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내과적 치료로 회복된 급성 췌장염에 병발된 간문맥 내 가스
동시헌 ( Shi Heon Dong ),조현근 ( Hyeon Geun Cho ),백정훈 ( Jeong Hoon Baek ),강버들 ( Beo Deul Kang ),김미성 ( Mi Sung Kim ),조재희 ( Jae Hee Cho ),이정훈 ( Jeong Hoon Lee ),천송욱 ( Song Wook Chun ) 대한소화기학회 2013 대한소화기학회지 Vol.61 No.3
Hepatic portal venous gas (HPVG) has been considered a rare entity associated with a poor prognosis. Portal vein gas is most commonly caused by mesenteric ischemia but may have a variety other causes. HPVG can be associated with ischemic bowel disease, inflammatory bowel disease, intra-abdominal abscess, small bowel obstruction, acute pancreatitis, and gastric ulcer. Because of high mortality rate, most HPVG requires emergent surgical interventions and intensive medical management. We experienced a case of hepatic portal venous gas caused by acute pancreatitis and successfully treated with medical management. (Korean J Gastroenterol 2013;61:170-173)
알코올성 간경변 환자에서 다량의 복수로 발현된 막증식성 사구체신염의 양상을 동반한 IgA 신병증
송선옥 ( Sun Ok Song ),이승원 ( Seung Won Lee ),이희우 ( Hee Woo Lee ),강버들 ( Beo Deul Kang ),동시헌 ( Shi Heon Dong ),최자성 ( Ja Sung Choi ),송지선 ( Ji Sun Dong ),윤수영 ( Soo Young Yoon ),이상철 ( Sang Choel Lee ) 대한신장학회 2009 Kidney Research and Clinical Practice Vol.28 No.2
IgA nephropathy can occur commonly in alcoholic liver cirrhosis and is the most common form of secondary IgA nephropathy. Defective clearance of IgA-containing complexes by liver is thought to contribute to the development of IgA nephropathy in alcoholic cirrhosis. Although IgA deposition is found up to 64% in autopsy cases of alcoholic cirrhosis, most patients have mild clinical symptoms, and nephrotic range proteinuria occurs rarely in these patients. We report a case of IgA nephropathy with a membranoproliferative pattern that is detected with unusual massive ascites in a patient with alcoholic liver disease. A 60-year-old male patient was referred to our hospital for evaluation and management of abdominal distension. Abdominal ultrasonographic findings were compatible with diffuse liver cirrhosis with splenomegaly and large amount of ascites. He had nephrotic range proteinuria, azotemia, hyperlipidemia, and hematuria in dipstick. Renal biopsy performed under the impression of acute nephritis revealed mesangial and endocapillary proliferative glomerulonephritis with double contour of capillary loop. Immunofluorescence findings showed mesangial IgA and C3 deposit, compatible with IgA nephropathy. He was treated with high dose steroid, and steroid was tapered during 2 months. Steroid treatment induced complete remission state, and ascites was resolved.
깊은 정맥혈전증이 합병된 이식신의 신대체 지방종증 1예
이상철 ( Sang Choel Lee ),김윤지 ( Yoon Ji Kim ),이상헌 ( Sang Hun Lee ),박형복 ( Hyung Bok Park ),현여경 ( Yu Kyung Hyun ),동시헌 ( Shi Heon Dong ),윤수영 ( Soo Yong Yoon ) 대한신장학회 2010 Kidney Research and Clinical Practice Vol.29 No.6
Purpose: Replacement lipomatosis of the kidney is a rare disorder in which a massive fatty tissue proliferation occurs within the renal sinus, hilum and perirenal region. Clinical symptoms includes flank pain, hematuria, fever usually associated with urinary tract infection and renal stone. But deep vein thrombosis due to mass effect has not been reported to be associated with replacement lipomatosis of kidney. A 37-year-old male was referred for the initiation of hemodialysis due to chronic rejection of allograft kidney. Collateral superficial veins were observed on his anterior abdominal wall and firm mass was palpable in the right lower quadrant abdomen. Abdominal-pelvis computed tomography revealed huge fatty mass originated from allograft kidney and non-visualization of inferior vena cava with lower density thrombus at both the common femoral veins. We report a rare case of replacement lipomatosis of the kidney complicated by deep vein thrombosis after renal transplantation.