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여승재 ( Seong Jae Yeo ),조창민 ( Chang-min Cho ),정민규 ( Min Kyu Jung ),김기주 ( Ki Ju Kim ),김명희 ( Myung Hi Kim ),조승현 ( Seung Hyun Cho ),김갑철 ( Gab Chul Kim ),서안나 ( An Na Seo ) 대한소화기학회 2017 대한소화기학회지 Vol.69 No.3
Actinomycosis is a slowly progressive, chronic infectious disease. It is caused by the genus Actinomyces, which are gram-positive anaerobic bacteria. It presents as a mass-like lesion, composed of bacterial nidus and characteristic granulomatous inflammatory fibrosis. As such, it has frequently been mistaken for a malignancy. Surgical resection is a common procedure in these patients prior to a definite diagnosis. Although actinomycosis can occur in a variety of regions, including oral-cervicofacial, thoracic, and abdominopelvic cavities, the involvement of the pancreas is very rare. We report a case of a 44-year-old male with a symptomatic actinomycosis caused by a mass in the tail of the pancreas. The diagnosis was made using an endoscopic ultrasound-guided fine needle aspiration biopsy without surgical resection. After the treatment with antibiotics, the pancreatic mass was confirmed to be resolved on the follow-up computed tomography. (Korean J Gastroenterol 2017;69:191-195)
증 례 : 내시경역행담췌관조영술을 이용한 내장 역위증 환자의 총담관결석 제거
여승재 ( Seong Jae Yeo ),허준 ( Jun Heo ),조창민 ( Chang Min Cho ),정민규 ( Min Kyu Jung ),박수영 ( Soo Young Park ),김명희 ( Myung Hi Kim ),이상원 ( Sangwon Lee ),유나리 ( Nari Yu ) 대한소화기학회 2015 대한소화기학회지 Vol.66 No.6
Situs inversus is an extremely rare autosomal recessive disease with left-right inversion of internal organs. It carries technical difficulties in diagnostic or therapeutic procedures. There have been a few case reports on stone extraction by ERCP in situs inversus patients. ERCP techniques in situs inversus can be classified into conventional method and mirror image method. In mirror image method, the procedure is performed with the patient in the right lateral decubitus position and the endoscopist on the patient’s left side. Until now, there is no consensus about which method is better. Herein, we report an unusual case of choledocholithiasis in a patient with situs inversus who underwent ERCP for stone extraction by both conventional method and mirror image method.(Korean J Gastroenterol 2015;66:354-358)
십이지장 소유두에 발생한 신경내분비종양의 내시경 유두절제술 2예
김명희 ( Myung Hi Kim ),여승재 ( Seong Jae Yeo ),김기주 ( Ki Joo Kim ),정민규 ( Min Kyu Jung ),조창민 ( Chang Min Cho ),서안나 ( An Na Seo ),배한익 ( Han Ik Bae ) 대한췌담도학회 2017 대한췌담도학회지 Vol.22 No.1
신경내분비종양은 잠재적인 악성의 경과를 가지는 드문 종 양으로 완전절제가 치료 원칙이고 십이지장 신경내분비종양 의 경우 완전 절제로 췌십이지장절제술이 원칙적으로 권고되 고 있다. 그러나 수술에 따른 합병증을 고려했을 때 분화도가 좋고 크기가 2 cm보다 작은 종양의 경우 국소 절제술이나 내 시경 절제술이 대안으로 제시되고 있다. 이번 증례는 내시경 유두절제술을 통해 십이지장 소유두에 발생한 신경내분비종 양을 성공적으로 치료한 예로 내시경 유두절제술이 췌십이지 장절제술의 대안이 될 수 있음을 보여주었다. Most of neuroendocrine tumors are usually found in the gastrointestinal tract. Recently, the incidence of gastrointestinal neuroendocrine tumors seems to have increased. However, only a few cases of neuroendocrine tumor arising from the minor duodenal papilla have been reported. Currently, several options are available to treat the tumors of the minor duodenal papilla. Endoscopic papillectomy is increasingly performed as a minimally invasive alternative treatment to conventional surgical resection. We present two cases of neuroendocrine tumor arising from minor duodenal papilla, which were successfully resected by endoscopic papillectomy. Although surgical resection is considered to be a standard treatment for gastrointestinal neuroendocrine tumors, our experience suggests that endoscopic papillectomy can be a minimally invasive alternative treatment for neuroendocrine tumors arising from the minor duodenal papilla.
증 례 : 전이성 신장암으로 오인된 방선균증에 의한 황색 육아종성 신우신염 1예
김명희 ( Myung Hi Kim ),여승재 ( Seong Jae Yeo ),유나리 ( Na Ri You ),이상원 ( Sang Won Lee ),전성우 ( Seong Woo Jeon ),조창민 ( Chang Min Cho ),이현석 ( Hyun Seok Lee ) 대한내과학회 2016 대한내과학회지 Vol.90 No.1
방선균증에 의한 황색 육아종성 신우신염은 국내에서 보고된 적이 없는 드문 질환이다. 영상의학적으로 종양이나 농양과 감별이 어려워 수술적 절제에 의해 진단되는 경우가 대부분이다. 저자들은 만성 음주력을 가지고 있는 환자에서 영상의학적으로 악성종양과 감별이 어려웠고 세침흡인세포검사나 균배양 검사로는 진단이 되지 않아 복강경하 근치적신장절제술로 방선균증에 의한 황색 육아종성 신우신염을 진단하는 증례를 국내에서 처음 경험하였기에 문헌고찰과 함께 보고하는 바이다. Xanthogranulomatous pyelonephritis (XP) is an uncommon, chronic, destructive, granulomatous disease of the renal parenchyma. The condition is generally associated with long-term urinary tract obstruction and infection, although the precise etiology of disease remains unknown. The condition often mimics neoplastic and inflammatory diseases, and XP associated with actinomycosis is extremely uncommon. A 60 year-old male was admitted complaining of abdominal pain and weight loss. His radiological findings were suggestive of metastatic kidney cancer, and we performed radical laparoscopic nephrectomy and mesenterectomy for diagnostic purposes. Pathologically, actinomycosis combined with XP was evident. We report here a rare case of XP associated with actinomycosis. (Korean J Med 2016;90:78-82)
증례 : 소화기 ; 위 내시경 점막하 박리술 후 발생한 기흉 1예
이유림 ( Yu Rim Lee ),허준 ( Jun Heo ),정민규 ( Min Kyu Jung ),김성국 ( Sung Kook Kim ),강은정 ( Eun Jeong Kang ),여승재 ( Seong Jae Yeo ),박혜윤 ( Hye Yoon Park ) 대한내과학회 2015 대한내과학회지 Vol.88 No.1
위장관 종양의 ESD는 상대적으로 안전한 시술이지만 다양한 합병증이 보고되고 있다. 그 중에서 위 ESD 후 발생한기흉은 아주 드문 합병증으로 저자들은 위 ESD 후 기흉, 공기복막증 및 공기후복막증이 발생한 환자에서 내시경 클리핑과 흉관삽관을 포함한 보존적 치료로 호전이 있었던 증례를 문헌고찰과 함께 보고한다. Endoscopic submucosal dissection (ESD) is widely accepted as an alternative treatment to surgical resection for gastric neoplasticlesions. Among the complications of gastric ESD, perforation is usually manifested as a pneumoperitoneum. Here, we reporta patient with a right-sided pneumothorax, pneumoperitoneum, and pneumoretroperitoneum as complications of gastric ESD. Thepatient recovered without further complications using conservative treatment, including endoscopic clipping, nasogastric drainage,and insertion of a chest tube.