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치명적 소장 출혈을 동반한 초저위험군의 공장 위장관간질종양 1예
주광로,이정일,홍인택,기혜진,차재명,강재빈 이화여자대학교 의과학연구소 2015 EMJ (Ewha medical journal) Vol.38 No.2
Gastrointestinal stromal tumor (GIST) is the most common mesenchymal neoplasm of the gastrointestinal (GI) tract. These tumors are frequently small, asymptomatic and found incidentally. GI bleeding is a common complication of these tumors, but small sized, very low risk GIST rarely complicated with fatal bleeding. In this report, we describe a 42-year-old woman with a jejunal GIST accompanied by severe GI bleeding. She presented with melena and an angiographic embolization was performed for a jejunal mass with bleeding. However, rebleeding was suspected after an angiographic embolization and an emergent segmental resection for the bleeding mass was performed. She was finally diagnosed as a 1.8 cm sized very low risk GIST in jejunum. In conclusion, physician should consider that even very low risk GIST can be the cause of GI bleeding when there is severe bleeding.
홍인택 ( In Taik Hong ),차재명 ( Jae Myung Cha ),기혜진 ( Hye Jin Ki ),곽민섭 ( Min Seob Kwak ),윤진영 ( Jin Young Yoon ),신현필 ( Hyun Phil Shin ),전정원 ( Jung Won Jeoun ),최성일 ( Sung Il Choi ) 대한소화기학회 2017 대한소화기학회지 Vol.69 No.5
Small bowel obstruction is a clinical condition commonly caused by postoperative adhesion, volvulus, intussusceptions, and hernia. Small bowel obstruction due to bezoars is clinically uncommon, accounting for approximately 2-4% of all obstructions. Computed tomography (CT) is a useful method in diagnosing the cause of small bowel obstruction. However, small bowel obstruction caused by bezoars may not be detected by an abdominal CT examination. Herein, we report a rare case of small bowel obstruction by Aloe vera bezoars, which were undetected by an abdominal CT. Phytobezoars should be included in the differential diagnosis of small bowel obstruction in patients with predisposing factors, such as excessive consumption of high-fiber food and diabetes. (Korean J Gastroenterol 2017;69:312-315)
Cerebral venous thrombosis in a patient with Crohn’s disease
조영학,채민규,차재명,이정일,주광로,신현필,백일현,전정원,임준욱,홍인택,기혜진,강재빈 대한장연구학회 2016 Intestinal Research Vol.14 No.1
Patients with inflammatory bowel disease (IBD) have an elevated risk of venous thromboembolism compared with the general population. The most common sites of venous thromboembolism in IBD patients are the deep veins of the legs, the pulmonary system, and portal and mesenteric veins. However, cerebral venous thrombosis is rarely associated with IBD. This report describes a case of cerebral venous thrombosis in a patient with Crohn’s disease. A 17-year-old girl, diagnosed 4 years earlier with Crohn’s disease, presented with headache and vomiting. Magnetic resonance imaging of the brain with venography showed venous thrombosis in the cortical veins, superior sagittal sinus, right transverse sinus, and right internal jugular vein. The patient immediately started anticoagulation therapy with intravenous heparin infusion followed by daily oral rivaroxaban 10 mg. Follow-up imaging after 2 weeks showed resolution of the thrombosis, with recanalization of the cortical veins, superior sagittal sinus, right transverse sinus, and right internal jugular vein. She continued rivaroxaban therapy for 6 months, and remained well, without neurologic sequelae. A high level of concern for cerebral venous thrombosis may be important when treating active IBD patients, because anticoagulation treatment can prevent fatal complications.