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김기훈 ( Ki Hoon Kim ),서검석 ( Geom Seg Seo ),김태현 ( Tae Hyeon Kim ),김용성 ( Yong Sung Kim ),최창수 ( Chang Soo Choi ),이명수 ( Myeung Su Lee ),오효정 ( Hyo Jung Oh ),서승오 ( Sung O Seo ),신새론 ( Sae Ron Shin ),최석채 ( Suck 대한소화기기능성질환·운동학회 2007 Journal of Neurogastroenterology and Motility (JNM Vol.13 No.2
The oropharyngeal dysphagia results from variable etiologies such as neuropathies, drugs, myopathies, structural disorders of esophagus. Polymyositis is rare and 12~54% of the patients develop dysphagia. Many patients with oropharyngeal dysphagia are complicated by asphyxia, aspiration during swallowing, severe pneumonia or death. Early diagnosis and proper management is important for the prevention of complication. The patients with oropharyngeal dysphagia can be diagnosed by the investigations such as barium contrast swallowing test, videofluoroscopy, esophagoscopy, esophageal manometry. We report a case of polymyositis with oropharyngeal dysphagia that diagnosed by clinical symptoms, EMG finding and elevated muscle enzyme treated with high dose prednisolone. (Kor J Neuro-gastroenterol Motil 2007;13:152-155)
김기훈 ( Ki Hoon Kim ),김용성 ( Yong Sung Kim ),서검석 ( Geom Seg Seo ),최창수 ( Chang Soo Choi ),최석채 ( Suck Chei Choi ) 대한소화기기능성질환·운동학회 2007 Journal of Neurogastroenterology and Motility (JNM Vol.13 No.1
Constipation with fecal impaction is a commonly overlooked problem. Fecaloma is an extreme variety of fecal impaction. Untreated colonic obstruction from fecaloma can lead to stercoral ulcers and perforation at the site of the obstruction or in the proximally dilated colon. Therefore, early diagnosis and proper managements are required. A 16-year-old female patient with constipation presented with left lower abdominal discomfort, anorexia and weight loss for 1 month. Investigations revealed the huge fecaloma in the rectosigmoid megacolon. There were non-specific abnormalities on the etiologic evaluation of her constipation. All the conservative managements such as oral laxatives, repeated enemas, digital evacuation and sigmoidoscopic fragmentations failed to evacuate the stubborn fecaloma. She was successfully treated by manual disimpaction during numerous sessions under general anesthesia without operation. We report here that a huge impacted fecaloma with an idiopathic megacolon was successfully treated by manual disimpaction. (Kor J Neuro-gastroenterol Motil 2007;13:81-85)