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고주파열치료 중 펜타닐에 의해 발생한 아나필락시스 1예
김진용 ( Jin Yong Kim ),엄상용 ( Sang Yong Om ),윤선영 ( Sun Young Yoon ),김태범 ( Tae Bum Kim ),조유숙 ( You Sook Cho ),문희범 ( Hee Bom Moon ),권혁수 ( Hyouk Soo Kwon ) 대한소아알레르기호흡기학회(구 대한소아알레르기 및 호흡기학회) 1991 소아알레르기 및 호흡기학회지 Vol.1 No.3
This case report describes a life-threatening anaphylaxis to fentanyl during radiofrequency ablation (RFA). A 50-year-old woman with hepatocellular carcinoma was admitted for RFA. She denied any history of adverse drug reactions or past adverse anesthetic reaction. Physical examination, vital signs, any laboratory findings were all within normal limits. Ten minutes after intravenous administration of 50 mcg of fentanyl before starting RFA, she developed generalized erythema and sudden onset of bronchospasm followed by respiratory arrest. Cardiopulmonary resuscitation (CPR) commenced with 100% oxygen and intravenous administration of epinephrine 1 mg. After 5 minutes of CPR, she had the return of spontaneous circulation. Chest X-ray revealed pulmonary edema which resolved over two days. She recovered completely and was discharged home. After six weeks, intradermal tests performed with fentanyl, remifentanyl, midazolam, and profopol. Among those, only fentanyl induced positive skin response. Fentanyl induced anaphylaxis was diagnosed for this case, and fentanyl was avoided in the subsequent general anesthesia for liver transplantation. This case suggested that fentanyl could induce anaphylaxis combined with uncommon comorbidities like pulmonary edema. (Allergy Asthma Respir Dis 2013;1:284-287)
김진용 ( Jin Yong Kim ),엄상용 ( Sang Yong Om ),윤선영 ( Sun Young Yoon ),김태범 ( Tae Bum Kim ),조유숙 ( You Sook Cho ),문희범 ( Hee Bom Moon ),권혁수 ( Hyouk Soo Kwon ) 대한천식알레르기학회 2013 Allergy Asthma & Respiratory Disease Vol.1 No.3
This case report describes a life-threatening anaphylaxis to fentanyl during radiofrequency ablation (RFA). A 50-year-old woman with hepatocellular carcinoma was admitted for RFA. She denied any history of adverse drug reactions or past adverse anesthetic reaction. Physical examination, vital signs, any laboratory findings were all within normal limits. Ten minutes after intravenous administration of 50 mcg of fentanyl before starting RFA, she developed generalized erythema and sudden onset of bronchospasm followed by respiratory arrest. Cardiopulmonary resuscitation (CPR) commenced with 100% oxygen and intravenous administration of epinephrine 1 mg. After 5 minutes of CPR, she had the return of spontaneous circulation. Chest X-ray revealed pulmonary edema which resolved over two days. She recovered completely and was discharged home. After six weeks, intradermal tests performed with fentanyl, remifentanyl, midazolam, and profopol. Among those, only fentanyl induced positive skin response. Fentanyl induced anaphylaxis was diagnosed for this case, and fentanyl was avoided in the subsequent general anesthesia for liver transplantation. This case suggested that fentanyl could induce anaphylaxis combined with uncommon comorbidities like pulmonary edema. (Allergy Asthma Respir Dis 2013;1:284-287)
증례 : 소화기; 내시경역행성췌담도조영술 중 발생한 간문맥 내 삽관 1예
김창래 ( Chang Lae Kim ),하연정 ( Yeon Jung Ha ),엄상용 ( Sang Yong Om ),지원준 ( Won Jun Ji ),김태오 ( Tae Oh Kim ),최준호 ( Jun Ho Choi ),김명환 ( Myung Hwan Kim ) 대한내과학회 2014 대한내과학회지 Vol.86 No.4
국내에서 내시경역행성췌담도조영술 시행 중 간문맥 삽관이 보고된 증례는 없었다. 황달이 발생한 췌장 두부암 환자에서 내시경역행성췌담도조영술 중 유도선을 따라 삽관캐뉼라를 삽입하였으나 간문맥 내 삽관이 발생하여 시술을 중단하고 보존적 치료를 통하여 회복된 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. A 68-year-old woman was admitted to our hospital with obstructive jaundice. Abdominal CT scan demonstrated a mass at the head of the pancreas. The patient was diagnosed as having obstructive jaundice caused by pancreatic cancer. We tried to relieve the bile duct obstruction by ERCP (endoscopic retrograde cholangiopancreatography). After several cannulation attempts, we thought that we had achieved deep cannulation of the bile duct and tried to place a biliary plastic stent. During ERCP, however, we noticed massive air in the portal venous system, indicating possible cannulation of the portal vein. The procedure was terminated immedi-ately and abdominal computed tomography revealed air in the portal venous system. Fortunately, there were no subsequent complications. The air in the portal vein had disappeared, ascertained by CT scan taken 5 days later. The patient underwent surgical resection for pancreatic cancer. Isolated portal vein cannulation per se does not usually result in mortality or serious morbidity. (Korean J Med 2014;86:462-465)