• 제목/요약/키워드: epigastric

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횡격막직상부 식도계실 3례 (Epiphrenic Diverticulum of the Esophagus)

  • 이남수;신창섭;손광현
    • Journal of Chest Surgery
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    • 제13권3호
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    • pp.312-318
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    • 1980
  • The first case was a 20 year old female who has been suffered from epigastric pain, and anorexia for 2 years. A thumb tip sized pulsion diverticulum 4cm above the esophagocardial junction was elicited by esophagogram and on exploration. A diverticulectomy with long esophagocardiomyotomy was performed. The second case was a 30 year old house wife who has had postprandial epigastric pain for 2 months accompained with frequent vomiting. Fiberscopy and esophagogram showed epiphrenic diverticulum of the esophagus. Same operative procedures were carried out and obtained a good result as first case. The third case was a 55 year old house wife who was admitted to this Chest Surgery Department because of regurgitation and intermittent vomiting for approximately 3 months. Esophagogram showed a large epiphrenic diverticulum of the esophagus. On exploration, a tennis ball sized pulsion diverticulum was found on the anterolateral wall of the esophagus. A partial esophagectomy including the diverticulum and esophagoesophagostomy was performed. The specimenshowed some erosive changes of the mucosal surface of the diverticulum and also the esophagus suggestive of diverticulitis and esophagitis. She has been satisfactory result until 4 months postoperatively, when she developed regurgitation and epigastric pain. Esophagogram showed stenosis of the operative site. Readmission and esophageal dilatations were done and improved without any problem. Epiphrenic or supradiaphragmatic diverticulum of the esophagus is a rare condition. Pathophysiologically, the conditions accompanied the spasm of the esophagus, many authors prefered the procedures of a diverticulectomy plus long esophagocardiomyotomy rather than simple diverticulectomy or esophagectomy and esophagoesophagostomy. Here we report the cases and reviewed the literatures.

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미세유방재건술시 깊은 아래 배벽 동맥의 해부학적 변형에 대한 임상 보고 (The Anatomical Variations of DIEA (Deep Inferior Epigastric Artery) in Microsurgical Breast Reconstruction: Clinical Report)

  • 장서윤;김덕우;동은상;윤을식;류우상;손길수
    • Archives of Reconstructive Microsurgery
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    • 제20권1호
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    • pp.14-17
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    • 2011
  • Autologous breast reconstruction after mastectomy in breast cancer patient is now increasing. The deep inferior epigastric artery (DIEA) free flap is well known as an ideal donor site for the microsurgical breast reconstruction. The branching pattern of the DIEA was well described in the literature. In that study, DIEA has three branching patterns near the arcuate line. We describe a case in which branching variation of the DIEA before entering the posterior surface of the rectus abdominis muscle. In three cases, DIEA originated from the external iliac artery ascended as a double trunk at 1cm, 2cm, and 4cm above the originating point, respectively. In one case, DIEA ascended as a single trunk along the linea alba toward to the umbilicus until it supply overlying subcutaneous tissue. Preoperative 3D computed tomographic angiography to identify the anomaly is recommended and meticulous dissection to the originating point of DIEA is needed.

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반하사심탕(半夏瀉心湯)을 활용한 소화성 궤양 치험 3례 (Three Case Reports of Peptic Ulcer Patients Treated with Banhasasim-tang)

  • 박근희;최선욱;박수정;주종천;박혜선
    • 동의생리병리학회지
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    • 제26권6호
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    • pp.940-946
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    • 2012
  • This study was designed to evaluate the effects of Korean medicine therapy(Banhasasim-tang) on a peptic ulcer patient. Three peptic ulcer patients with symptoms of epigastric pain, heartburn and nausea, were treated with Banhasasim-tang. The progress was evaluated with the Visual analogue scale. In all three cases, after 3 weeks of treatment with Banhasasim-tang, the patient's symptom of epigastric pain, heartburn and nausea evaluated with the Visual analogue scale improved. This study suggests that Korean medicine(Banhasasim-tang) could be effective in the treatment of peptic ulcer.

