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방사선 치료로 치유된 대장 Mucosa-associated Lymphoid Tissue 림프종: 증례보고 및 문헌고찰
이면재 ( Myeon-jae Lee ),명은 ( Eun Myung ),오형훈 ( Hyung-hoon Oh ),주영은 ( Young-eun Joo ) 대한소화기학회 2020 대한소화기학회지 Vol.76 No.6
Mucosa-associated lymphoid tissue (MALT) lymphoma predominantly involves the gastrointestinal tract, with the stomach being the most commonly affected site. Colonic involvement is quite rare. Hence, the etiology, clinical characteristics, treatment, and outcome of colonic MALT lymphoma are not well established. This paper reports a case of MALT lymphoma of the transverse colon, presenting as a subepithelial tumor in a 50-year-old woman. The patient received 3,060 cGy in 17 fractions with external beam radiation therapy for three weeks. At 2 months after radiation therapy, a colonoscopy examination revealed complete resolution and a scar change of the lesion. The follow-up at 24 months revealed no evidence of tumor recurrence after radiation therapy. (Korean J Gastroenterol 2020;76:327-330)
내시경 정맥류 결찰술 실패의 위험인자 및 내시경적 구제 치료
김동현 ( Dong Hyun Kim ),조은애 ( Eunae Cho ),전충환 ( Chung Hwan Jun ),손동준 ( Dong Jun Son ),이면재 ( Myeon Jae Lee ),박창환 ( Chang Hwan Park ),조성범 ( Sung Bum Cho ),박선영 ( Seon-young Park ),김현수 ( Hyun Soo Kim ),최성규 대한소화기학회 2018 대한소화기학회지 Vol.72 No.4
Background/Aims: The success rate of endoscopic variceal ligation (EVL) is about 85-94%. There is only a few studies attempting to determine the cause of EVL failure, and to date, on-site rescue treatments remains unestablished. This study aimed to elucidate the risk factors for EVL failure and the effectiveness of on-site rescue treatment. Methods: Data of 454 patients who underwent emergency EVL at Chonnam National University Hospital were retrospectively analyzed. Enrolled patients were divided into two groups: the EVL success and EVL failure groups. EVL failures were defined as inability to ligate the varices due to poor endoscopic visual field, or failure of hemostasis after band ligation for the culprit lesion. Results: Forty-seven patients experienced EVL failure. In the multivariate analysis, male patients, initial hypovolemic shock, active bleeding on endoscopy, and history of previous EVL were independent risk factors for EVL failure. During endoscopic procedure, we came across the common causes of EVL failure, including unsuctioned varix due to previous EVL-induced scars followed by insufficient ligation of the stigmata and inability to ligate the varix due to poor endoscopic visual field. Endoscopic variceal obturation using N-butyl- 2-cyanoacrylate (48.9%) was the most commonly used on-site rescue treatment method, followed by insertion of Sangstaken Blakemore tube (14.9%), and EVL retrial (12.8%). The rescue treatments successfully achieved hemostasis in 91.7% of those in the EVL failure group. Conclusions: The risk factors of EVL failure should be considered before performing EVL, and in case of such scenario, on-site rescue treatment is needed. (Korean J Gastroenterol 2018;72:188-196)