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혈청 음성 Celiac 병을 의심하는 소장 융모 위축과 연관된 단백상실장병증 1예
한성희 ( Sung Hee Han ),이오영 ( Oh Young Lee ),은창수 ( Chang Su Eun ),노병주 ( Byoung Joo Roh ),손원 ( Won Sohn ),백승삼 ( Seung Sam Baeg ),윤병철 ( Byung Chul Yoon ),최호순 ( Ho Soon Choi ) 대한소화기학회 2007 대한소화기학회지 Vol.49 No.1
Protein losing enteropathy is described as a diverse group of disorders associated with excessive loss of serum proteins into the gastrointestinal (GI) tract. The etiology of protein losing enteropathy is various. Increased mucosal permeability to protein as a result of cell damage, mucosal erosion, or lymphatic obstruction may develop protein losing enteropathy. Celiac disease is a common cause of protein losing enteropathy associated with small bowel villous atrophy in Europe. We experienced a case of protein losing enteropathy associated with small bowel villous atrophy of unknown origin. A 36-year-old woman was admitted due to chronic watery diarrhea and weight loss. Laboratory findings showed total protein 4.7 g/dL, albumin 2.7 g/dL, cholesterol 100 mg/dL, WBC 6,000/mm3 (lymphocyte 13.6%) with the absence of proteinuria. On esophagogastroduodenoscopic examination, duodenal ulcer scar was noted on the bulb and colonoscopic finding was nonspecific. On small bowel enteroscopy, jejunal and ileal villi was scantly noticed. Small bowel biopsy showed marked villous atrophy. Her symptoms did not improve after supportive care. Gluten free diet was tried because celiac disease could not be ruled out completely. Diarrhea ceased and body weight regained after gluten free diet. (Korean J Gastroenterol 2007;49:31-36)
하부식도 근육층 비후를 동반한 호두까기 식도 환자에서 발생한 Steakhouse 증후군
양선영 ( Sun Young Yang ),이오영 ( Oh Young Lee ),한성희 ( Sung Hee Han ),전대원 ( Dae Won Jun ),노병주 ( Byoung Joo Roh ),윤창옥 ( Chang Ok Yoon ),이항락 ( Hang Lak Lee ),윤병철 ( Byung Chul Yoon ),최호순 ( Ho Soon Choi ),함준수 대한소화기기능성질환·운동학회 2005 Journal of Neurogastroenterology and Motility (JNM Vol.11 No.2
Acute esophageal obstruction caused by the impaction of a large bolus of food has been called the `steakhouse syndrome`. Esophageal stenosis is usually found in adults suffering with steakhouse syndrome, but occasionally the syndrome occurs in the absence of any underlying organic abnormality. A 71-year-old male patient had complained of swallowing difficulty after ingesting meat two days previously. We performed endoscopy and found a meat bolus at 30 cm from the incisors, and we so removed the meat with a basket. No pathologic findings were observed endoscopically after the removal of the esophageal meat bolus. The esophageal manometry showed segmental, high amplitude esophageal pressure at the lower esophagus with normal peristalsis. We performed endoscopic ultrasonography with a high frequency catheter and we found thickening of the lower esophageal muscle layer. This case shows that nutcracker esophagus may be the cause of esophageal foreign body impaction and thickening of muscle layer may be associated with the symptom. (Kor J Neurogastroenterol Motil 2005;11:166-169)