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자연 용해된 급성 췌장염에 동반된 고립성 상장간막정맥 혈전증
나병수 ( Byung Soo Na ),전병민 ( Byung Min John ),김기범 ( Ki Bum Kim ),이제수 ( Je Soo Lee ),조현우 ( Hyun Woo Jo ),석창현 ( Chang Hyeon Seock ),김동휘 ( Dong Hui Kim ),이기성 ( Ki Sung Lee ) 대한소화기학회 2011 대한소화기학회지 Vol.57 No.1
Acute pancreatitis can result in many vascular complications in both artery and vein. Venous complication usually occurs as a form of splenic or portal vein thrombosis, and also can simultaneously occur in superior mesenteric vein as well. Rarely, isolated superior mesenteric vein thrombosis occurs as a venous complication. Although it is uncommon, mesenteric vein thrombosis is an important clinical entity because of the possibility of mesenteric ischemia and infarction of small bowel. The treatments of mesenteric venous thrombosis include anticoagulation therapy, transcatheter therapy and surgical intervention. We report a case of 45-yearold man who had acute pancreatitis with isolated superior mesenteric vein thrombosis, which was spontaneously dissolved with the resolution of underlying inflammation without anticoagulation or surgical intervention. (Korean J Gastroenterol 2011;57:38-41)
요로 결석에 대한 체외 충격파 쇄석술 이후 발생한 급성 췌장염 1예
홍정운 ( Jung Un Hong ),전병민 ( Byung Min John ),정태섭 ( Tae Seob Jung ),노인영 ( In Young Noh ),강남규 ( Nam Kyu Kang ),민인선 ( In Sun Min ),이주영 ( Ju Young Lee ),김해성 ( Hae Sung Kim ) 대한췌담도학회 2016 대한췌담도학회지 Vol.21 No.2
48세 여자가 좌측 옆구리 통증을 주소로 내원하여 좌측 요관 결석으로 진단되어 체외 충격파쇄석술을 시행받았으나, 12시간 후 갑작스런 복통을 호소하며 혈압저하, 폐부종을 보였다. 국소적인 합병증을 동반한 중등도의 급성 췌장염으로 진단하고 수액과 승압제, 항생제 등의 대증적 치료 시행 후 퇴원하였다. 체외 충격파쇄석술은 요로결석의 대표적인 치료법이다. 안전하고 효과적으로 알려져 있으나 시술받은 환자의 1%에서 급성 췌장염, 신장주위 혈종, 비뇨기계 패혈증, 정맥혈전, 담도 폐쇄, 장천공, 폐손상, 부정맥 등의 심각한 합병증이 보고되고 있다. 쇄석술 이후 발생한 급성 췌장염은 드물지만 임상의는 이러한 합병증에 대한 주의가 필요하다. 48-year-old woman was admitted to emergency room due to left flank pain. It was diagnosed with left ureteral stone and underwent extracorporeal shock wave lithotripsy (ESWL). However, 12 hours later, the patient complained acute upper abdominal pain with pulmonary edema and low blood pressure. A diagnosis of moderate acute pancreatitis with local complication was considered and we decided conservative therapy including fluid resuscitation, inotropics and antibiotics. It was suggested that ESWL was responsible for the acute pancreatitis. The patient gradually recovered and was discharged on 13th day of admission. ESWL is considered the standard treatment for urolithiasis. Although, it has proved to be safe and effective, serious complications have been reported in 1% of patients, including acute pancreatitis, perirenal hematoma, urosepsis, venous thrombosis, biliary obstruction, bowel perforation, lung injury, and cardiac arrhythmia. Although the possibility of post-ESWL acute pancreatitis is extremely low, physicians should take care of this complication.
증례 : 담관 낭종 환자에서 발생한 선종 기원의 조기 담관암 1예
이태승 ( Tae Seung Lee ),김해경 ( Hae Kyung Kim ),안홍민 ( Hong Min Ahn ),이우주 ( Uh Joo Lee ),최영철 ( Young Chul Choi ),전병민 ( Byung Min John ),박태일 ( Tae Il Park ),구진회 ( Jin Hoi Koo ) 대한소화기학회 2009 대한소화기학회지 Vol.54 No.1
Choledochal cyst is an uncommon premalignant anomaly. The morphology and pathogenesis of the premalignant lesion of cholangiocarcinoma arising from the choledochal cyst has not been well described. Herein, we report a rare case of bile duct adenoma arising from choledochal cyst with anomalous union of pancreaticobiliary duct (AUPBD). 50-year-old woman was admitted to our hospital with the complaint of epigastric pain. She had received common bile duct (CBD) exploration and choledocholithotomy and cholecystectomy 3 months earlier under the diagnosis of multiple CBD stones. Intraoperalive cholangiogram was not remarkable except CBD dilatation at that time. Endoscopic retrograde cholangiopancreatography revealed choledochal cyst with AUPBD and round filling defect which disappeared easily on the balloon cholaniogram. On magnetic resonance cholangiopancreatography, the filling defect was confirmed as 2 cm polypoid mass attached to the distal bile duct wall. At laparotomy, a soft whitish mass was palpable on the lower CBD. On histological examination, adenoma with focal carcinoma change arising from choledochal cyst was diagnosed. (Korean J Gastroenterol 2009;54:55-59)
Anti-LKM1 양성 자가면역 간염에서 병발한 전신홍반루프스 1예
최대한 ( Dae Han Choi ),김해경 ( Hae Kyung Kim ),박태일 ( Tae Il Park ),전병민 ( Byung Min John ),강성환 ( Sung Hwan Kang ),이윤석 ( Yoon Serk Lee ),김태현 ( Tae Hyun Kim ),이우주 ( Uh Joo Lee ),이태승 ( Tae Seung Lee ),윤귀옥 ( G 대한소화기학회 2008 대한소화기학회지 Vol.51 No.3
Overlap of autoimmune hepatitis and systemic lupus erythematosus (SLE) is a comparatively rare condition. Although both autoimmune hepatitis and SLE can share common autoimmune features such as polyarthralgia, hypergammaglobulinemia and positive ANA, it has been considered as two different entities. We report a case of anti- LKM1 positive autoimmune hepatitis who developed SLE two years later. The presence of interface hepatitis with lymphoplasma cell infiltrates and rosette formation points to the autoimmune hepatitis rather than SLE hepatitis. Autoimmune hepatitis is infrequently accompanied by SLE, therefore, it could be recommended to investigate for SLE in patients with autoimmune hepatitis. (Korean J Gastroenterol 2008;51:190-193)