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복강경 담낭절제술 후 헤모락 클립의 이동으로 발생한 복통 1예
류우선 ( Woo Sun Rou ),주종석 ( Jong Seok Joo ),강선형 ( Sun Hyung Kang ),문희석 ( Hee Seok Moon ),김석현 ( Seok Hyun Kim ),성재규 ( Jae Kyu Sung ),이병석 ( Byung Seok Lee ),이엄석 ( Eaum Seok Lee ) 대한소화기학회 2018 대한소화기학회지 Vol.72 No.6
During laparoscopic cholecystectomy, a surgical clip is used to control the cystic duct and cystic artery. In the past, metallic clips were usually used, but over recent years, interest in the use of Hem-o-lok clips has increased. Surgical clip migration into the common bile duct (CBD) after laparoscopic cholecystectomy has rarely been reported and the majority of reported cases involved metallic clips. In this report, we describe the case of a 53-year-old woman who presented with abdominal pain caused by migration of a Hem-o-lok clip into the CBD. The patient had undergone laparoscopic cholecystectomy 10 months previously. Abdominal CT revealed an indistinct, minute, radiation-impermeable object in the distal CBD. The object was successfully removed by sphincterotomy via ERCP using a stone basket and was identified as a Hem-o-lok clip. (Korean J Gastroenterol 2018;72:313-317)
지속성 외래 복막투석환자에서 Kocuria varians에 의해 발생한 재발성 복막염 1예
류우선 ( Woo Sun Rou ),이효근 ( Hyo Keun Lee ),곽이경 ( Yee Gyung Kwak ),한상엽 ( Sang Youb Han ),한금현 ( Kum Hyun Han ) 대한신장학회 2010 Kidney Research and Clinical Practice Vol.29 No.4
Kocuria species are the normal flora of skin, mucosa and oropharynx, and can be the causative organisms of complications associated with intravenous catheterization, ambulatory peritoneal dialysis, and ventricular shunt. We report a case of relapsing peritonitis by Kocuria varians in a patient undergoing continuous ambulatory peritoneal dialysis (CAPD). A 62 year old woman was admitted to the hospital with a complaint of abdominal pain and a turbid peritoneal dialysate. The patient was treated with a combination of intraperitoneal antibiotics. A culture of the peritoneal dialysate revealed K. varians, and the patient was discharged after she showed improvement with the treatment. Although the organism was sensitive to the administered antibiotics, the patient experienced 2 episodes of peritonitis. This continuing recurrence could be attributed to an insufficient treatment period or biofilm formation. Therefore, the patient underwent further treatment with intraperitoneal antibiotics and showed no recurrence for 1 year thereafter. This is the first report of relapsing peritonitis by K. varians. Although peritonitis caused by rare pathogens has been described recently, K. varians is known to have a low pathogenecity and occurs rarely. The findings in this case emphasize the importance of careful consideration on the rare pathogen and administration of the appropriate antibiotics for a sufficient duration.
류우선 ( Woo Sun Rou ),주종석 ( Jong Seok Ju ),강선형 ( Sun Hyung Kang ),문희석 ( Hee Seok Moon ),성재규 ( Jae Kyu Sung ),이병석 ( Byung Seok Lee ),정현용 ( Hyun Yong Jeong ),송규상 ( Kyu Sang Song ) 대한소화기학회 2015 대한소화기학회지 Vol.65 No.2
Leiomyosarcoma is an uncommon tumor that originates from various organs, including uterus, kidney, retroperitoneum, and soft tissues. In particular, leiomyosarcoma of the stomach is extremely rare. Only 9 cases have been reported worldwide since the discovery of KIT-activating mutation. A 48-year-old woman was admitted to our hospital with abdominal discomfort and generalized weakness. Upon detection of multiple nodules in both lung on chest posterior-anterior radiograph taken at the time of admission, chest CT was performed and it revealed multiple mass lesions in the lung, liver, and pancreas along with multiple lymph node metastases. On endoscopic examination, a 2.0 cm sized ulcerofungating mass lesion was found on the stomach body. Biopsy was performed and the mass lesion proved to be leiomyosarcoma confirmed by immunohistochemical staining. Chemotherapy was thus initiated, but the patient died after one year due to tumor progression. Our experience suggests that leiomyosarcoma can manifest aggressive behavior in its early stage. Herein, we report a case of gastric leiomyosarcoma with multiple metastases along with review of relevant literature.
