• Title/Summary/Keyword: 위장관 출혈

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Indication and Post-Procedural Management of Upper GI Stent Implantation (상부 위장관 스텐트 삽입술의 이해 -적응증 및 추적 관리-)

  • Joo, Moon-Kyung;Park, Jong-Jae
    • Journal of Hospice and Palliative Care
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    • v.12 no.2
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    • pp.49-55
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    • 2009
  • Self expandable metal stent (stent) implantation of upper gastrointestinal (UGI) tract is now widely accepted for the palliation of obstructive symptoms caused by inoperable malignant UGI obstruction. With the technical progress and accumulation of clinical experiences, it became possible to perform the procedure easily, safely and effectively. However, clinicians should pay attention to the post-procedural care, because early or late complications such as ulceration, pain, bleeding, food impaction, perforation, migration or in-stent tumor growth could occur. In this review, several topics about stent placement in the UGI tract are discussed, such as major indications for stenting, kinds of stents, and post-procedural management.

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Upper Gastrointestinal Bleeding in Full-Term Infants (만삭아에서 발생한 상부위장관 출혈에 대한 임상적 고찰)

  • Choi, Hyon Ju;Kim, Jae Seon;Yoon, Hye Sun;Bae, Sun Hwan
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.8 no.2
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    • pp.164-171
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    • 2005
  • Purpose: The aim of this study was to evaluate the clinical characteristics, endoscopic findings and risk factors related to the upper gastrointestinal bleeding (UGIB) seen in full-term infants. Methods: A clinical analysis for 9 cases with UGIB confirmed by endoscopy was carried out retrospectively. Patients were admitted to the Department of Pediatrics, Eulji Hospital, from January to December 2003. Results: UGIB from gastric or duodenal mucosal lesions has been seen in 0.13% in newborns infants. All patients were full-term AGA neonates without asphyxic findings at birth. Hematemesis, melena or recurrent vomiting developed within $4.4{\pm}3.8days$ after birth. Vital sign and laboratory test was normal on admission. Endoscopic findings showed hemorrhagic gastritis in 6 cases and peptic ulcers in 3 cases. All patients were successfully managed by medical treatment for $18.6{\pm}5.0days$. On treatment, clinical symptoms improved within $0.9{\pm}0.3days$. Follow-up endoscopy was not performed because there was no recurrence of symptoms in all patients. Case mothers had no history of gastritis, ulcer or anti-ulcer medications before and during pregnancy. Conclusion: If the healthy full-term infants express UGIB within a few days after birth, it is necessary to take careful history of family, mother and delivery process and to practice endoscopy for mucosal lesions of the patients. A follow-up endoscopy dose not seem to be necessary if the infant is clinically well.

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Case Reports of Intravascular Treatment for Gastrointestinal Bleeding Associated with Pancreatitis: Hemosuccus Pancreaticus and Pancreaticocolic Fistula (췌장염에 합병된 위장관 출혈의 혈관내 치료에 대한 증례 보고: Hemosuccus Pancreaticus와 췌장대장루)

  • Seong Jae Bae;Sangjoon Lee;Yong Hwan Jeon;Go Eun Yang;Sung-Joon Park;Hyoung Nam Lee;Youngjong Cho
    • Journal of the Korean Society of Radiology
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    • v.83 no.6
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    • pp.1418-1425
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    • 2022
  • Elderly patients with a history of chronic alcoholism presented to our hospital with episodes of melena, abdominal pain, and anemia. During admission, hemorrhagic cystic lesion at the pancreas was observed on abdominal CT. Transcatheter angiography confirmed active bleeding foci and arterial embolization was performed. After the procedure, the bleeding was resolved. The authors report two cases of hemosuccus pancreaticus and pancreaticocolic fistula associated with pancreatitis, a rare cause of gastrointestinal bleeding, treated with vascular intervention.

