. The patient was a 58-year-old man living in a rural area of Talsong-gun, Kyongsangbuk-do.He had gastrointestinal symptoms such as epigastric pain, indigestion, and abdominal discomfort for 3 months, and severe diarrhea, abdominal pain, and vomiting for about 1 month before hospitalization. Endoscopy of the upper part of the small intestine revealed a Meckel's diverticulum, and it was excised and histo-pathologically examined. Three adult flukes were incidentally found sectioned in the mucosa, and they were identified as H.nocens. The patient had a history of eating raw mullets at a fish market in Pusan 6 months ago, and the mullets were presumed to be the source of infection. This case brings a considerable interest in that specific diagnosis of heterophyid infections could be done by sectional morphology of the worms.

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A Case of Recurrent Liver Abscess Due to Choledochoduodenal Fistula (재발하는 간농양에서 총담관-십이지장 누공의 내시경적 치료 1예)

  • Hur, Jun Ho;Choi, Sun Taek;Sohn, Min Su;Lee, Ji Eun;Chung, In Hee;Ki, Sung Ho
    • Journal of Yeungnam Medical Science
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    • v.30 no.1
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    • pp.39-42
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    • 2013
  • Cholelithiasis, duodenal ulcer, duodenal perforation and tumor invasion may lead to choledochoduodenal fistula (CDF). CDF often has no specific symptoms and may be incidentally detected in an upper gastrointestinal radiographic study or endoscopy; but in some cases, it may be accompanied by recurrent cholangitis and liver abscess. In this paper, a case of recurrent liver abscess caused by CDF is reported. A 62-year-old female was admitted to the authors' hospital because of right upper quadrant pain and fever. The abdominal computed tomography showed a liver abscess in the right lobe. A duodenal fistulous orifice was detected with endoscopy, and a contrast was injected through the duodenal orifice using a catheter under fluoroscopy. The injection of the contrast revealed a fistulous track between the duodenal bulb and the common hepatic duct. In fistulas complicated by recurrent liver abscess, surgery or medical management may be needed. The CDF in this case study was treated via endoscopic clipping.

BRUNNER'S GLAND ADENOMA - Case report, and review of etiopathogenesis and clinical features - (Brunner 씨 선종 - 임상증례 및 임상상적 문헌고찰 -)

  • Lee, Kyung-Chul
    • Journal of Yeungnam Medical Science
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    • v.2 no.1
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    • pp.265-269
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    • 1985
  • Brunner's glands of the duodenum rarely develop proliferative lesions, occasionally in association with gastric hyperchlorhydria or chronic pancreatitis. The clinical presentation can vary from vague upper abdominal symptoms with dyspepsia and nausea to diarrhea, jaundice, obstruction and gastrointestinal bleeding. The diagnosis is usually made by radiological studies followed by upper endoscopy which can also provide definitive treatment. At times surgery is necessary for adequate removal of these lesions, as in the case herein described.

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Feasibility Study of Early Oral Intake after Gastrectomy for Gastric Carcinoma

  • Jo, Dong-Hoon;Jeong, Oh;Sun, Jang-Won;Jeong, Mi-Ran;Ryu, Seong-Yeop;Park, Young-Kyu
    • Journal of Gastric Cancer
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    • v.11 no.2
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    • pp.101-108
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    • 2011
  • Purpose: Despite the compelling scientific and clinical data supporting the use of early oral nutrition after major gastrointestinal surgery, traditional bowel rest and intravenous nutrition for several postoperative days is still being used widely after gastric cancer surgery. Materials and Methods: A phase II study was carried out to evaluate the feasibility and safety of postoperative early oral intake (water intake on postoperative days (POD) 1-2, and soft diet on POD 3) after a gastrectomy. The primary outcome was morbidity within 30 postoperative days, which was targeted at <25% based on pilot study data. Results: The study subjects were 90 males and 42 females with a mean age 61.5 years. One hundred and four (79%) and 28 (21%) patients underwent a distal and total gastrectomy, respectively. The postoperative morbidity rate was within the targeted range (15.2%, 95% CI, 10.0~22.3%), and there was no hospital mortality. Of the 132 patients, 117 (89%) successfully completed a postoperative early oral intake regimen without deviation; deviation in 10 (8%) due to gastrointestinal symptoms and in five (4%) due to the management of postoperative complications. The mean times to water intake and a soft diet were $1.0{\pm}0.2$ and $3.2{\pm}0.7$ days, respectively, and the mean hospital stay was $10.0{\pm}6.1$ days. Conclusions: Postoperative early oral intake after a gastrectomy is feasible and safe, and can be adopted as a standard perioperative care after a gastrectomy. Nevertheless, further clinical trials will be needed to evaluate the benefits of early oral nutrition after upper gastrointestinal surgery.

Traumatic Hemobilia Following Blunt Chest Trauma -Report of 2 Cases- (흉벽 손상후 발생한 외상성 Hemobilia -2례 보고-)

  • Hahn, Young Sook;Lee, Hong Kyun
    • Journal of Chest Surgery
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    • v.9 no.2
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    • pp.117-124
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    • 1976
  • Hemorrhage into the biliary system as a consequence of injury to the liver has been called "traumatic hemobilia," a term introduced by Sandblom in 1948. The source of gastrointestinal hemorrhage has been frequently misinterpreted, resulting in inadequate or inappropriate treatment, often with catastrophic results and needless fatalities. It is now being diagnosed with increasing frequency, due to more widespread knowledge of the syndrome and improved diagnostic means. we experienced 2 cases of hemobilia following blunt chest trauma, One patient had! multiple rib fractures on right chest by car traffic accident and 13 days later, suddenly massive melena was developed with nausea, vomiting, jaundice and severe pain on right upper quadrant. And so, he had operated on the ligation of Rt. hepatic artery and partial right hepatectomy for a traumatic hemobilia. The other one also revealed similar symptoms 20 days later following blunt chest injury by falling down accident. However, uneventful recovery was seen without any of surgical intervention in this case.

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Infantile Hypertrophic Pyloric Stenosis -Clinical Differences between Premature and Full-term Infants (미숙아와 만삭아에서의 비후성 유문 협착증의 임상적 차이)

  • Lee, Suk-Koo;Kim, Seong-Hwan;Lee, Woo-Yong;Kim, Hyun-Hahk
    • Advances in pediatric surgery
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    • v.4 no.1
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    • pp.34-38
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    • 1998
  • Infantile hypertrophic pyloric stenosis(IHPS) is common in full-term babies, and relatively rare in prematures. The diagnosis of IHPS in premature infants may be obscured because of the lack of classic symptoms and signs and the absence of the standard criteria for ultrasonic diagnosis. The purpose of this study is to discover the clinical differences between premature and full-term infants with pyloric stenosis, and determine the appropriate diagnostic methods for early diagnosis in premature infants. The clinical records of 52 IHPS patients who had been operated upon from October, 1994 to April, 1997 were reviewed. The incidence of IHPS in premature infants was 25 %. The onset of symptom was 4.7 weeks of age in premature, and 2.9 weeks in full-term babies. Diagnosis was established by typical symptoms. signs. and diagnostic imaging studies. In two premature infants, diagnosis was confirmed by upper gastrointestinal(GI) series, because ultrasonography did not meet the diagnostic criteria. Two premature infants initially diagnosed as gastroesophageal reflux by esophagography. were found to have IHPS by upper GI series. For the diagnosis of IHPS, a new set of criteria for premature babies has to be developed.

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