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증례 : 소화기 ; 내시경 조직 생검 후 발생한 점막하 식도 박리 1예
김동현 ( Dong Hyun Kim ),윤정빈 ( Jeong Bin Yoon ),김동완 ( Dong Wan Kim ),장세원 ( Se Won Jang ),윤종민 ( Jong Min Yoon ),김민정 ( Min Jung Kim ),김상현 ( Sang Hyun Kim ) 대한내과학회 2011 대한내과학회지 Vol.81 No.6
점막하 식도 박리 발생의 위험인자는 혈소판감소증, 혈우병, 내시경 경화요법, 심부 정맥 혈전증으로 항응고치료를 받는 환자, 이물, 약물, 내시경 등의 기계적 손상 또는 자발적으로 발생한 점막하 출혈 및 혈종이 있다. 하지만 조직검사로 인한 증례는 아직 발표된 바가 없다. 저자들은 식도 조직검사 후 발생한 흉골하 통증을 주증상으로 내원한 환자에서 상부위장관 내시경 검사를 시행하여서 점막하 식도 박리증을 진단하였다. 금식 및 수액요법 등의 보존 치료로 증상이 호전된 드문 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. The incidence of gastrointestinal complications has increased as endoscopic biopsy has become a standard diagnostic technique. However, esophageal dissection is a rare complication. A 71-year-old man suffered retrosternal pain for 15 days. Fifteen days previously, he had undergone an endoscopic gastrointestinal examination at a local clinic and an esophageal biopsy to obtain microscopic confirmation of esophageal candidiasis. The patient then underwent a subsequent endoscopic examination, which showed features specific to esophageal submucosal dissection. The predisposing conditions for esophageal dissection are coagulopathy, iatrogenic trauma (variceal sclerotherapy), drugs (thrombolytic agents, aspirin), foreign bodies/certain foods (fish, chicken bones), and emesis. However, endoscopic biopsy is a rare predisposing condition. Here, we report a case of esophageal submucosal dissection that developed after esophageal biopsy. We observed the healing process of this lesion with a series of endoscopies as part of a conservative treatment plan. (Korean J Med 2011;81:759-763)
편성익 ( Sung Ik Pyeon ),송근암 ( Geun Am Song ),백동훈 ( Dong Hoon Baek ),김광하 ( Gwang Ha Kim ),이봉은 ( Bong Eun Lee ),이성준 ( Seong Jun Lee ),윤정빈 ( Jung Bin Yoon ),한성용 ( Sung Yong Han ),박도윤 ( Do Youn Park ) 대한소화기학회 2017 대한소화기학회지 Vol.69 No.2
The gastrointestinal tract is the most common site of extra-nodal non-Hodgkin lymphoma. However, the incidence of primary rectal lymphoma is extremely rare. Among the primary gastrointestinal lymphomas, follicular lymphoma has been described as a rare disease. It is difficult to diagnose rectal lymphoma due to its variable growth patterns and inadequate biopsies. Majority of patients with rectal lymphoma have non-specific symptoms or negative biopsies, often delaying the diagnosis. Our patient is a 62-year-old female. Two sessile and smooth subepithelial lesions with a yellowish normal mucosa were found on a screening colonoscopy. The initial mucosal biopsy finding was chronic inflammation, but we were highly suspicion of malignancy; we performed an endoscopic mucosal resection. Herein, we present a rare case of rectal follicular lymphoma diagnosed by endoscopic mucosal resection with a literature review. (Korean J Gastroenterol 2017;69:139-142)
남자에서 발생한 Fitz-Hugh-Curtis Syndrome 1예
백현철 ( Hyun Choul Baek ),배영석 ( Young Seok Bae ),이광재 ( Kwang Jae Lee ),김동현 ( Dong Hyun Kim ),배상훈 ( Sang Hoon Bae ),김동완 ( Dong Wan Kim ),윤정빈 ( Jung Bin Yoon ),송철수 ( Chul Soo Song ) 대한소화기학회 2010 대한소화기학회지 Vol.55 No.3
Fitz-Hugh-Curtis syndrome has been described as focal perihepatitis accompanying pelvic inflammatory disease caused by Neisseria gonorrhea and Chlamydia trachomatis. The highest incidence occurs in young, sexually active females. However, the syndrome has been reported to occur infrequently in males, according to the foreign literature. The predominant symptoms are right upper quadrant pain and tenderness, and pleuritic right sided chest pain. The clinical presentation is similar in men and women. In women, the spread of infection to liver capsule is thought to occur directly from infected fallopian tube via the right paracolic gutter. In men, hematogenous and lymphatic spread is thought to be postulated. Recently, we experienced a case of Fitz-Hugh-Curtis syndrome occurred in a man. As far as we know, it is the first report in Korea, and we report a case with a review of the literature. (Korean J Gastroenterol 2010;55:203-207)