• 제목/요약/키워드: 식도 정맥류

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Iatrogenic Large Esophageal Perforation Caused by Sengstaken-Blackmore Tube (식도 정맥류 출현 환자에서 Sengataken-Blackmore관에 의한 의인성 거대 흉부식도 파열)

  • 윤영철;조광현;권영민;전희재;최강주;이양행;황윤호
    • Journal of Chest Surgery
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    • v.36 no.1
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    • pp.51-54
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    • 2003
  • This patient was an 53-year-old man who had undergone Sengstaken-Blackmore tube insertion for esophageal varix bleeding. Two days after Sengstaken-Blackmore tube insertion, he developed severe left hemothorax and was transferred to our hospital. The esophagoscopic findings revealed a large perforation lengthening 8-cm in the intrathoracic esophagus. A left thoracotomy was performed 33 days after the injury due to repeated varix bleedings and poor conditions. An 8-cm longitudinal perforation of the intrathoracic esophagus with gross suppurative empyema was found. Primary repair and esophageal exclusion was performed 2cm proximal and distal to the perforation, using rows of nonabsorbable staplers(TA stapler 60 $\times$ 4.8) and large bore thoracostomy tubes were placed for local drainage. Six days after intrathoracic esophageal exclusion, an esophagogram revealed a leakage at just above the proximal stapling site. A cervical esophageal exclusion was performed using the same method. One hundred thirty seven days after exclusion operation for the intra-thoracic esophageal perforation, the patient was able to eat per orally without any secondary esophageal reconstructive surgery.

A Case of Superior Mesenteric Venous Thrombosis after Endoscopic Sclerotherapy (식도정맥류 출혈에 내시경적 경화요법 후 합병된 상 장간막 정맥 혈전증 1예)

  • Kim, Won-Duck;Choi, Kwang-Hae;Hah, Jeong-Ok
    • Journal of Yeungnam Medical Science
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    • v.18 no.2
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    • pp.297-301
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    • 2001
  • The efficacy of injection sclerotherapy for treatment of acute esophageal variceal bleeding is well established. But several complications of endoscopic sclerotherapy have been reported. One of the complications is mesenteric venous thrombosis which develops when vasopressin is used for the sclerotherapy. We report a case of superior mesenteric venous thrombosis which developed after endoscopic sclerotherapy for control of esophageal variceal bleeding.

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Inferior Vena Cava Stenosis Following Orthotopic Liver Transplantation: Differentiating Points from False Positives (뇌사자 간이식 후 발생한 하대정맥 협착: 위양성과의 감별점)

  • Yeonsoo Choi;Jin Hyeok Kim;Ung Bae Jeon;Joo Yeon Jang;Tae Un Kim;Hwaseong Ryu
    • Journal of the Korean Society of Radiology
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    • v.84 no.3
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    • pp.713-718
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    • 2023
  • Orthotopic liver transplantation has become the treatment of choice for patients with end-stage liver disease. Various early or delayed vascular complications, including arterial pseudoaneurysm, thrombosis, or stenosis, and venous stenosis or occlusion, may lead to graft failure. Early detection and prompt management of such complications are essential to achieve successful transplantation and prevent the need for retransplantation. This report presents differentiating points, using computed tomography and digital subtraction angiography findings and measurement of pressure gradient across the stenotic lesion, that require immediate intervention in patients with inferior vena cava stenosis after orthotopic liver transplantation.

The Effect of the Preoperative Semen Parameters for a Patient with Varicolcele on its Operative Results (정계정맥류 환자에서 수술 전 정액지표가 수술 결과에 미치는 영향)

  • Kim, Kyung-Tae;Kim, Tae-Hong;Joo, Young-Min;Choe, Jin-Ho;Lee, Joong-Shik;Seo, Ju-Tae
    • Clinical and Experimental Reproductive Medicine
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    • v.35 no.4
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    • pp.303-308
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    • 2008
  • Purpose: The purpose of this study is to determine the effect of preoperative semen parameters on both seminal improvement and pregnancy rates following varicocelectomy. Methods: This survey was done in 278 patients who underwent microsurgical inguinal varicocelectomy from January 2001 until October 2006. By the total motile sperm counts (TMSC) before operation, the patients were stratified into three groups. Group A (mild oligoasthenospermia) was defined as above 20 million, group B (moderate oligoasthenospermia) was defined as between 5 and 20 million, and group C (severe oligoasthenospermia) was defined as below 5 million. Improvement rates of TMSC and pregnancy rates following varicocelectomy of each groups were compared. Results: The average TMSC of all the patients was 25.75 million before operation and after operation, it was 80.24 million, showing an average increase of 54.49 million (211.6%). To take a look at mean absolute increase (mean relative increase proportion), group A showed 67.90 million (131.2%), group B 62.20 million (482.5%) and group C 26.33 million (1841.2%). The patients with varicocele whose semen parameter is in bad condition show relatively a low mean absolute increase but high mean relative increase proportion. There was no significant difference in natural pregnancy rate among each groups (p=0.119, p=0.059). Conclusions: Even in the varicocele patient whose semen parameter was in bad condition before surgical operation. varicocelectomy could be chosen as the first treatment to male infertility.

