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진단적 내시경적 역행성 담관조영술 중에 발생한 총수담관천공 1예
김은주,김인호,김홍수,이문호,김선주,정일권,박관석,박상홈,은수훈,김상균 대한소화기학회 2001 대한소화기학회지 Vol.37 No.3
Bile duct perforation caused by therapeutic procedures such as endoscopic sphincterotomy, guide-wire, and biliary stent were frequently reported. However, the case of bile duct perforation developed during diagnostic endoscopic retrograde cholangiogram (ERC) was very rare and there has been only one case report until now. A 57-year-old man was admitted for the evaluation of dilated bile duct. During the diagnostic ERC, he suddenly complained of severe right upper quadrant abdominal pain and cholangiogram showed dye leakage from the duodenal side of distal common bile duct where the tip of catheter was closely adhered. He was successfully treated with endoscopic retrograde bililary drainage for 4 weeks.
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성인 위 배출구 폐쇄의 임상 양상의 변화 및 내시경술의 의의
김은주,이석호,김홍수,이문호,김선주,정일권,박상홈,함정호 대한소화기내시경학회 2001 Clinical Endoscopy Vol.22 No.2
Background/Aims: The causes of gastric outlet obstruction (GOO) have changed from peptic ulcer disease (PUD) to malignant diseases in recent years. The aims of this study are to determine the relative incidence of malignany and other causative diseases, and to consider therapeutic and diagnostic usefulness of endoscopy. Methods: 95 patients with GOO who diagnosed by radiologic and endoscopic examination or surgery were reviewed by causative diseases, clinical features, endoscopic findings and outcome of treatment. Results: 1) The mean age was 57.5 years (M: F=2.4: 1). 2) The causative diseases were gastric or duodenal malignancy (56.8%), complication of PUD (39.2%), and biliary and pancreatic disease (4,2%). 3) Malignancy was diagnosed by upper gastrointestinal (UGI) endoscopy in 95.8%; obstruction by complication of PUD was detected by endoscopy in 100%. 4) The most common endoscopic type of malignancy was Borrman type 3 (84.8%) and the most common benign lesions were duodenal or pyloric ulcer (94.5o). 5) The managements of malignancy were operation (53.5%), endoscopic stenting (18.5%), and conservative treatment (38.8%). The complications of PUD were treated by anti-ulcer medication (S5.3%), endoscopic dilatation (4.8%) and operation (13.6%). Conclusions: The main causes of GOO are changed to malignancy in recent 5 years. Endoscopy is useful to detect the various causes of GOO, and necessary procedure to decide the method of their management.
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Cyclosporine과 Azathioprine으로 관해된 스테로이드 저항성 궤양성 대장염 1예
김은주,김홍수,이문호,김선주,정일권,박상홈,은수훈,김은나 대한소화기내시경학회 2001 Clinical Endoscopy Vol.22 No.2
Ulcerative colitis is chronic inflammatory disease of bowel without definite cause. Standard therapy of ulcerative colitis consists of aminosalicylates and glucocorticoid. In recent years, the effectiveness of cyclosporine in inflammatory bowel disease has been reported. Cyclosporine is useful in inducing remission in patients with acute exacervation phase who do not achieve remission with an intensive intravenous steroid therapy. We report a case of steroid-resistnat ulcerative colitis, treated with cyclosporine in 45-year-old man. Remission was not achieved with treatment of sulfasalazine and intensive intravenous glucocorticoid therapy for 10 days. We administered cyclosporine parenterally in dose of 4 mg/kg/day for 10 days. He improved dramatically without significant side effects of drug and avoided colectomy. He was discharged with oral cyclosporine and azathioprine and has been followed up outpatients department remained in clinically remission. Cyclosporine seems to be an effective treatment for patients with steroid-resistnat severe ulcerative colitis in whom colectomy seems inevitable.
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김은주,김홍수,이문호,김선주,정일권,정인섭,박상홈 대한소화기내시경학회 2000 Clinical Endoscopy Vol.20 No.3
Duodenal divertula are relatively frequent findings in the adult gastrointestinal tract. The majority of them are asymptomatic, but vague gastrointestinal complaints have often been attributed to these lesions. These diverticula occasionally result in the obstruction of the biliary and pancreatic ducts, which leads to jaundice and pancreatitis. Other complications such as hemorrhage, perforation, sepsis, and death can occur. With the advent of therapeutic endoscopy, the diagnosis and primary treatment of duodenal diverticula associated with bleeding has changed dramatically since its first reported occurrence. Effectiveness of therapeutic endoscopy is very high in patients with diverticular bleeding in the medial aspect of sencond portion of the duodenum because of its high operative mortality. A cases of a patient suffering from gastrointestinal bleeding in the duodenal diverticulum who was diagnosed and managed by endoscopy alone is herein reported with review of relevant literature.
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