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제왕절개 출산 후 발생한 특발성 중증 급성 췌장염 1예
김정 ( Jung Kim ),최진호 ( Jin Ho Choi ),신방섭 ( Bang Sup Shin ),남준열 ( Joon Yeul Nam ),강은애 ( Eun Ae Kang ),김주성 ( Joo Seong Kim ),황진혁 ( Jin Hyeok Hwang ),김재환 ( Jaihwan Kim ) 대한소화기학회 2016 대한소화기학회지 Vol.68 No.3
Acute pancreatitis rarely occurs in the postpartum period. Furthermore, there are very few reports of it after cesarean section delivery. A 35-year-old woman presented with dyspnea and abdominal distension on the third day after cesarean section delivery. Under a suspicion of acute pancreatitis, she was initially managed with conservative treatment. However, she developed intra-abdominal fluid collections and gastric bleeding, which were managed with percutaneous drainage, endoscopic hemostasis, and angiographic embolization. She was discharged with good clinical recovery. Postpartum pancreatitis, especially after cesarean section, is rare; however, its management is not different from that for usual pancreatitis. (Korean J Gastroenterol 2016;68:161-165)
최진호 ( Jin Ho Choi ),이상협 ( Sang Hyub Lee ),김주성 ( Joo Seong Kim ),김정 ( Jung Kim ),신방섭 ( Bang Sup Shin ),장동기 ( Dong Kee Jang ),류지곤 ( Ji Kon Ryu ),김용태 ( Yong Tae Kim ) 대한소화기학회 2016 대한소화기학회지 Vol.67 No.6
Adenomyomatous hyperplasia is a reactive malformation or non-neoplastic tumor-like lesion frequently observed in the gallbladder, stomach, duodenum and jejunum, but rare in the extrahepatic bile duct. A 42-year-old man with epigastric discomfort had a stricture in the common bile duct on initial CT scans. Initially, it was regarded as a malignant lesion with some evidence, but histopathologic examinations of multiple biopsies obtained by multiple sessions of endoscopic retrograde cholangiopancreatography showed no evidence of malignancy. The patient had undergone the pylorus preserving pancreaticoduodenectomy because of the possibility of malignancy; however, the final diagnosis was adenomyomatous hyperplasia. It is important to distinguish a malignancy from benign biliary stricture with endoscopic biopsies. Surgery for suspected biliary malignancy often reveals benign lesions. Therefore, a correct diagnosis is important before deciding upon treatment of bile duct stricture. In conclusion, in younger patients with bile duct stricture where there is no evidence of histologic malignancy despite multiple biopsies, the possibility of benign disease such as adenomyomatous hyperplasia should be considered, to avoid unnecessary radical surgery. (Korean J Gastroenterol 2016;67:332-336)