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증례 : 호흡기 ; 유방 성형 목적으로 폴리아크릴아마이드 주입 후에 발생한 폐포 출혈 1예
임준혁 ( Jun Hyeok Lim ),이정민 ( Jeong Min Lee ),최성환 ( Seong Huan Choi ),남해성 ( Hae Seong Nam ),조재화 ( Jae Hwa Cho ),류정선 ( Jeong Seon Ryu ),곽승민 ( Seung Min Kwak ) 대한내과학회 2015 대한내과학회지 Vol.88 No.4
Polyacrylamide는 최근 주사용 필러로서의 사용이 증가되고 있는 물질로 본 증례에서와 같이 무자격 시술자에 의한 주입되는 경우가 있다. Polyacrylamide에 의한 국소적인 부작용에 대하여는 여러 차례 보고된 바가 있으나 전신적 부작용에 대하여는 보고된 바가 없다. 저자들은 유방 성형 목적으로 polyacrylamide를 양측 유방에 주입 받았던 환자에서 폐포 출혈이 발생한 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Polyacrylamide hydrogel is used widely in plastic surgery due to its nontoxic, nonabsorbent nature. There have been reports of silicone leading to pulmonary embolism and acute respiratory distress syndrome with systemic adverse effects. However, there have been case reports only of local reactions involving polyacrylamide; systemic reactions appear to be rare. Furthermore, there has been no report of alveolar hemorrhage after polyacrylamide injection for breast augmentation. We treated a 53-year-old female with an alveolar hemorrhage that occurred 2 days after a polyacrylamide injection. On the day of admission, the patient had a fever with chills and dyspnea. The chest X-ray showed multiple infiltrations and chest computed tomography showed consolidation and a ground-glass appearance in both lung fields. The alveolar hemorrhage was confirmed at fiber-optic bronchoscopy and bronchoalveolar lavage. The symptoms and radiology findings improved after corticosteroid administration and conservative treatment. We report the first case of alveolar hemorrhage after a polyacrylamide injection for breast augmentation.
이정민 ( Jeong Min Lee ),박진석 ( Jin Seok Park ),정석 ( Seok Jeong ),이돈행 ( Don Haeng Lee ),최성환 ( Seong Huan Choi ),김신일 ( Shin Il Kim ),김민주 ( Min Ju Kim ),윤광석 ( Gwang Seok Yoon ) 대한췌장담도학회 2014 대한췌담도학회지 Vol.19 No.4
Mirizzi`s syndrome (MS) caused by the retention of a stone in the cystic duct stump after cholecystectomy is rare. Most cases of MS are treated by surgical intervention. However, developments of endoscopic accessories and techniques have resulted in the recent introduction of endoscopic treatments for MS. Furthermore, in view of the postoperative morbidity caused by post-operative scarring, the endoscopic approach should be preferred to the surgical approach. In the described case, the authors were able to remove a remnant cystic duct stone endoscopically because the cystic duct stump was wide and non-tortuous. This case shows endoscopic retrograde cholangiopancreatography with mechanical lithotripsy can be utilized in suitable cases of type I MS development after cholecystectomy. Korean J Pancreatobiliary 2014;19(4):199-203