• Title/Summary/Keyword: 만성췌장염

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Hereditary Pancreatitis - Report of a Kindred - (유전성 췌장염 - 1가계보고 -)

  • Kim, Hyoung-Ran;Chung, Jae-Hee;Song, Young-Tack;Yoon, Won-Jae;Ryu, Ji-Kon;Kim, Yong-Tae
    • Advances in pediatric surgery
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    • v.12 no.1
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    • pp.24-31
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    • 2006
  • Hereditary pancreatitis (HP) appears as an autosomal dominant trait. If the patient has (1) more than 2 affected relatives in different generations and (2) no known etiological factors such as alcohol or gallstones, or has R122H or N29I mutation in the cationic trypsinogen (CT) gene, the diagnosis of HP can be applied. Risk of pancreatic cancer is estimated to be 53-fold higher than in a general population after the age of 50 years. We report a kindredof HP, involving three of its family together; two siblings (14 years old, 13 years old) and cousin (26 years old). The patient had complicating chronic pancreatitis and pancreatic stone, and was treated with amodified Puestow-Gillesby procedure. Her sisters showed chronic pancreatitis. Her cousin underwent a drainage procedure of the pancreatic duct for chronic pancreatitis during the high school period. All the three members showed the R122H mutation of the CT gene.

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췌장염

  • 최흥재
    • The Korean Chronic Disease News
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    • no.8
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    • pp.7-7
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    • 1980
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Image Findings of Primary Squamous Cell Carcinoma of the Pancreas in Patient with Chronic Pancreatitis: A Case Report (만성췌장염 환자에서 생긴 편평세포암종의 영상의학적 소견: 증례 보고)

  • Kim, Jong-Bum;Kim, Mi-Young;Suh, Chang-Hae;Lee, Kun-Young;Joo, Young-Chae;Cho, Jae-Young
    • Investigative Magnetic Resonance Imaging
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    • v.15 no.2
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    • pp.160-164
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    • 2011
  • Squamous cell carcinoma of the pancreas is a rare, uncommon tumor that is characterized by squamous metaplasia of the ductal columnar cells. We report the image findings of a rare case of the pancreatic squamous cell carcinoma associated with chronic pancreatitis.

A case of hereditary pancreatitis with a N29I mutation in the cationic trypsinogen gene (Cationic Trypsinogen N29I 유전자 변이에 의한 유전 췌장염 1례)

  • Shin, Jee Youn;Oh, Dae Sung;Rheu, Jeong Min;Shim, Jeong Ok;Park, Ji Sook;Ko, Jae Sung;Seo, Jeong Kee
    • Clinical and Experimental Pediatrics
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    • v.49 no.10
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    • pp.1111-1115
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    • 2006
  • Hereditary pancreatitis is an autosomal dominant disease characterized by recurrent episodes of pancreatitis, often beginning in childhood, with a positive family history involving at least two other affected family members with no known other precipitating factors. Most forms of hereditary pancreatitis are caused by one of two common mutations, i.e., R122H in exon 3 and N29I in exon 2 of the cationic trypsinogen (CT) (PRSS1) gene, located on chromosome 7. The authors describe the case of a 15-year-old boy who had suffered from recurrent attacks of pancreatitis since age three. His mother and grandmother had chronic pancreatitis and diabetes mellitus. Mutation analysis was performed on the family due to the suspicion of hereditary pancreatitis. The CT gene was analyzed in DNA samples extracted from the peripheral blood of three family members, the mother, the proband, and the proband's sister. Two members of the family, the mother and the proband, were found to have a N29I mutation in the CT gene. The authors document the first family with hereditary pancreatitis associated with the N29I mutation in Korea.

A Case of Chronic Relapsing Pancreatitis with Multiple Pancreatic Stones in Childhood (다발성 췌관석에 의한 만성 재발성 췌장염 1례)

  • Lee, Seung -Yeon;Um, Ji-Hyun;Chung, Ki-Sup;Kim, Myung-Joon
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.4 no.2
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    • pp.256-260
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    • 2001
  • Chronic pancreatitis is a rare problem in childhood and sometimes shows pancreatic calcification. The most common symptom is recurrent upper abdominal pain with or without associated nausea or vomiting. Pancreatic calcifications are virtually pathognomonic of chronic pancreatitis. In our case, however, chronic pancreatitis caused by multiple pancreatic stones in dilated pancreatic duct, which was very rare in childhood. Endoscopic retrograde cholangiopancreaticography (ERCP) is valuable in confirming the diagnosis and decision making process for further medical or surgical management of pancreatic disease. We experienced a case of chronic relapsing pancreatitis with pancreatic stones in 13-year-old girl who presented with recurrent upper abdominal pain. She was investigated with ERCP and treated by endoscopic sphincterotomy of sphincter of Oddi and by some stone removal with endoscopic basket. We report this case and review related literatures briefly.

