• Title/Summary/Keyword: acute abdominal pain

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A Case of Spontaneous Common Iliac Atery Dissection

  • Noh, Juho;Rhee, Il;Kim, Minsung;Lee, Jonghyun;Kim, Kisu;Park, Byungwhan
    • Kosin Medical Journal
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    • v.33 no.3
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    • pp.431-437
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    • 2018
  • Spontaneous and isolated dissection of the limb arteries without involvement of the aorta is extremely rare, and has been reported previously in pregnant patients in association with collagen vascular disease, and in cases of high-energy trauma or intensive activity in athletes. There is no consensus yet on indications for medical or surgical therapeutic modality. Due to the rarity of spontaneous dissection of external iliac artery, its natural history has been poorly described. A healthy 50-year-old male with normotension was admitted with an acute onset of left flank pain. Left external iliac artery dissection was diagnosed by abdominal computed tomography.

Acute Abdominal Pain after Ingestion of Bowel Cleansing Agent for Colonoscopy (장정결제 복용 후 발생한 급성 복통)

  • Kim, Hwon;Park, Jong Seol;Kim, Yong Sung
    • The Korean journal of helicobacter and upper gastrointestinal research
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    • v.18 no.4
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    • pp.275-276
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    • 2018
  • 42세 여자가 갑작스러운 복통으로 소화기내과 외래를 방문하였다. 환자는 당일 건강검진 대장내시경이 예정되어 있었으며 전날 밤 장정결제인 피코라이트 산(sodium picosulfate hydrate 10 mg, magnesium oxide 3.5 g, citric acid 12 g; Pharmbio Korea Inc., Seoul, Korea)을 물에 녹이지 않고 그냥 복용한 후부터 증상이 발생하였다. 신체 검사에서 복부는 부드러웠으며 압통은 없었다. 즉시 시행한 상부위장관 내시경 검사에서 황색의 두터운 가피가 덮여 있는 다발성 병변이 위체부 대만 및 저부에서 관찰되었다(Fig. 1A). 가피는 생검 겸자를 이용해 쉽게 벗겨졌으며(Fig. 1B), 가피를 제거한 후 급성 출혈성 미란 병변들이 확인되었다(Fig. 1C). 이 환자에서 관찰된 위병변의 진단은 무엇인가?

Acute cocaine poisoning in a body packer

  • Park, Mee-Jung;Choi, Sang-Kil;Son, Haeng-Ja;Lee, Jae-Sin;Kim, Eun-Mi;Lim, Mi-Ae;Chung, Hee-Sun
    • Proceedings of the PSK Conference
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    • 2003.10b
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    • pp.113.1-113.1
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    • 2003
  • A 35-year-old Perubian who suffered from grand mal seizures died in aircraft on his way from United States to Hongkong. When he boarded the aircraft, he was normal but later he suffered from hyperthermia, dizziness, abdominal pain, agitation and convulsion in the flight before dead. While performing the autopsy, 115 cocaine packs were found in the GI tract. To determine the concentration of cocaine and its metabolites, blood, urine, bile juice, gastric content, liver, spleen, heart, kidney, cellebrum and lung were taken and analyzed. (omitted)

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A Case of Concomitant Scrub Typhus and Leptospirosis (쓰쓰가무시병과 렙토스피라병 동시 감염 1예)

  • Lee, Sang-Pyo;Shin, Hyun Jong;Lee, Hee-Kyung;Kwak, Hyun Jung;Kim, Sang-Heon;Kim, Tae-Hyung;Sohn, Jang-Wong;Yoon, Ho-Joo;Shin, Dong-Ho;Park, Sung-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.4
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    • pp.378-381
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    • 2007
  • Tsutsugamushi disease (Scrub typhus) is an acute, febrile illness caused by Orientia tsutsugamushi, which is transmitted to humans through chigger bites. Leptospirosis, a febrile disease caused by various pathogenic Leptospira, and is acquired by exposure to contaminated water and soil. Both diseases have been the most common acute febrile diseases in the autumn in Korea for many years. Concomitant leptospirosis and scrub typhus is quite rare. We report a case of a coinfection with leptospirosis and scrub typhus in a 51-year-old male who presented with fever, abdominal pain and acute dyspnea. The patient was diagnosed with as acalculous cholecystitis, acute respiratory distress syndrome, and septic shock caused by the infection. This is the first case report of a coinfection with leptospirosis and scrub typhus in Korea.