Perforator Reconstruction to Salvage the Jeopardized Flaps

  • Eom, Jin Sup;Choi, Dong Hoon
    • Archives of Reconstructive Microsurgery
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    • 제24권1호
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    • pp.24-27
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    • 2015
  • During flap elevation, most perforators are cut except one or more perforators that are essential to flap survival. However these cutout perforators can cause deterioration of the blood circulation of the flap. To salvage the jeopardized flaps, rebuilding the perforator system is essential for flap survival. In the first case, after flap elevation, the upper abdominal flap margin was severely ischemic. To supply blood to the upper abdominal flaps, we found and used a major perforator underneath the upper abdominal flap which was cut earlier during the elevation, and we performed reanastomosis with ipsilateral deep inferior epigastric artery. Upper abdominal flap ischemic area was limited to a narrow suture area. In the second case, we performed free superficial inferior epigastric artery (SIEA) flap reconstruction. After successful anastomosis of the SIEA and superficial inferior epigastric vein (SIEV) with internal mammary artery and vein, serious venous congestion occurred immediately because of SIEV malfunction. We found the largest perforator vein under the flap, as an alternate way to drain, then connected it with the thoracoacromial vein with a vein graft harvested in the contralateral SIEV. Circulation has improved. In conclusion, perforator system reconstruction is essential in a jeopardized flap salvage.

Initial report of extraperitoneal pedicle dissection in deep inferior epigastric perforator flap breast reconstruction using the da Vinci SP

  • Jung, Ji Hyuk;Jeon, Yeo Reum;Lee, Dong Won;Park, Hyung Seok;Lew, Dae Hyun;Roh, Tae Suk;Song, Seung Yong
    • Archives of Plastic Surgery
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    • 제49권1호
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    • pp.34-38
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    • 2022
  • The deep inferior epigastric perforator (DIEP) flap has been widely used for autologous breast reconstruction after mastectomy. In the conventional surgical method, a long incision is needed at the anterior fascia of the rectus abdominis muscle to obtain sufficient pedicle length; this may increase the risk of incisional hernia. To shorten the incision, several trials have investigated the use of endoscopic/robotic devices for pedicle harvest; however, making multiple additional incisions for port insertion and operating in the intraperitoneal field were inevitable. Here, we describe the first case, in which a DIEP free flap was successfully made using the da Vinci SP model. Our findings can help surgeons perform operations in smaller fields with a single port in the extraperitoneal space. Moreover, this method is expected to lead to fewer donor-related complications and faster healing.

위완통(胃脘痛)의 임상변증(臨床辨證)과 위내시경(胃內視鏡) 미관변증(微觀辨證)의 관계(關係)에 대한 증례(證例) 연구(硏究) (Case Study for the Relation between Clinical Bian Zheng and Gastroscopic Bian Zheng of Epigastric Pain)

