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마대원 ( Dae Won Ma ),김민경 ( Min Kyung Kim ),윤선옥 ( Sun Och Yoon ),이광원 ( Kwang Won Rhee ),윤동섭 ( Dong Sup Yoon ),박효진 ( Hyo Jin Park ) 대한소화기학회 2013 대한소화기학회지 Vol.61 No.3
Gastrointestinal neuroendocrine tumors arise from cells of the diffuse neuroendocrine system and can take place almost anywhere within the gastrointestinal tract. A 40-year-old man admitted to evaluate a duodenal subepithelial lesion which was incidentally found at health check-up. The polypoid duodenal subepithelial lesion, measuring about 7 mm, was removed by the endoscopic mucosal resection and the pathology confirmed a neuroendocrine tumor. Abdominopelvic computed tomography, done for staging work up, revealed a mass in the pancreatic head and the patient received pylorus preserving pancreaticoduodenectomy. Mass at the pancreas also found out to be neuroendocrine tumor but showed different histopathologic traits under immunohistochemical staining. The patient was also diagnosed as hyperparathyroidism and pituitary microadenoma. Finally, multiple endocrine neoplasia type 1 was confirmed, which was accompanied by duodenal neuroendocrine tumor. (Korean J Gastroenterol 2013;61:155-159)
담도를 침범한 간세포암에서 TACE 및 단기간 방사선치료 시행 후 발생한 bronchobiliary fistula의 경험 1예
최정란 ( Jung Ran Choi ),박유미 ( Yoo Mi Park ),이광원 ( Kwang Won Rhee ),마대원 ( Dae Won Ma ),김자경 ( Ja Kyung Kim ),이정일 ( Jung Il Lee ),이관식 ( Kwan Sik Lee ),이광훈 ( Kwang Hun Lee ),함석진 ( Seok Jin Haam ) 대한간암학회 2013 대한간암학회지 Vol.13 No.2
Trans-arterial chemoembolization (TACE) is widely used in the treatment of unresectable hepatocellular carcinoma (HCC). Its common complications are right upper quadrant pain, nausea, vomiting, whereas some rare complications include focal pancreatic necrosis, gastric ulcer, renal failure, DIC, biliary tree necrosis and splenic infarction. Bronchobiliary fistula (BBF) is a rare complication that consists of the formation of a passageway between the biliary system and the bronchial tree. We report a case of BBF due to previous TACE for HCC.
증례 : 감염 ; 담관암종 환자에게 발생한 Hafnia Alvei에 의한 담도 패혈증 1예
김민경 ( Min Kyung Kim ),박지수 ( Ji Soo Park ),마대원 ( Dae Won Ma ),윤지영 ( Gi Young Yun ),임재윤 ( Jae Yun Lim ),조재용 ( Jae Yong Cho ) 대한내과학회 2012 대한내과학회지 Vol.83 No.4
Hafnia alvei is a Gram-negative rod that is rarely isolated from human specimens and is rarely pathogenic. It has been associated with gastroenteritis, pneumonia, urinary tract infection, bacteremia, and nosocomial wound infection, but extra-intestinal H. alvei infection is very rare. We present a case of biliary sepsis caused by H. alvei. A 42-year-old woman was admitted with abdominal pain and jaundice. She was diagnosed with metastatic cholangiocarcinoma and received conservative treatment. Six days later, hyperbilirubinemia and signs of sepsis developed and H. alvei was isolated from both the bile and blood. Despite treatment with antibiotics the organism was sensitive to (it was documented as susceptible to piperacillin/tazobactam and ciprofloxacin in sensitivity tests), the patient`s condition grew worse. The antibiotics were switched to meropenem and the biliary sepsis was resolved. (Korean J Med 2012;83:534-537)