이차 부갑상샘기능항진증이 있는 혈액투석 환자에게서 발생한 종양성 석회증
류우선 ( Woo Sun Rou ),이효근 ( Hyo Keun Lee ),한금현 ( Kum Hyun Han ),김덕원 ( Deok Weon Kim ),김용훈 ( Yong Hoon Kim ),주미 ( Mee Joo ),한상엽 ( Sang Youb Han ) 대한신장학회 2010 Kidney Research and Clinical Practice Vol.29 No.3
Tumoral calcinosis is a periarticular calcific lesion and rare complication in patients with maintenance hemodialysis. The pathogenesis of tumoral calcinosis is poorly understood but may be due to elevated serum phosphorus, a high calcium phosphorus (Ca×P) product or secondary hyperparathyroidism in hemodialysis patients. A 30-year-old man presented with pain and palpable mass of left shoulder. He had been on maintenance hemodialysis with high flux dialyzer for 10 years. Laboratory finding showed hyperphosphatemia and elevated intact PTH concentration. A shoulder X-ray and CT scan demonstrated a massive calcification. Following partial resection, pain was relieved. Here we report a case of tumoral calcinosis of shoulder in a hemodialysis patient with untreated hyperphosphatemia and secondary hyperparathyroidism.
류우선,김주석,강선형,문희석,성재규,정현용,Woo Sun Rou,Ju Seok Kim,Sun Hyung Kang,Hee Seok Moon,Jae Kyu Sung,Hyun Yong Jeong 대한소화기암연구학회 2018 Journal of digestive cancer reports Vol.6 No.2
Mucinous adenocarcinoma occurs in 1.6-25.4% of patients with colorectal cancer. We report a case of a 27-year-old man with negative findings on initial colonoscopic biopsy, but finally diagnosed with mucinous adenocarcinoma of the colon. After undergoing an abdominal CT due to persistent abdominal pain, he was transferred to our hospital. The abdominal CT showed a diffuse and irregular wall thickening in the distal transverse colon. Due to the edema and stenosis of colonic wall, it was difficult to insert the colonoscope into the proximal region; a biopsy revealed chronic colitis with lymphofollicular hyperplasia. Transverse colectomy and lymph node dissection were performed. The diagnosis was mucinous adenocarcinoma of approximately 20×4.5 cm. Compared to adenocarcinoma, mucinous adenocarcinoma is found in a younger population with an advanced stage and is less responsive to palliative chemotherapy. Therefore, recalcitrant abdominal pain even in young people warrants early detection through appropriate examinations such as abdominal CT and colonoscopy.
김주석 ( Ju Seok Kim ),류우선 ( Woo Sun Rou ),안병무 ( Byung Moo Ahn ),문희석 ( Hee Seok Moon ),강선형 ( Sun Hyung Kang ),성재규 ( Jae Kyu Sung ),정현용 ( Hyun Yong Jeong ),송규상 ( Kyu Sang Song ) 대한소화기학회 2015 대한소화기학회지 Vol.65 No.1
Spontaneous gastric perforation is a rare complication of gastric lymphoma that is potentially life threatening since it can progress to sepsis and multi-organ failure. Morbidity also increases due to prolonged hospitalization and delay in initiating chemotherapy. Therefore prompt diagnosis and appropriate treatment is critical to improve prognosis. A 64-year-old man presented to the emergency department with severe abdominal pain. Chest X-ray showed free air below the right diaphragm. Abdominal CT scan also demonstrated free air in the peritoneal cavity with large wall defect in the lesser curvature of gastric lower body. Therefore, the patient underwent emergency operation and primary closure was done. Pathologic specimen obtained during surgery was compatible to diffuse large B cell lymphoma. Fifteen days after primary closure, the patient received subtotal gastrectomy and chemotherapy was initiated after recovery. Patient is currently being followed-up at outpatient department without any particular complications. Herein, we report a rare case of gastric lymphoma that initially presented as peritonitis because of spontaneous gastric perforation.
김영두 ( Young Doo Kim ),김경아 ( Kyung Ah Kim ),류우선 ( Woo Sun Rou ),이준성 ( June Sung Lee ),송태준 ( Tae June Song ),배원기 ( Won Ki Bae ),김남훈 ( Nam Hoon Kim ) 대한소화기학회 2011 대한소화기학회지 Vol.57 No.5
The pathogenesis of autoimmune hepatitis (AIH) is unclear, but viral infections have been proposed as a potential trigger in patients with genetic predisposition. We report a case of AIH following acute hepatitis A (AHA). A 57-year-old woman presented with fatigue and pitting edema for last 3 months. She had been diagnosed as an AHA 15 months ago based on clinical features, biochemical tests and positive HAV IgM antibody at a local clinic. Her biochemical tests was normalized one month after AHA diagnosis, but the serum levels of aminotransferase started to rise four months after AHA diagnosis. Antinuclear antibody was positive at a titer of 1:40, and anti-smooth muscle antibody was also positive. Hypergammaglobulinemia and liver pathology were typical for AIH. The patients had a score of 17 according to the International Autoimmune Hepatitis Group`s system. She was given prednisolone and azathioprine and showed complete response to immunosuppressive therapy. The present case is the first report on AIH triggered by AHA in Korea. (Korean J Gastroenterol 2011;57:315-318)