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증례 : 낭성 기관지확장증 환자에서 비대된 관상동맥 -기관지동맥 문합 1예-
천병철 ( Byoung Cheol Cheon ),박인호 ( In Ho Park ),유정화 ( Jeong Hwa Yu ),장세중 ( Sei Joong Chang ),홍종서 ( Jong Seo Hong ),안경주 ( Kyoung Ju Ahn ),전의용 ( Eui Yong Jeon ) 대한내과학회 2007 대한내과학회지 Vol.73 No.3
관상동맥-기관지동맥 간 문합은 특별한 증상이 없는 일반인에서도 관찰할 수 있는 혈관기형이다. 하지만 기저폐질환이 문제가 된다거나 다른 원인들에 의해 문합을 통해 폐로 가는 혈류량이 늘어 심근에 허혈성 증상을 나타내는 경우에는 치료가 필요한 경우가 있다. 우리가 보고한 환자는 심한 낭성 기관지확장증으로 인하여 종격동 내 비정상적 문합의 비대가 심한 환자였다. 환자는 비특이적인 흉통을 주소로 시행한 심혈관 조영술에서 우연히 혈관 이상이 발견 되었고, 기관지동맥 색전술과 폐부분절제술을 통하여 성공적인 치료를 받았다. Anastomoses between a coronary artery and bronchial or mediastinal arteries have been described since the 19th century. Although coronary-to-bronchial artery communication has been well described, it remains an unusual finding. We report one adult case of abnormally enlarged two coronary-to-bronchial artery communications in a severe cystic bronchiectasis patient. In this case, the bronchial arteries were also supplied from the multiple systemic arteries (the internal mammary, subclavian, inferior phrenic and intercostal arteries) because of severe cystic bronchiectasis. We treated the patient by embolization of the bronchial artery with the abnormal anastomoses and then by surgical resection of the cystic bronchiectatic lung lesion. To date, the patient remains free of symptoms.(Korean J Med 73:330-335, 2007)
내시경적 역행성 췌담관조영술중 췌선방 조영 후 발생한 중증 췌장염 1예
장세중,기승석,김훈일,신혜영,박장원,송은훈,태재웅 朝鮮大學校 附設 醫學硏究所 2008 The Medical Journal of Chosun University Vol.33 No.2
내시경적 역행성 담췌관조영술 후 발생한 급성췌장염의 발생인자로 여러 가지 인자들이 관여하지만 특히 담췌관조영술 시행 후 과도한 췌선방 조영화에 의한 중증의 췌장염 증례를 경험하였기에 보고하는 바이다 Endoscopic retrograde cholangiopancreatography (ERCP) has been considered as a valuable tool for the diagnosis and management of disease of the pancreas and biliary tree. Post-ERCP pancreatitis is the most frequent and clinically significant complication following ERCP. But a few complication associated with this procedure are unforeseeable. Specially, acinarization as a result of a careless cooperation between operator and assistant may be influenced in complications of ERCP. Severe post-ERCP pancreatitis is rare complication, and its prognosis will be poor. Therefore, careful process and good relationship between operator and assistant in ERCP may be prevented this complication, but is not clear. Neglect of acinarization may be resulted in more aggravation of pancreatitis. We have cared for one patient with severe post-ERCP pancreatitis with pseudocyst after water-soluble contrast media spreading into the acini (acinarization) via ERCP in resolving phase idiopathic pancreatitis.
Polyethylene glycol 용액(Colyte^(R))을 복용한 후 발생한 Boerhaave 증후군 1예
이관행,기승석,김인숙,김민정,박인호,장세중,하지수,김응수 朝鮮大學校 附設 醫學硏究所 2006 The Medical Journal of Chosun University Vol.31 No.3
Spontaneous esophageal rupture (Boerhaave's syndrome) is a rare case that require early diagnosis and treatment because of its high mortality. The oral administration of osmotically balanced polyethylene-glycol-based electrolyte preparation is a commonly prescribed preparation for cleansing in patients undergoing colonoscopy. Nausea, vomiting and abdominal pain are frequently seen, but serious adverse reactions are rare. Esophageal rupture secondary to severe vomiting, which occurred during colonoscopy preparation using polyethylene gIycoI(PEG) electrolyte solution is extremely rare and only few cases have been published in the literature. We report a case of spontaneous esophageal rupture after routine administration of the PEG before colonoscopy. 대장 정결을목적으로 PEG 사용 후 아주 드물게 발생하는 Boerhaave 증후군 1예를 경험하였기에 보고하는 바이다.