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파열된 후 복강으로 파종된 간세포암종이 위벽으로 침윤되어 일으킨 상부 위장관 출혈
김동희 ( Dong Hee Kim ),은종렬 ( Jong Ryul Eun ),문희정 ( Hee Jung Moon ),오희주 ( Hee Ju Oh ),김용길 ( Yong Kil Kim ),장병익 ( Byung Ik Jang ),김태년 ( Tae Nyeun Kim ),이헌주 ( Heun Ju Lee ) 대한소화기학회 2009 대한소화기학회지 Vol.53 No.3
Hepatocellular carcinoma (HCC) rarely invades the gastrointestinal (GI) tract. It occurs in 0.7% to 2% of clinical HCC cases. Moreover, gastric invasion with GI hemorrhage via peritoneal seeding is very rare. We report the case of 67-year-old woman who had a history of HCC rupture and was admitted due to left upper quadrant abdominal pain. The patient was diagnosed with three omental metastatic masses and underwent hepatic segmentectomy and omental tumorectomy. Two months later, the patient had massive melena, and an esophagogas-troduodenoscopy showed very large ulcerated friable mass on the gastric body. The histology was consistent with the diagnosis of metastatic HCC. The patient died from persistent GI hemorrhage 93 days after the admission. This case illustrates the very rare event of peritoneal seeding of a ruptured HCC causing direct invasion of the stomach, followed by GI hemorrhage. (Korean J Gastroenterol 2009;53:194-197)
이형우,조철규,이현우,이헌주,조인호,원규장,김영수,이찬우,윤경우,윤현대 영남대학교 의과대학 1993 Yeungnam University Journal of Medicine Vol.10 No.2
저자들은 당뇨병 환자에서 발생한 기종성 신우신염을 내과적 치료와 응급 신적출술로 성공적으로 치험하였기에 문헌고찰과 함께 보고하는 바이다. Emphysematous pyelonephritis is a necrotizing renal infections characterized by intrarenal and occasional perirenal gas production. Although uncommon (89 cases in the literature), it occurs almost exclusively in diabetic patients (87% of the cases). Prompt and aggressive management is required to salvage these patients. We describe a recent case of a diabetic woman with emphysematous pyelonephritis due to E. Coll, successfully managed with unilateral nephrectomy.
심민철,김홍진,권광보,노성균,이헌주,이태숙,장재천 영남대학교 의과대학 1990 Yeungnam University Journal of Medicine Vol.7 No.1
영남대학교 의과대학 외과학교실에서는 1989년 11월에 한국에서 발병한 간흡충병의 여섯 번째 증례로, 특히 간내 담관에 발생한 첫 증례를 우측 간엽 절제술 및 담낭 적출술로 좋은 결과를 얻었으며, 간내 담관에 발생한 경우에는 간암과의 구별이 요구되어야 한다는 점을 상기 시키면서 증례보고와 더불어 문헌적 고찰을 하였다. Human Fasciola hepatica infection is a rare entity involving infestation of the liver and biliary tree with adult flukes, which can result in hepatitis, cirrhos is and biliary tract inflammation, obstruction and lithiasis. The patient had the typical diagnostic tetrad of fever, eosinophilic leukocytos is, tender hepatomegaly and fluke ova in the stools. Theatment consistes of Emetine hydrochloride administration for hepatic involvement and common bile duct exploration for removal of flukes, with cholecystectomy for associated cholelithiasis. The combination of medical and surgical therapy cal be expected to produce an arrest of this infection. The removed liver revealed eggs of the fasciols species in the intrahepatic bile duct. The clinical history, pathological findings and treatment of this case were described.