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하헌돈(Heon Don Ha),강창규(Chang Gyu Kang),김영운(Young Un Kim),오성광(Sung Kwang Oh),황석주(Soek Joo Hwang),김대영(Dae Young Kim),임선재(Seon Jae Yim),박승욱(Seung Wook Park),이두용(Doo Yong Lee) 대한소화기학회 1996 대한소화기학회지 Vol.28 No.6
Internal biliary fistula is a very rare disease. Fistula is usunlly produced by chrnnic disease of liiliary tract associated with ;allstone,and may be produced by peptic ulcer, by malignancy or traurna The common types giien in order are cholecystoduodenal, cholecystocolic, choledochoduo- <Ienal, cholecystogastric fistula. Etc. The mechanism of fistula forniatinns is due to adherence of the inflnmmed gallbladder or cnn mnn bile duct to adjacent viscus and exit of a gallstone into the adjacent orgm. Thc clinical .,ymptoms,signs, laboratory findings are often so nnnspecific that f'istiila is u.iually difficult tn <Jiagnose preoperatively. Preoperative diagnostic rate is io between 31% fn m7% of reported case. A 4S years old male visited Dae Senn SlJN general hospital because of persistent diarrhea ond abdominal discomfort. Of' 15 years prior to his visit, he had been suffered from the severe RlSQ pain ancl treated by medical regimen nnder impression of acute cholecystitis associated with gallstnne. And occasionally intermitent RIJQ pain persisted imtill 6 years ago, when sudden disappearence oF RUO pain developed, then followed by persistent diarrhea and lower abdominal discomfort. Pneumchilia is found on abdorninal sonogram, and the fistula trnct between gallbladder arvt colon has bee disclosed on barium enema study and F.RCP, abdominal CT. But surgical intcrvcntinn h,I t eer delayed because of patients cvnsent. (Korean 3 tastroenterol ]995:27: 893-89'7l
전소장과 대장 전체에서 발생한 원발성 위장관 림프종 1예
김영운,이두용,김종설,박승욱,하헌돈,강창규,권주원 대한소화기학회 1995 대한소화기학회지 Vol.27 No.5
Primary gastrointestinal lymphoma which is primarily confined to gastrointestinal tract without evidence of systemic involvement is a relatively rare disease. Non-Hodgkin's lymphoma has a tendency to involve extranodal areas as its primary site and the gastrointestinal tract is the most commonly involved extranodal site. Many cases of primary gastrointestinal lymphoma have been reported mostly of gastric origin followed by small howel, ileocecal portion and colon; however, the concurrent lymphoma of colon and small bowel is very rare in reported cases. This article is about a case of 55-year old male who was diagnosed as primary concurrent malignant lymphoma of the entire small bowel and colon. The colonoscopic finding revealed smootb pink-red colored multiple polypoid masses and ulcerations in the total colon. We suspected lymphoma by endoscopic punch biopsy, thereafter laparatomy was performed. Multiple subserosal nodules were scattered from Treitzs ligament to rectum, and mesenteric lymph node enlargement was also observed. As a result malignant lymphoma was confirmed pathohistologically. We report this case with a review of the related literature.
김영운,이두용,김종설,박승욱,하헌돈,강창규,오성광,황석주,권주원,선정민 대한내과학회 1995 대한내과학회지 Vol.49 No.1
Upper esophageal webs consist of thin mucosal membranes projecting into the esophageal lumen at level of just below the cricoid cartilage. A specfic syndrome characterized by a cervical esophageal web with dysphagia, mucosal lesions of the mouth and pharynx, and iron deficiency anemia is variably known as Plummer-Vinson syndrome, Paterson Kelly syndrome or sideropenic dysphagia, These terms are all used interchangeably. Recently we experienced a case of upper esophageal web with dysphagia and iron deficiency anemia. A 46-year-old women had complained of dysphagia for 15 years. Esophagogram showed a anterior diaphragm-like web protruding into the esophageal lumen at the level of the 4th-to-5th cervical vertebrae. Also esophagoscopy showed a eccentric circular web at 18cm from incisors. Bougienation under endoscopy with Savary-Gilliard dilatory was perfomed Successfully and she could well tolerate in swallowing of solid food after this procedure. Hereby we report a case of classical Plummer-Uinson syndrome together with a review of literatures.