• Title/Summary/Keyword: epigastric diagnosis

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Deleyed Cardiac Tamponade After Open Heart Surgery (Two Cases Report) (개심술후에 발생한 지연성 심장압진증)

  • 김병열
    • Journal of Chest Surgery
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    • v.15 no.2
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    • pp.218-221
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    • 1982
  • Delayed cardiac tamponade in an uncommon and frequently fatal complication after open-heart surgery. We had been experienced two cases of delayed cardiac tamponade as a complication of open-heart surgery and treated successfully by reinsertion of pericardial drain through subxiphoid route. First case was 60 years old female patient and underwent MVR under impression of MSi + Ti Second case was 19 years old male patient and underwent total correction of T.O.F.with Blalock shunt [Lt]. Both cases had Initial symptoms, which were epigastric pain, chest tightness, dropped blood pressure, and increased pulse rate and respiratory rate, mimic as low cardiac output syndrome after open-heart surgery. Roentgenogram of the chest showed a rapid increased cardiothoracic ratio. It is important to realize the presence of late cardiac tamponade for proper diagnosis of complication after open-heart surgery.

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A Case of Congenital Bronchoesophageal Fistula Accompanied with Hematemesis (토혈을 주소로 하는 선천성 식도기관지루 1례)

  • Oh, Jae-Cheol;Cha, Ki-Moon;Tchah, Hann;Park, Ho-Jin;Lee, Jung-Sang
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.1 no.1
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    • pp.115-119
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    • 1998
  • Congenital bronchoesophageal fistula associated esophageal atresia usually presents in the newborn period or infancy but those without esophageal atresia are more insidious in disease process. Symptoms which include cough, hemoptysis, choking on swallowing liquids, uncommonly dysphagia, and epigastric discomfort may not begin until adult life. Most of the cases are curative unless there are serious underlying conditions. The diagnosis is usually made by gastroesophagoscopy, esophagogram, bronchogram and bronchoscopy. And the most of the cases can be cured by fistulectomy and resection of involved pulmonary lobes. We experienced one case of congenital bronchoesophageal fistula which occurred in a 13- year-old girl who complained of paroxysmal cough and intermittent hematemesis for 3 years.

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A Case of Woman with Histrionic Personality who Suffered from Chronic Gastrointestinal Dysfunction (만성 위장장애를 호소하는 히스테리성 성격의 여자)

  • Song, Ji-Young
    • Korean Journal of Psychosomatic Medicine
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    • v.1 no.1
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    • pp.101-108
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    • 1993
  • A case of a 38 year-old woman with histrionic personality who had chronic epigastric pain, dyspepsia and alternating bowel habit for more than 10 years was presented in detail on its course of two times of admission and follow-up. The diagnosis was thought as psychophy-siological disorder or gastrointestinal motility disorder of undefined etiology rather than hypo-chondriasis or Briquet's syndrome. She was characterized by sustained illness behavior and combined several physical illnesses. i.e. tuberculosis. anemia and hepatic stone. These physical diseases led to a blurring of psychological and physical boundaries regarding symptom formation. The points on consultation from medical part to psychiatric department were discussed and the supposed causal mechanisms in non-organic functional gastrointestinal disturbances were also reviewed. Physical and psychological modalities for the treatment and the abnormal illness behavior were mainly emphasized in this case.

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A case of gastric pseudoterranoviasis in a 43-year-old man in Korea

  • Koh, Moon-Soo;Huh, Sun;Sohn, Woon-Mok
    • Parasites, Hosts and Diseases
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    • v.37 no.1
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    • pp.47-49
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    • 1999
  • A case of Pseudoterranova decipiens infection was found in a 43-year-old man by gastroendoscopic examination on August 20, 1996. On August 6, 1996, he visited a local clinic, complaining of epigastric pain two days after eating raw marine fishes. Although the symptoms were relieved soon, endoscopic examination was done for differential diagnosis. A white, live nematode larva was removed from the fundus of the stomach. The larva was $38.3{\times}1.0{\;}mm$ in size and had a cecum reaching to the mid-level of the ventriculus. A lot of transverse striations were regularly arranged on the cuticle of its body surface, but the boring tooth and mucron were not observed at both ends of the worm. The worm was identified as the 4th stage larva of P. decipiens.

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Isolated Traumatic Injury of the Pancreatic Head: A Case Report

  • Kim, Dong Hun
    • Journal of Trauma and Injury
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    • v.29 no.2
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    • pp.51-55
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    • 2016
  • Isolated injury to the pancreas after abdominal trauma is uncommon, and a delay in diagnosis and treatment can increase the morbidity and mortality. Therapeutic decisions with respect to pancreatic trauma are usually made based on the site of injury and the status of the pancreatic ductal system. In this report, we describe the surgical management of pancreatic head transection as an isolated injury following blunt abdominal trauma. A 55-year-old man presented with epigastric pain that radiated to the back. Abdominal computed tomography revealed a hematoma in the pancreatic head and upstream dilatation of the main pancreatic duct. Endoscopic retrograde cholangiopancreatography showed complete disruption of and contrast leakage from the main pancreatic duct in the pancreatic head region with a nonenhanced upstream duct. Emergency pancreaticoduodenectomy was successfully performed, and the patient was discharged on postoperative day 9 without any complications.