Gastric neurofibroma in von Recklinghausen disease : a cause of upper gastrointestinal bleeding (Von Recklinghausen disease병 환아에서 상부위장관 출혈로 발현한 위의 신경섬유종 1례)

  • Kwon, Bo Sang;Shim, Jeong Ok;Seo, Jeong Kee;Yang, Hye Ran;Ko, Jae Sung;Jung, Seong Eun;Kim, Woo Sun;Kang, Gyeong Hoon
    • Clinical and Experimental Pediatrics
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    • v.49 no.2
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    • pp.203-207
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    • 2006
  • Neurofibromatosis type 1 (von Recklinghausen disease, NF1) involves the central and peripheral nervous systems as well as the skin, bone, endocrine, gastrointestinal and vascular systems. The gastrointestinal neurofibroma associated with NF1 has been infrequently reported. We report our experience with a 15-year-old boy who had a gastric plexiform neurofibroma with upper gastrointestinal bleeding and underwent a tumorectomy because of massive upper gastrointestinal bleeding. We conclude that gastrointestinal bleeding and anemia in the setting of NF1 mandates complete endoscopic examination of the digestive tract to rule out neurofibromas. Surgical resection is the standard treatment.

Endoscopic Findings of Upper GI Bleedings in Full Term Newborn Infants (만삭아에서 발생한 상부 위장관 출혈의 내시경적 진단과 치료)

  • Rhim, Suk-Ho;Lee, Hye-Kyung;Min, Yong-Sik;Kim, Han-Jin;Kim, Young-Chang
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.4 no.2
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    • pp.142-147
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    • 2001
  • Purpose: We are going to establish the efficacy of endoscopic examinations in diagnosing and treating upper GI bleeding in full term neonates. Methods: We retrospectively reviewed newborns who underwent endoscopic examination because of hematemesis from July 1998 to April 2001. Results: Gestational ages were between 38 and 41weeks, and birth weights were between 2,730 and 3,400 gm. Total of 9 patients were reviewed. Endoscopic examination revealed gastric ulcer in 6 cases, multiple erosions in 2 cases and negative finding in 1 case. All 6 gastric ulcers were multiple and among them 2 patients endoscopic hemostatic therapy. No complication due to the procedure was noticed. Five patients recieved transfusions. All 9 cases were cured through conservative and endoscopic therapy without recurrence. Conclusion: The common cause of upper GI hemorrhage in newborns with no preceding disease turns out to be multiple gastric ulcers and the prognosis is good. The endoscopic approach is useful in diagnosing and treating upper GI bleeding in newborns.

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Endoscopic Findings of Children with Henoch-Schonlein Purpura (소아 알레르기성 자반증의 위장관 내시경 소견)

  • Lee, Dong Hoon;Park, Chul Han;Park, Ji Min;Park, Geun Soo;Kim, Heung Sik;Kang, Chin Moo
    • Clinical and Experimental Pediatrics
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    • v.46 no.6
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    • pp.572-575
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    • 2003
  • Purpose : This study was performed to analyze the endoscopic findings in Henoch-Schonlein purpura patients, and to compare the differences in endoscopic findings according to age and gastrointestinal symptoms. Methods : We examined children with Henoch-Schonlein purpura aged 3 to 15 years between September 1996 and October 2002. The total number studied was 65, consisting of 41 boys and 24 girls. Endoscopy was performed and the results were analysed. Results : Among 65 cases, 12 cases of duodenitis, nine cases of gastritis and duodenitis, six cases of duodenal erosion, five cases of gastritis, five cases of duodenal ulcer, two cases of gastric ulcer and one case of colonic erosion were noted. Endoscopic abnormality was found in 38 of 53 who had gastrointestinal symptoms, and in two of 12 who didn't have gastrointestinal symptoms. Conclusion : Most of the gastrointestinal symptoms in Henoch-Schonlein purpura patients were relieved without complication. But in some cases severe symptoms such as hematemesis, melena, and abdominal pain localized to epigastric area were developed when diagnosis was delayed. Prompt endoscopy will be helpful for diagnosis and therapy of Henoch-Schonlein purpura with gastrointestinal involvement.

