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김병근,이동호,김나영,이상협,박영수 대한소화기내시경학회 2009 Clinical Endoscopy Vol.39 No.2
Intussusception in adults is not common unlike in pediatrics. It also differs from the pediatric intussusception in its origins, symptoms, and treatment. Since more than half of intussusception cases come from malignancy, laparotomy is considered to be the treatment of choice in most cases. This report deals with a patient who visited our hospital complaining of abdominal pain after colonoscopic polypectomy. The patient was diagnosed with colonic intussusception. After a conservative treatment regimen including antibiotics and fluid therapy, the intussusception was spontaneously reduced. 성인 장중첩증은 소아에 비하여 매우 드물고, 원인, 증상, 치료면에서 다른 특징을 보인다. 또한 원인의 반 이상이 악성 종양이기 때문에 특수한 경우를 제외하고는 수술이 일차 치료로 권고된다. 저자들은 개복술의 병력이 있는 환자가 대장내시경을 통한 용종 절제술 후 발생한 복통으로 내원하여, 전산화 단층 촬영을 통하여 장중첩증으로 진단되고, 수액 요법, 항생제 치료 등 보존적인 치료를 시행하여 자발적으로 정복된 특이한 증례를 경험하여 보고한다.
김병근,노명환,류충헌,남화성,우수미,유승희,장진석,이종훈,최석렬,박병호 대한내과학회 2013 The Korean Journal of Internal Medicine Vol.28 No.3
Background/Aims: The bedside index of severity in acute pancreatitis (BISAP)is a new, convenient, prognostic multifactorial scoring system. As more data are needed before clinical application, we compared BISAP, the serum procalcitonin (PCT), and other multifactorial scoring systems simultaneously. Methods: Fifty consecutive acute pancreatitis patients were enrolled prospectively. Blood samples were obtained at admission and after 48 hours and imaging studies were performed within 48 hours of admission. The BISAP score was compared with the serum PCT, Ranson’s score, and the acute physiology and chronic health examination (APACHE)-II, Glasgow, and Balthazar computed tomography severity index (BCTSI) scores. Acute pancreatitis was graded using the Atlanta criteria. The predictive accuracy of the scoring systems was measured using the area under the receiver-operating curve (AUC). Results: The accuracy of BISAP (≥ 2) at predicting severe acute pancreatitis was 84% and was superior to the serum PCT (≥ 3.29 ng/mL, 76%) which was similar to the APACHE-II score. The best cutoff value of BISAP was 2 (AUC, 0.873; 95% confidence interval, 0.770 to 0.976; p < 0.001). In logistic regression analysis, BISAP had greater statistical significance than serum PCT. Conclusions: BISAP is more accurate for predicting the severity of acute pancreatitis than the serum PCT, APACHE-II, Glasgow, and BCTSI scores.