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최유이 ( Yu Yi Choi ),이지원 ( Ji Won Yi ),강동환 ( Dong Hwahn Kahng ),서형일 ( Hyung Il Seo ),김석 ( Suk Kim ),박도윤 ( Do Youn Park ) 대한내과학회 2013 대한내과학회지 Vol.84 No.5
췌장의 AVM은 매우 드문 질환이나 원인이 명확하지 않은 복통, 반복적인 상부위장관 출혈 환자에서 감별 진단으로 고려되어야 하며, 컬러 도플러 초음파나 컴퓨터단층촬영 등의 적극적인 검사로 빠르게 진단하여 치료하는 것이 필요하다. Pancreatic arteriovenous malformations (AVMs) are rare, and most cases occur as congenital anomalies. Many patients with AVM are asymptomatic, but occasionally present with abdominal pain or gastrointestinal bleeding. The increased portal vein flow that forms these malformations can lead to portal hypertension and gastrointestinal bleeding in the absence of primary liver pathology. Early diagnosis can lead to successful surgical resection or percutaneous transarterial embolization. We report a case of a patient with pancreatic AVM in the tail of the pancreas, in which endoscopic ultrasonography was helpful. This patient presented with abdominal pain and was subsequently treated with distal pancreatectomy. (Korean J Med 2013; 84:708-712)
소화기 ; 검진 내시경 상 구불 결장의 상피하 병변으로 관찰된 충수염 1예
최유이 ( Yu Yi Choi ),김수진 ( Su Jin Kim ),강대환 ( Dae Hwan Kang ),김형욱 ( Hyung Wook Kim ),최철웅 ( Cheol Woong Choi ),오숙경 ( Sook Kyoung Oh ),신영신 ( Young Shin Shin ) 대한내과학회 2015 대한내과학회지 Vol.89 No.5
본 증례는 검진 목적의 대장내시경에서 충수돌기 개구부가 정상 소견을 보였지만, 구불결장의 점막하 병변으로 나타난 충수염의 드문 증례이다. 화농성 배액이 보이는 점막하 병변이 구불 결장에서 관찰될 때 충수염의 가능성 또한 감별진단으로 고려해 볼 수 있겠다. Acute appendicitis is common in all age groups. Although many patients with acuteappendicitis present with migrating abdominal pain, the initial presentation can be atypical and nonspecific. Unusual manifestations can lead to diagnostic delay, which is associated with increased morbidity and mortality. Colonoscopic findings suggestinga diagnosis of asymptomatic appendicitis include hyperemia and bulging at the appendiceal orifice area with surrounding mucosal edema, and drainage of pus from the appendiceal orifice. We report a case of asymptomatic perforated appendicitis and periappendiceal abscess that presented as a subepithelial sigmoid colon lesion at screening colonoscopy. On colonoscopy, a subepithelial lesion with pustular drainage surrounded by hyperemic mucosa was seen at the sigmoid colon. Computed tomography revealed appendicitis and a periappendiceal abscess with adjacent sigmoid colon wall thickening. The patient underwent an appendectomy, with a final diagnosis of a perforated appendicitis with a periappendiceal abscess. (Korean J Med 2015,89:548-552)
국소성 융모막암종 분화를 동반한 S상결장의 원발성 선암종
오숙경 ( Sook Kyoung Oh ),김형욱 ( Hyung Wook Kim ),강대환 ( Dae Hwan Kang ),최철웅 ( Cheol Woong Choi ),최유이 ( Yu Yi Choi ),임홍규 ( Hong Kyu Lim ),구자준 ( Ja Jun Goo ),최성열 ( Sung Yeol Choi ) 대한소화기학회 2015 대한소화기학회지 Vol.66 No.5
Primary colorectal choriocarcinoma is a rare neoplasm. Only 19 cases have been reported worldwide, most of which involved adenocarcinomas. The prognosis is usually poor, and the standard therapy for this tumor has not been established. A 61-year-old woman presented with constipation and lower abdominal discomfort. She was diagnosed with primary adenocarcinoma with focal choriocarcinomatous differentiation in the sigmoid colon and liver metastasis. Because the serum beta-human chorionic gonadotropin level was not significantly elevated, and because only focal choriocarcinomatous differentiation was diagnosed, we selected the chemotherapy regimen that is used for the treatment of metastatic colorectal adenocarcinoma. The patient survived for 13 months after the initial diagnosis. This is the first case in Korea to assess the suppressive effects of the standard chemotherapy for colorectal adenocarcinoma against coexisting colorectal choriocarcinoma and adenocarcinoma. (Korean J Gastroenterol 2015;66:291-296)