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증례 : 소화기 ; 당뇨병 환자에서 발생한 식도 방선균증 1예
구동영 ( Dong Yeong Gu ),노지훈 ( Ji Hun Roh ),임대관 ( Dae Gwan Lim ),조영화 ( Yeong Hwa Jo ),유재훈 ( Jae Hoon Yu ),윤준모 ( Jun Mo Yoon ),김기수 ( Gi Su Kim ) 대한내과학회 2012 대한내과학회지 Vol.82 No.5
A 47-year-old patient with diabetes mellitus was admitted with the complaints of sore throat and dysphagia. We performed an esophagogastroduodenoscopy and found esophageal ulcers. Histological examination of the esophageal biopsy revealed sulphur granules, and immunological findings ruled out viral infection. Thus, we diagnosed an isolated actinomycotic infection of the esophagus and treated the infection with oral amoxicillin. This case illustrates that actinomycotic infection of the esophagus can occur in immunocompetent patients. Therefore, when evaluating dysphagia, the probability of actinomycotic infection must be considered not only in immunocompromised patients, but in immunocompetent individualswith diabetes mellitus. (Korean J Med 2012;82:580-584)
히스토아크릴을 이용한 십이지장 궤양 출혈의 지혈 후 발생한 급성췌장염
유재훈,문원,노지훈,구동영,조영화,김기수,윤준모 고신대학교 의과대학 2010 고신대학교 의과대학 학술지 Vol.25 No.1
Upper gastrointestinal bleeding is common and potentially life threatening medical emergency. Emergency endoscopy is the first choice of diagnostic and treatment measure for patients with active upper gastrointestinal bleeding. Histoacryl should be considered a second-line treatment modality when conventional treatments were failed. However, it might cause several complications. Herein, we report a case of acute pancreatitis developed after histoacryl injection therapy for active duodenal ulcer bleeding. A 71-year-old man was admitted with melena and hematemesis. On emergency endoscopy, a 2 cm sized active ulcer with bleeding from an exposedvessel was seen at the duodenal bulb. Attempts to arrest the bleeding with hemoclipping and submucosal epinephrine injection were tried, but failed. We changed the method to endoscopic histoacryl injection, and obtained hemostasis immediately. A few hourslater, after successful hemostasis, patient complained diffuse abdominal pain. Ultrasonography revealed hyperechoic heterogenous diffuse pancreatic enlargement and right pararenal space fluid collection, this ultrasonographic findings and elevated serum pancreatic enzymes are compatible with acute pancreatitis.