  • 고수미;문석재;문구
    • 대한한의학회지
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    • 제17권1호
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    • pp.266-279
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    • 1996
  • To complement and develop the Orient Medical Bian Zheng treatmemt(韓方辨證施治), I have observed and analysed 68 persons who have recieved medical treatment because of the epigastric pain. Considering and analysed the Clinical Diagnosis(臨床診斷) and Clinical Bian Zheng(臨床辨證), Clinical Diagnosis(臨床診斷) and Gastroscopic Bian Zheng(微觀辨證), Clinical Bian Zheng(臨床辨證) and Gastroscopic Bian Zheng(微觀辨證), case history, age and sex, I have obtained the conclusion as follows. 1. The frequency of epigastric pain according to the classfication of Clinical Bian Zheng(臨床辨證) most occured in Gi Che Zheng(氣滯證), then in Huh Han Zheng(虛寒證). and least in Wi Youl Zheng. 2. There is no clear connection between the Clinical Bian Zheng(臨床辨證) and Clinical Diagnosis(臨床診斷). 3. The frequency of the epigastric pain according to Gastroscopic Bian Zheng(微觀辨證), mainly occurred in Wi youl Type(胃熱型), Wi Rac Jac Sang Type(胃絡灼傷滯型)and then occurred in Wi Han Type(胃寒型), and least occurred in Wi Rac A Che Type(胃絡瘀滯型) 4. Having observed the relation between the Gastroscopicin Bian Zheng(微觀辨證), and Clinical Diagnosis(臨床診斷) as pathological process, I have obtained the result that Wi Youl type(胃熱型) and Wi Rac Jac Sang Type(胃絡灼傷型) mainly occurred in Erosive Gastritis and Superficial Gastritis at the early stage, and Wi Rac A Che Type(胃絡瘀滯型) occurred in the whole stage among the Wuperficial Gastritis, Atro pic Gastritis, and Erosive Gastritis, Gastric Cancer, and the Wi Han Type(胃寒型) mainly occurred in Atropic Gastritis at the later stage. 5. The relation between Clinical Bian Zheng(臨床辨證) and Gastroscopic Bian Zheng(微觀辨證) do not coincide. 6. Observing the relation between the Clinical Bian Zheng(臨床辨證) and case history, Gi Che Zheng(氣滯證), Huh Han Zheng(虛寒證), Wi Youl Zheng(胃熱證) were commonly seen in the early stage of the case history, and Eum Huh Zheng(陰虛證) and Houl A Zheng(血瘀證) were seen in every stage. 7. Observing the relation between the Clinical Bian Zheng(臨床辨證) and age, Gi Che Type(氣滯型) was mostly seen in the thirties and other Bian Zheng(辨證) was seen after the middle 8. Observing the relation between the Clinical Bian Zheng(臨床辨證) and sex, Gi Che Type(氣滯型) was seen at high ratio in both sexes. 9. Observing the relation between the Gastroscopic Bian Zheng(微觀辨證) and case history Wi Han Type(胃寒證), Wi Youl Type(胃熱型), Wi Rac Jac Sang Type(胃絡灼傷型) were seen in the early stage of the case history Wi Rac A Che Type(胃絡瘀滯型) was mostly seen in the later stage. 10. There was no clear connection between the Gastroscopic Bian Zheng(微觀辨證) and age, sex. Although the examples were not sufficient, recipe regarding the partial variation state of stomach mucos together with Orient Medical Bian Zheng(韓方辨證) treatment seems to be useful in the effective treatment of Bi wi(脾胃) disease besides the epigastric pain.

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각종 소화기 증상에 대한 HPS-A의 임상실험 (Clinical Study of HPS-A on Various Digestive Symptoms)

  • 조종관
    • 동의신경정신과학회지
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    • 제3권1호
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    • pp.107-116
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    • 1992
  • In order to study the effect and safety of HPS-A on various digestive symptom, it was taken 3 times a day for 2 weeks on 31 patients. The results were as follows ; 1. The sex distribution was male 42% and female 58% 2. The age distribution was thirties 35% twenties 20%, forties 19% 3. The average improvement rate after 1 week was 85.2% and improvement rate of each symptom was epigastric soreness 89.9%, dyspepsia 85.1%, hunger pain 84.6% 4. The average improvement rate after 2 weeks was 94.5% and improvement rate of each symptom was epigastric soreness 96.6%,hunger pain 96.5%, dyspepsia 96.3% 5. No cases were showen side effects. Aecording to the above results, it is proved that PHS-A can be applied to care gastritis and early peptic ulcer.

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Immediate Bilateral Breast Reconstruction with Unilateral Deep Superior Epigastric Artery and Superficial Circumflex Iliac Artery Flaps

  • Hansen, Keith S.;Gutwein, Luke G.;Hartman, Brett C.;Sood, Rajiv;Socas, Juan
    • Archives of Plastic Surgery
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    • 제43권5호
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    • pp.457-460
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    • 2016
  • Autologous breast reconstruction utilizing a perforator flap is an increasingly popular method for reducing donor site morbidity and implant-related complications. However, aberrant anatomy not readily visible on computed tomography angiography is a rare albeit real risk when undergoing perforator flap reconstruction. We present an operative case of a patient who successfully underwent a bilateral breast reconstruction sourced from a unilateral abdominal flap divided into deep superior epigastric artery and superficial circumflex iliac artery flap segments.