A Case of Small Bowel GIST Initially Suspected as Peritoneal Seeding of Gastric Cancer

  • Jo, Dae-Hyeun;Song, Jeong-Yoon;Kim, Yong-Ho
    • Journal of Gastric Cancer
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    • v.10 no.3
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    • pp.137-140
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    • 2010
  • Gastrointestinal stromal tumors (GISTs) constitute the most common primary mesenchymal tumors of the digestive tract and characteristically express c-kit (CD117). GISTs are the most common non-epithelial tumor of the GI tract and frequently originate from the stomach and small bowel. Specifically, the synchronous occurrence of a GIST with other epithelial tumors is rarely reported. Recently, we discovered one case of a concurrent gastric cancer and a small bowel GIST that was initially suspected to be peritoneal seeding from gastric cancer. The patient was initially admitted with epigastric pain. Gastric cancer with peritoneal seeding was suspected after an evaluation. Following a laparoscopic examination, a distal gastrectomy with D2 lymph node dissection and small-intestine segmental resection was performed. The final pathologic diagnosis was early gastric cancer and high-risk small bowel GIST. The patient refused adjuvant therapy for the GIST, and currently shows no other marked indisposition. He has been disease-free for 14 months.

A Clinical Study of Correlation Between Frequently Occurring Headache from Gastrointestinal Disorder and Dyspepsia (소화불량증에서 호발하는 두통의 위장질환과의 상관성에 대한 임상연구)

  • Choi, Young-Gyoo;Kim, Jae-Kwan;Choi, Seo-Hyung
    • The Journal of the Society of Korean Medicine Diagnostics
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    • v.14 no.1
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    • pp.36-43
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    • 2010
  • Objectives: Since we found patients with dyspepsia as their major symptom had high rate of headache, would like to find out a rational diagnosis ground by using EAV correlation between headache and gastrointestinal disorder Methods: We did survey and EAV inspection on 128 patients came by gastrointestinal disorder who quoted 4 and 5 degree for their headache symptoms) Results & Conclusion The results of this study were as follows: 1. From dyspepsia, we saw higher rate by order of epigastric discomfort, bloating, stomach trouble, bleching, etc. 2. By EAV analysis, found functional deterioration by order of stomach, nerval degeneration vessel, gall bladder/bile duct, liver. 3. By EAV analysis, functional deterioration of stomach, gall bladder/bile duct, liver represent dyspepsia and nerval degeneration vessel represent headache. We found the correlation between dyspepsia and headache by observation at a time.

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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The Usefulness of Electrogastrography on the Differential Diagnosis of Deficiency or Excess Condition in Patients with Functional Dyspepsia (기능성 소화불량증의 허실진단에 대한 위전조의 유용성)

  • Ryu, Jong-Min;Lim, Jung-Hwa;Han, Sook-Young;Jang, Sun-Young;Kim, Hyun-Kyung;Lee, Joon-Suk;Kim, Jin-Sung;Ryu, Bong-Ha;Ryu, Ki-Won;Yoon, Sang-Hyub
    • The Journal of Internal Korean Medicine
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    • v.25 no.4
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    • pp.346-355
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    • 2004
  • Background & Object : The aim of this study was to investigate the usefulness of electrogastrography on differential diagnosis of deficiency or excess Condition in patients with functional dyspepsia Methods : Selected symptoms for diagnosis of deficiency and excess in functional dyspepsia have been reviewed in some literatures, notably within Oriental medicine, Donguibogam and Gogeumdoseojipseong-uibujeolrok. This is what was investigated in this study. 93 patients (male 32, female 61) were divided into three groups; Non-pain group, Pre-treatment pain group (chief complain was abdominal pain at the first medical examination), and Mid-treatment pain group(they had no pain at the time of first medical examination, but showed abdominal pain within two weeks). 10 healthy people participated as normal controls. Gastric motility were recorded and analyzed using electrogastrography during fasting and postprandial period. In assessment, effectiveness was divided into validity, sensitivity and specificity. Results : Epigastric pain reflected the tendency for excess condition in comprehensive diagnosis, which was linked with postprandial arrhythmia in electrogastrography(p=0.001). Postprandial arrhythmia detected abdominal pain with a validity of 78.6%, a sensitivity of 79.2%, and a specificity of 78%(p<0.001). Conclusions : Results 1Tom Postprandial arrhythmia in electrogastrography support that the index of excess condition in the comprehensive diagnosis of symptoms is useful for patients with functional dyspepsia.

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Carcinosarcoma of the Stomach: A Case Report

  • Choi, Kyeong Woon;Lee, Woo Yong;Hong, Seong Woo;Chang, Yeo Goo;Lee, Byungmo;Lee, Hye Kyung
    • Journal of Gastric Cancer
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    • v.13 no.1
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    • pp.69-72
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    • 2013
  • Carcinosarcoma is a rare malignant, biphasic tumor comprised of carcinoma and sarcoma components. In the gastrointestinal tract, carcinosarcoma is most frequently seen in the esophagus and rarely in the stomach. We report a 51-year-old female patient with 2-month-history of epigastric pain and dyspepsia. Endoscopic finding revealed a huge ulcerative lesion that infiltrated from the antrum to the mid-body. An endoscopically taken biopsy revealed poorly differentiated malignant round cell neoplasm. After the palliative subtotal gastrectomy, immunohistochemical studies showed two positive reactions for the epithelial marker and mesenchymal marker. Based on the above findings, the patient was diagnosed with gastric carcinosarcoma. The immunohistochemical analysis is a critical method in making an accurate diagnosis of carcinosarcoma.