Severe ileus after colonoscopy in a patient on peritoneal dialysis

  • Kim, Sang Un;Kim, Su Hee;Hwang, So Yoon;Kim, Ryang Hi;Choi, Ji-Young;Cho, Jang-Hee;Kim, Chan-Duck;Kim, Yong-Lim;Park, Sun-Hee
    • Journal of Yeungnam Medical Science
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    • v.34 no.1
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    • pp.119-122
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    • 2017
  • Peritoneal dialysis (PD) is associated with the development of various complications, such as exit site infection or peritonitis, and rarely, intestinal obstruction in prolonged PD patients with recurrent peritonitis. However, post-colonoscopy acute intestinal obstruction has not been reported in PD patients to date. Herein, we report a case of severe ileus after a colonoscopy without previous episodes of peritonitis in a PD patient. A 51-year-old man undergoing PD for 7 years visited our emergency department due to severe abdominal pain and vomiting after colonoscopic polypectomy. A simple abdominal radiography and abdominal computed tomography showed ileus with collapsed distal ileal loop. A peritoneal dialysate study revealed no evidence of peritonitis. The patient was treated with decompression therapy, and ileus was successfully treated without complications. This case suggests that it is not only necessary to prevent peritonitis, but also important to monitor the development of ileus after colonoscopy in PD patients.

The oriental-western literal study of Crohn's disease (크론씨병(극한성(局限性) 장염(腸炎))에 관(關)한 한의학적(韓醫學的) 고찰(考察))

  • Choi, Chang-Woo;Son, Chang-Gyu;Cho, Chong-kwan
    • Journal of Haehwa Medicine
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    • v.9 no.2
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    • pp.251-268
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    • 2001
  • We arrived at the following conclusion after we have studied crohn's disease through the literatures of western and oriental medicine. 1. Crohn's disease has a characteristic of granulomatous necrosis and cicatricial inflammation which is called by segmental enteritis, granulomatous enteritis. This falls under the category of "Diarrhea", "Dysentery" and is similar to "small intestinal diarrhea", "acute temesmus", "splenic diarrhea" in oriental medicine. 2. In western medicine, the cause of crohn's disease indefinites, but it is presumed immunological unbalance of alimentary canal. In oriental medicine, it is summarized as the abnormal ascending and descending circulation of stomach and splenic energies, the hepatic stagnation, being the lower part of cleaning qi by exogenous disease, dyspeptic convulsion. 3. The presenting symptoms of crohn's disease are intermittent chronic diarrhea, fever, weight loss, abdominal spastic pain or abdominal discomfort. When anyone has a abdominal mass, a rectal abcess, and a rectal constriction by physical examination, we can doubt crohn's disease. 4. The methods of western medical treatment are a suppression of intestinal toxic contents and inflammatory mediator, a supply of nutritive substanceus to intestinal epithelial cell. Oriental medical treatments of these are "inducing diuresis", "warming kidney to reinforce yang", "nourishing qi to invigorate spleen", "eliminatin dampness by cooling" according to syndrome differentiations. As mentioned above, we can confirm possibility of oriental medical treatment that induces recovery of immunologic control function and we need advanced experiment, study, and clinical approach.

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A Study on the 'Diagnosis and Treatment of the Woonded, Carbuncle, intestinal infection and acute eczema' in Synopsis of Golden Chamber(金?要略) (금궤요략(金?要略).창옹장옹침음병맥병증치제십팔(瘡癰腸癰浸淫病脈幷證治第十八)에 대(對)한 연구(硏究))

  • Han, Sung-Kyu;Yun, Ju-Heon;Ryou, Jeong-Kyu;Lee, Yun-Cheon;Lee, Young-Sub;Jeong, Heon-Young
    • Journal of Korean Medical classics
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    • v.19 no.3
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    • pp.365-380
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    • 2006
  • All of the disease which was referred in ${\ulcorner}$Diagnosis and Treatment of the Woonded, Carbuncle, intestinal infection and acute eczema in Synopsis of Golden Chamber${\lrcorner}$ are belong to surgery. Woonded in this chapter, specially, come under in case occur by metal, and spoke that this thing is metal wounded(金瘡). I am considered by something to use Wangbulryuhaengsan(王不留行散) in wound that is not festered, Baenongtang(排膿湯) and Baenongsan(排膿散) in wound that is festered. Carbuncle is one of Venus festering nature file that happen in skin and muscle because blood does not circulate with flag and part's flare, calorification, pain, puffiness are characteristic. Carbuncle is agreed with concept of inflammation of modern medicine. When treat carbuncle, without using surgery medical treatment, used together internal medicine surgery medical treatment. Intestines carbuncle(腸癰) is come in inflammation in abdominal cavity as kind of inflammation, partiality peritoneum festering disease round present cecum as one of inside carbuncle. I think, when treat intestines carbuncle, in case cold and moisture become stasis and heat is less, Uiibujapaedoksan(薏苡附子敗毒散) can be used. Independently of festering, Daehwangmokdantang(大黃收丹湯) can be used in case heat and extravasated blood become stasis. Saliva ulcer on the vulva is comes in impetigo In Case of young child, and is come in Venus eczema in case is general. Prognosis of saliva ulcer on the vulva widespread thing can treat by arm, leg at Lips region, but it does not treat to grow at Lips region from limb, and treatment uses Hwangryunbun(黃連粉)

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A Clinical Score and Ultrasonography for the Diagnosis of Childhood Acute Appendicits (소아급성충수염의 진단에서 점수제와 초음파검사)