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A Case of Autoimmune Chronic Pancreatitis in a Child (자가면역성 만성 췌장염으로 진단된 소아 1예)

  • Choi, In-Young;Jin, So-Hee;Choi, Kyung-Dan;Kim, Kyung-Mo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.10 no.2
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    • pp.215-220
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    • 2007
  • We present a case of autoimmune chronic pancreatitis in a previously healthy child without any history of autoimmune disease. A 12-year-old boy was admitted to the hospital with abdominal pain. The serum amylase, lipase, and IgG levels were elevated and autoantibodies (antinuclear antibody, antineutrophil antibody) were detected. An abdominal CT (computed tomographic) scan revealed diffuse enlargement of the pancreas. ERCP (endoscopic retrograde cholangiopancreaticography) demonstrated an irregular stricture of the main pancreatic duct in the pancreas tail. After two years of oral steroid and immunosuppressive drug therapy, the clinical, laboratory and radiological findings were improved. The patient has been symptom-free for 18 months after the discontinuation of medication.

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Etiology and Analysis of Severity in Childhood Pancreatitis (소아 췌장염의 원인과 중증도 분석)

  • Park, Jun-Eun;Kim, Kyong-Mo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.2 no.2
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    • pp.194-203
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    • 1999
  • Purpose: Childhood pancreatitis has more various and somewhat different etiology than adult. Until now the analysis of severity in childhood pancreatitis were not well-known, although several studies have been made. Therefore, we studied the etiology and complications in childhood pancreatitis and analyzed whether Ranson and CT criteria could be applicated to evaluate the severity of childhood pancreatitis patients. Methods: The records of 30 patients with pancreatitis under 15 years of ages who were diagnosed in Asan medical center were reviewed. Age, sex, history, etiology, clinical features and treatment was reviewed in all patients but complications, Ranson and CT criteria were available in only 12 patients. Correlation between the number of complications and both Ranson and CT criteria were calculated with Spearman correlation coefficient. Results: 1. Median age at diagnosis was 7.3 years of age. 28 cases were acute pancreatitis and 2 cases were chronic pancreatitis. 2. Etiology: choledochal cyst(8 cases), drug (7 cases), trauma (4 cases), infection (3 cases), biliary stone or bile sludge (3 cases), idiopathic (2 cases) Hemolytic uremic syndrome, pancreatic duct obstruction, iatrogenic (1 case). 3. Local complications were ascites (5 cases), pseudocyts (4 cases) and systemic complications were hyperglycemia (4 cases), hypocalcemia (3 cases), pleural effusion (3 cases), etc. 4. Positive correlation was found between the number of complication and Ranson creteria (r=0.78, P=0.0016) and between the number of complication and CT criteria (r=0.65, P=0.015) in 13 cases. Conclusion: A trial to search the biliary duct anomaly may help to find the causes of childhood idiopathic pancreatitis, and both Ranson and CT criteria can be applicated to pediatric patients to evaluate the severity of childhood pancreatitis.

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Pleural Effusion and Pancreatico-Pleural Fistula Associated with Asymptomatic Pancreatic Disease (췌장염 증상없이 췌장-흉막루를 통해 발생한 흉막저류)

  • Park, Sang-Myun;Lee, Sang-Hwa;Lee, Jin-Goo;Cho, Jae-Youn;Shim, Jae-Jeong;In, Kwang-Ho;Kang, Kyung-Ho;Yoo, Se-Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.2
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    • pp.226-230
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    • 1995
  • Effusions arising from acute pancreatitis are usually small, left sided and self limiting. The incidence of pleural effusions in acute pancreatitis is reported between 3% and 17%. In chronic pancreatitis, as a consequence of fistula and pancreatitic pseudocyst formation or by spontaneous rupture of a pancreatic psudocyst directly into thoracic cavity, extremely large effusions may be seen. When the underlying pacreatic disease is asymptomatic, the diagnosis is made by measuring the amylase content of the pleural fluid. We experience a case of left sided pleural effusions caused by pancreatico-pleural fistula associated with pancreatic pseudocyst. The diagnosis was made by measuring of pleural fluid amylase level(80000U/L). Abdominal CT scan revealed pancreatic pseudocyct and pancreatitis with extension to left pleural space through esophageal hiatus and extension to left subdiaphragmatic space. Left pleural effusions were decreased after fasting, total parenteral nutrition and percutaneous pleural fluid catheter drainage. We reported a case of pleural effusions and pacreatico-pleural fistula asssociated with asymptomatic pancreatic disease with review of literatures.

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Alcohol Neurolysis of the Celiac Plexus of Upper Abdominal Pain Relief (상복부(上腹部) 통증완화(痛症緩和)를 위한 복강신경총차단(腹腔神經叢遮斷))

  • Kim, Inn-Se
    • The Korean Journal of Pain
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    • v.1 no.2
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    • pp.164-170
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    • 1988
  • Neurolysis of the celiac plexus is performed to relieve intractable pain caused by carcinoma of the stomach, liver and pancreas, and upper abdominal metastasis of tumors having more distant origins. It is also occasionally effective in controlling the pain of chronic pancreatitis. Alcohol celiac plexus blocks were done in 22 patients of whom 18 had intractable upper abdominal pain from cancer and 4 had pain from chronic pancreatitis. In most cases, an initial diagnostic block with 0.2 percent bupivacaine was followed by the therapeuntic block performed by injecting 50ml of 60 percent ethyl alcohol. Good to excellent pain relief occurred in 86 percent of patients. Duration of pain relief was from 4 months to 7 months in 55 percent of patients. Complications and side effects were infrequently seen but did include a 16 percent decrease of mean systolic arterial pressure and 16 cases of facial flushing. This block is remarkably safe as well as effective for the relief of upper abdominal pain from cancer origin.

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