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RISS 인기검색어
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- 저자 : ( Suut Gokturk ) (검색결과 2 건)
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( Tugrul Burak Genc ),( Yildiz Okuturlar ),( Ozlem Harmankaya ),( Suut Gokturk ),( Bulent Durdu ),( Samet Sayilan ),( Selcuk Sezikli ),( Meral Mert ),( Abaki Kumbasar ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: In developing countries, tuberculosis (tbc) incidence is reduced; but immunocompromised patients still remain at high risk for the disease. Malignancy and Crohn`s disease should be considered in the differential diagnosis of gastrointestinal (GIS) tbc in immunocompromised patients. We present here the clinical course of a patient with fever of unknown origin and rectal bleeding. Methods: A 31-year-old male cachectic patient was admitted to hospital with abdominal pain, fever and diarrhea. The history of the patient revealed systemic lupus erythematosus, lupus nephritis and left middle cerebral artery infarction. Right hemiparesis was present. He was on warfarin 5mg/day, cilazapril 2,5mg/day, methylprednisolone 4mg/day, mycophenolate mofetil 2g/day, hydroxychloroquine 200mg/ day, levodopa+benserazide 375mg/day, levetiracetam 1 g/day. Creatinine was 2,79mg/dL, and C-reactive protein was 10 mg/dL. No pneumonic infi ltration was shown. Blood, urine and faeces cultures, Chlamydia IgM, mycoplasma IgM, toxoplasma IgM, EBV IgM, CMV IgM and PPD test were negative. Transesophageal echocardiography excluded infective endocarditis. Empiric antibiotic treatment with ceftriaxone, piperacillin-tazobactam and moxifi oxacin, and antifungal fi uconazole was started. On the 15th day hematochezia occured. Colonoscopy revealed three different massive lesions straightening the lumen in caecum, hepatic fi exure of colon and transverse colon (figure-1). Results: Pathologic examination demonstrated granulomatous lesion. Considering the positive results of Tbc-PCR treatment, the patient was diagnosed as GIS tbc and isoniazid, rifampicin, pyrazinamide and ethambutol were started. Conclusions: The ileocecal region is the most frequent localization of intestinal tbc. Colonic tbc is often localized in proximal colon and caecum, and usually associated with ileal tbc. It is rarely seen in transverse colon. Our patient is a rare case of gastrointestinal tbc presenting without pneumonic infi ltration and with an unusual localization in colon.
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Belching in Irritable Bowel Syndrome: An Impedance Study
( Tuba Obekli ),( Filiz Akyuz ),( Umit Akyuz ),( Serpil Arici ),( Raim Iliaz ),( Suut Gokturk ),( Sami Evirgen ),( Bilger Cavus ),( Cetin Karaca ),( Kadir Demir ),( Fatih Besisik ),( Sabahattin Kaymak 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 2017 Journal of Neurogastroenterology and Motility (JNM Vol.23 No.3
Background/Aims There are limited data about the relation between belching and irritable bowel syndrome (IBS). We aim to evaluate belching in patients with IBS. Methods Twenty-five patients with IBS and 12 healthy volunteers were enrolled in the study. IBS was diagnosed in accordance with the Rome III criteria. All patients were questioned about the presence of symptoms for belching, gastroesophageal reflux disease, and dyspepsia. Esophageal manometry and 24-hour pH-impedance were performed in all patients and healthy volunteers. Each of the patients with IBS underwent gastroscopy and colonoscopy. Results Demographic features were similar in both groups (P > 0.05). The belching rate was 32% in patients with IBS. The mean DeMeester score was significantly higher in IBS patients (13.80 ± 14.40 vs 6.04 ± 5.60, P = 0.027) and 24% of patients had pathologic acid reflux (DeMeester score > 14). Gastroscopy was normal in all patients. Symptom association probability positivity was detected in 24% of patients in the impedance study. The rate of weak acid reflux was also significantly higher in patients with IBS (97.00 ± 56.20 vs 58.20 ± 29.30, P = 0.025). The number of supine gas reflux (7.50 ± 6.40 vs 2.42 ± 2.80, P = 0.001) and supragastric belches was significantly higher in patients with IBS (51.20 ± 41.20 vs 25.08 ± 15.20, P = 0.035). Although the number of gastric belching was higher in controls, the difference did not reach statistical significance (12.10 ± 17.60 vs 4.90 ± 3.80, P = 0.575). We did not find any correlation between belching and any symptoms of IBS. Conclusions Belching is frequent in patients with IBS. Non-erosive reflux disease is frequent in IBS, which may be related to supragastric belching. (J Neurogastroenterol Motil 2017;23:409-414)
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