  • Chung, Jae-Hee;Jeon, Su-Youn;Song, Young-Tack
    • Advances in pediatric surgery
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    • v.10 no.2
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    • pp.117-122
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    • 2004
  • Diagnosis of acute appendicitis in children is sometimes difficult. The aim of this study is to validate a clinical scoring system and ultrasonography for the early diagnosis and treatment of appendicitis in childhood. This is a prospective study on 59 children admitted with abdominal pain at St. Mary's Hospital, the Catholic University of Korea from July 2002 to August 2003. We applied Madan Samuel's Pediatric Appendicitis Score (PAS) based on preoperative history, physical examination, laboratory finding and ultrasonography. This study was designed as follows: patients with score 5 or less were observed regardless of the positive ultrasonographic finding, patients with score 6 and 7 were decided according to the ultrasonogram and patients above score 8 were operated in spite of negative ultrasonographic finding. The patients were divided into two groups, appendicitis (group A) and non-appendicitis groups (group B). Group A consisted of 36 cases and Group B, 23 cases. Mean score of group A was 8.75 and group B was 6.13 (p<0.001). Comparing the diagnostic methods in acute appendicitis by surveying sensitivity, specificity, positive predictive value, negative predictive value, and accuracy, PAS gave 1.0000, 0.3043, 0.6923, 1.0000, and 0.7288, and ultrasonography gave 0.7778, 0.9130, 0.9333, 0.7241, and 0.8300 while the combined test gave 1.0000, 0.8696, 0.9231, 1.0000, and 0.9490, respectively. Negative laparotomy rate was 3 %. In conclusion, the combination of PAS and ultrasonography is a more accurate diagnostic tool than either PAS or ultrasonography.

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Ulcerative Colitis Mimicking Acute Hemorrhagic Colitis (급성 출혈성 대장염으로 오인된 궤양성 대장염 1예)

  • Moon, Hee-Jung;Jang, Byung-Ik;Kim, Sung-Bum;Lee, Ho-Chan;Park, Jae-Hyun;Eun, Jong-Ryul;Kim, Tae-Nyeun
    • Journal of Yeungnam Medical Science
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    • v.25 no.2
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    • pp.182-186
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    • 2008
  • Ulcerative colitis (UC) is a chronic inflammatory disorder of the gastrointestinal tract that affects the large bowel. Its etiology remains controversial. However, an infectious or immunologic origin is considered the primary cause. The onset of UC is typically slow and insidious, but some patients may present acutely with symptoms mimicking infectious colitis. We report a case of ulcerative colitis mimicking acute hemorrhagic colitis at initial presentation. A 60-year-old man was referred to Yeungnam University Hospital for bloody diarrhea and abdominal pain. Sigmoidoscopy revealed mildly edematous mucosa in the rectum and hyperemic mucosa with petechiae in the sigmoid colon. The patient was treated with antibiotics for several days, and his symptoms improved. However, after one month, his bloody diarrhea relapsed. Follow-up sigmoidoscopy revealed mucosal friability in the rectum and sigmoid colon. He was diagnosed with ulcerative colitis, and his symptoms were improved with mesalazine and a steroid enema.

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Acute Kidney Injury after Dose-Titration of Liraglutide in an Obese Patient (비만 환자에서 리라글루티드 증량 과정에서 발생한 급성 신손상)

  • Lee, Hee Jin;Park, Hye Soon
    • Archives of Obesity and Metabolism
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    • v.1 no.2
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    • pp.78-82
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    • 2022
  • Liraglutide (SaxendaR) is prescribed to induce and sustain weight loss in obese patients. The starting dose of liraglutide is 0.6 mg/day for 1 week, which is increased by 0.6 mg/day every week until the full maintenance dose of 3 mg/day is achieved. Such dose titration is needed to prevent side effects, which primarily include gastrointestinal problems such as nausea, diarrhea, constipation, vomiting, dyspepsia, and abdominal pain. A 35-year-old, reportedly healthy obese man receiving liraglutide treatment for obesity visited the emergency room complaining of generalized weakness and dizziness accompanied by repeated diarrhea and vomiting. He reported over 20 episodes of diarrhea starting the day after liraglutide dose escalation from 1.2 mg/day to 1.8 mg/day. Laboratory findings suggested pre-renal acute kidney injury, including serum creatinine 4.77 mg/dl, blood urea nitrogen (BUN) 37 mg/dl, estimated glomerular filtration rate (eGFR) 15 ml/min/1.73 m2, and Fractional excretion of sodium 0.08. After volume repletion therapy, his renal function recovered to a normal range with laboratory values of creatinine 1.08 mg/dl, BUN 14 mg/dl, and eGFR 88 ml/min/1.73 m2. This case emphasizes the need for caution when prescribing glucagon-like peptide-1 receptor agonists, including liraglutide, given the risk of serious renal impairments induced by volume depletion and dehydration through severe-grade diarrhea and vomiting.