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내시경적 역행성 췌담관조영술중 췌선방 조영 후 발생한 중증 췌장염 1예
장세중,기승석,김훈일,신혜영,박장원,송은훈,태재웅 朝鮮大學校 附設 醫學硏究所 2008 The Medical Journal of Chosun University Vol.33 No.2
내시경적 역행성 담췌관조영술 후 발생한 급성췌장염의 발생인자로 여러 가지 인자들이 관여하지만 특히 담췌관조영술 시행 후 과도한 췌선방 조영화에 의한 중증의 췌장염 증례를 경험하였기에 보고하는 바이다 Endoscopic retrograde cholangiopancreatography (ERCP) has been considered as a valuable tool for the diagnosis and management of disease of the pancreas and biliary tree. Post-ERCP pancreatitis is the most frequent and clinically significant complication following ERCP. But a few complication associated with this procedure are unforeseeable. Specially, acinarization as a result of a careless cooperation between operator and assistant may be influenced in complications of ERCP. Severe post-ERCP pancreatitis is rare complication, and its prognosis will be poor. Therefore, careful process and good relationship between operator and assistant in ERCP may be prevented this complication, but is not clear. Neglect of acinarization may be resulted in more aggravation of pancreatitis. We have cared for one patient with severe post-ERCP pancreatitis with pseudocyst after water-soluble contrast media spreading into the acini (acinarization) via ERCP in resolving phase idiopathic pancreatitis.
Polyethylene glycol 용액(Colyte^(R))을 복용한 후 발생한 Boerhaave 증후군 1예
이관행,기승석,김인숙,김민정,박인호,장세중,하지수,김응수 朝鮮大學校 附設 醫學硏究所 2006 The Medical Journal of Chosun University Vol.31 No.3
Spontaneous esophageal rupture (Boerhaave's syndrome) is a rare case that require early diagnosis and treatment because of its high mortality. The oral administration of osmotically balanced polyethylene-glycol-based electrolyte preparation is a commonly prescribed preparation for cleansing in patients undergoing colonoscopy. Nausea, vomiting and abdominal pain are frequently seen, but serious adverse reactions are rare. Esophageal rupture secondary to severe vomiting, which occurred during colonoscopy preparation using polyethylene gIycoI(PEG) electrolyte solution is extremely rare and only few cases have been published in the literature. We report a case of spontaneous esophageal rupture after routine administration of the PEG before colonoscopy. 대장 정결을목적으로 PEG 사용 후 아주 드물게 발생하는 Boerhaave 증후군 1예를 경험하였기에 보고하는 바이다.
The Usefulness of a Colonoscopy with Biopsy in the Early and Accurate Diagnosis of Ischemic Colitis
( Eui Joong Kim ),( Soon Man Yoon ),( Sang Hwa Lee ),( Ki Bae Kim ),( Joo Young Lee ),( Dong Hwa Lee ),( Eun Bee Kim ),( Soonyoung Park ),( Joung Ho Han ),( Hee Bok Chae ),( Seon Mee Park ),( Sei Jin 대한장연구학회 2013 Intestinal Research Vol.11 No.2
Background/Aims: Ischemic colitis has a clinical spectrum ranging from mild reversible colitis to an acute fulminant course. Early and accurate diagnosis is therefore mandatory for a good clinical outcome. The aim of this study is to evaluate the efficacy and safety of a colonoscopy and histological examination with biopsy in the early and accurate diagnosis of ischemic colitis. Methods: We investigated the clinical characteristics and endoscopic findings with the histopathology of 89 cases of ischemic colitis from October 2002 to August 2012 in a tertiary-care hospital. All patients underwent a colonoscopy with biopsy within a few days of the onset of symptoms, and the histological features from the biopsy specimens were reviewed. In addition, the occurrence of complications by colonoscopy with biopsy was evaluated. Results: The mean age of the patients was 65.8±12.6 years (male:female, 1:2.2). The major combined disorders were hypertension (51.7%), diabetes (31.5%), and arrhythmia (19.1%). The clinical features usually presented with hematochezia (83.1%), abdominal pain (77.5%), and diarrhea (60.7%). The involved patterns were the left colon (56.2%), right colon (39.3%), and pancolon (4.5%). Based on the main histological features of ischemic colitis, including glandular atrophy (67.4%), hemorrhage (61.8%), capillary thrombi (42.7%), and coagulative necrosis of mucosa (29.2%), 67 of the 89 cases (75.3%) could be confirmed with ischemic colitis. There were no serious complications such as bowel perforation or major bleeding following the colonoscopy with biopsy. Conclusions: A colonoscopy with biopsy is beneficial and safe for the early and precise diagnosis of ischemic colitis. (Intest Res 2013;11:100-106)
So-young Choi,Joong Suck Kim,Sei Joong Kim,Yun Jeong Kim,Lucia Kim,Young Up Cho 한국유방암학회 2009 Journal of breast cancer Vol.12 No.3
An adenomyoepithelioma (AME) is an uncommon neoplasm characterized by proliferation of both epithelial and myoepithelial cells in the salivary gland, skin, lung and breast. AMEs can recur, progress to malignancy and metastasize. A 68-year-old woman presented a large mass occupying her whole right breast. The mass had grown slowly for about 20 years and the preoperative biopsy of the mass was chondroid syringoma. The mass was completely resected and the postoperative biopsy revealed malignant AME with a negative resection margin. The patient didn’t receive any adjuvant therapy and has been free of recurrence or metastasis up to now. We report herein a case of a malignant AME that was diagnosed in the largest breast mass reported to date. This mass grew slowly and without metastasis. Clinicians should consider this rare disease entity in the differential diagnosis of a breast mass and remember the importance of complete excision of this tumor.