화학물질의 독성 - 금속과 금속관련 화합물

  • No, Jae-Hun
    • 월간산업보건
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    • s.84
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    • pp.31-33
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    • 1995
  • 입에서 금속성 입맛을 동반하여 심한 위장관계 증상(예, 혈변, 복통, 오심, 구토)과 상부위장관출혈이 있으면 중금속 중독이 있음을 시사한다. 중금속은 유기형태와 무기형태 모두 유독함을 기역해야 한다. 혈액, 소변, 그리고 특히 모발내의 레벨이 급인성 중독을 정확하게 반영하지 않은 경우가 종종 있다. 중금속 중독이 된 많은 환자들이 킬레이션 치료(chelation therapy)에 효과가 있다.

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Intravenous immunoglobulin for severe gastrointestinal manifestation of Henoch-Schönlein purpura refractory to corticosteroid therapy (스테로이드 치료에 반응하지 않는 심한 위장관 증세의 Henoch-Schönlein 자반증 환아에서 정맥 면역글로불린 치료)

  • Yang, Hye Ran;Choi, Won Jung;Ko, Jae Sung;Seo, Jeong Kee
    • Clinical and Experimental Pediatrics
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    • v.49 no.7
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    • pp.784-789
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    • 2006
  • Purpose : $Henoch-Sch{\ddot{o}}nlein$ purpura(HSP) is a systemic vasculitis involving small vessels of skin, gastrointestinal(GI) tract and kidney. Digestive involvement of HSP can be serious with massive GI bleeding, perforation, and intussusception. However, some patients do not respond to conventional corticosteroid therapy. In this study, we investigated the efficacy of intravenous immunoglobulin (IVIG) for serious digestive manifestations not responding to steroid. Methods : From April 1999 to January 2005, 22 children diagnosed as HSP with severe GI symptoms were included. Initially, all patients were treated with intravenous methylprednisolone. IVIG 2 g/kg of body weight was infused in children refractory to steroid therapy. Clinical data were reviewed retrospectively. Results : Among 22 children, 12 children underwent IVIG therapy. The mean duration of corticosteroid therapy was $5.61{\pm}4.9$ days before IVIG therapy, and 11 of 12 patients experienced disappearance of GI manifestations after the initiation of IVIG infusion. In one patient, IVIG was ineffective in relieving abdominal pain, but melena subsided. Comparison of the duration of hospitalization between IVIG group and corticosteroid group revealed no significant difference($12.8{\pm}7.6$ days vs. $13.2{\pm}7.8$ days, P=0.777). But, the total duration of abdominal pain decreased in IVIG group although the difference between two groups was not significant($8.8{\pm}8.1$ days vs. $14.8{\pm}16.9$ days, P=0.306). Among 10 children treated with steroid only, 2 children were operated for bowel perforation and intussusception. In contrast, there was no perforation in 12 children who underwent IVIG therapy. Conclusion : IVIG could be the alternative therapy to corticosteroids in children with severe digestive manifestations of HSP.

Surgical Treatment for a Primary Arterioenteric Fistula between a Common Iliac Artery Aneurysm and the Terminal Ileum with Massive Bleeding (대량출혈을 동반한 총장골동맥류와 회장 사이에 생긴 일차성 동맥-장관루의 치험)

  • Lee, Hyung-Chae;Jun, Hee-Jae;Choi, Kwang-Ho;Lee, Yang-Haeng;Hwang, Youn-Ho;Lee, Seong-Kwang
    • Journal of Chest Surgery
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    • v.42 no.5
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    • pp.635-638
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    • 2009
  • A 72-year-old man with progressive, unexplained lower gastrointestinal bleeding presented to the emergency department with abdominal pain and shock. Computed tomography of the abdomen showed a fistula between a right common iliac artery aneurysm and the small intestine. Laparotomy demonstrated a saccular aneurysm of the common iliac artery with a fistulous communication to the terminal ileum. Aneurysmectomy, aortoiliac graft replacement and segmental ileocecal resection with end-to-side anastomosis were all successfully performed. For a patient having an arterioenteric fistula along with lower gastrointestinal bleeding, making an early diagnosis using computed tomography and then performing immediate surgery can be expected to save the patient's life.