A Case of Congenital Hepatic Fibrosis with Variceal Bleeding (식도 정맥류 출혈을 동반한 간섬유증 1례)

  • Shin, Dong Soo;Lim, Si Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.1
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    • pp.98-101
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    • 2004
  • Congenital hepatic fibrosis is an inherited, congenital disorder of the liver characterized by portal hypertension and hepatic fibrosis. We experienced a case of congenital hepatic fibrosis with esophageal varix in a 9-year-old male. He complained hematemesis, hematochezia, dizziness. In laboratory examination, AST/ALT was slightly increased. Esophageal varix was noted by an endoscopic examination. Hepatosplenomegaly and hypoechoic lesion of periportal area were seen by abdominal CT scanning. Histologic finding of liver biopsy showed fibrous tracts containing dilated bile ductules connecting adjacent portal spaces that were widened by mature fibrosis. Endocopic sclerotherpy and ligation was done. We summarized a case with review of literatures

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A Case of Idiopathic Portal Hypertension in a 3-year-old Girl (3세 여아에서 진단된 특발성 문맥 고혈압 1예)

  • Son, Ki-Young;Baek, Seoung-Yon;Chung, Ki-Sup
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.10 no.2
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    • pp.221-225
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    • 2007
  • A previously healthy 3-year-old girl was admitted to the Department of Pediatrics in Severance Hospital with sudden symptoms of melena. The vital signs were stable, and splenomegaly was found in a physical examination. The patient had moderate thrombocytopenia. There was no evidence of autoimmune disease. A upper gastrointestinal endoscopy and esophagogram showed a varix on the lower esophagus. Coarse liver parenchymal echoes and increased periportal echogenicity were seen on a Doppler sonogram. The velocity of the portal vein mildly increased. Magnetic-resonance-cholangiopancreatogram (MRCP) demonstrated normal portal structures. A sono-guided liver biopsy was performed, but the pathological findings were unremarkable. Based on these findings, we diagnosed the patient with idiopathic portal hypertension. The patient was discharged and was treated with oral beta blocker. We report a case of idiopathic portal hypertension with a brief review of the literature.

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Bronchial Hyperresponsiveness in Liver Cirrhosis (간경변증 환자에서 기관지 반응성에 대한 연구)

  • Kim, Ki-Ryang;Kim, Min-Gu;Lee, Sang-Kab;Jang, Se-Ho;Park, Jong-Hwa;Lee, Jong-Deog;Hwang, Yung-Sil
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.3
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    • pp.639-648
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    • 1997
  • Background : Arterial hypoxemia has been noted in patients with liver cirrhosis because of bronchial vessel dilatation. Cabenes et al. reported that bronchial hyperresponsiveness to the metacholine inhalation was observed in patients of left side heart failure, he suggested that one of the mechanism was bronchial vessel dilatation. We hypothesized that patients of liver cirrhosis might have bronchial hyperresponsiveness to metacholine inhalation due to portal hypertension. We evaluate the relationship between bronchial responsiveness and severity of liver cirrhosis, severity of portal hypertension. Methods : In the 22 patients of the liver cirrhosis with clinical portal hypertension, metacholine provocation test was done and determined $PC_{20}FEV1$. We classified liver cirrhosis according to Pugh-Child classification. Esophagogastroscopies were performed for the evaluation of the relationship between bronchial hyperresponsiveness and severity of esophageal varix. Results : In the 22 cases of the liver cirrhosis with clinical portal hypertension. The causes of liver cirrhosis, alcoholic hepatitis was 9 cases, hepatitis B virus was 12 cases, hepatitis C virus was 1 case, and 151 cases (68.18%) of total 22 cases were positive in metacholine provocation test. In positive cases. There was no significant relationship between $PC_{20}FEV1$ and severity of liver cirrhosis which were classified by Pugh-Child classification or severity of esophageal varix(p<0.05). Conclusion : we observed that bronchial responsiveness to metacholine increased in the patients of liver cirrhosis and there was no significant relationship between the severity of liver cirrhosis and the severity of esophageal varix.

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