• Title/Summary/Keyword: Epigastric pain

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A clinical Evaluation of Esophageal Cancer (식도암의 임상적 고찰)

  • Lee, Seong-Yun;Ji, Haeng-Ok
    • Journal of Chest Surgery
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    • v.23 no.2
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    • pp.285-298
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    • 1990
  • The records of 67 patients who had been operated as an esophageal cancer during the period from 1973 to 1989 at the Department of Thoracic and Cardiovascular Surgery, Hanyang University Hospital were reviewed retrospectively. The results were summarized as follows ; The age ranged from 28 years old to 80 years old. The highest incidence was 5th decades, then 6th decades, and the incidence of male was 10 times as the incidence of female[M:F= 10.16: 1]. The locations were lower esophagus 44%, middle esophagus 38.8%, upper esophagus 11.9% and cervical esophagus 4.4% The frequent symptoms were dysphagia [88%], epigastric or substernal pain and discomfort [29.8%], weight loss [20.8%], and laryngeal dryness [1.4%]. The most common interval between the onset of dysphagia and admission was 2-3 months; 82% of patients was within 6 months, The cancer consisted of stage I [3%], stage II [11.9%], stage III[47.6%], and stage IV [33.7%] The resectability of cancer was 67%. The organs of substitute were stomach in 21 cases, right colon 6 cases, and jejunum in 8 CRSCS. The relation between invasion of tumor and lymph node metastasis was analyzed: mucosal involvement: 1 case/2case, muscle invasion; 0/2 full thickness; 4/6, adjacent structure 7/12. Postoperative complications were pneumonia, pleural effusion, hoarseness, mediastinitis, anastomosis site leakage, reoperation due to stenosis, chylothorax, empyema, mechanical ileus, wound infection, meat impaction at anastomosis site, and repair of gastrostomy site leakage. Adjuvant therapies were irradiation [15cases], chemotherapy [14cases], and Bougie dilatation [4 cases],

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A Case of Rhabdomyosarcoma in the Liver (간에서 발견된 횡문근육종 1례)

  • Lee, Dong-Jun;Yoon, Ji-Sung;Kim, Joon-Hwan;Park, Chan-Won;Suh, Jeong-Il;Lee, Heon-Ju;Kim, Ki-Kweon
    • Journal of Yeungnam Medical Science
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    • v.13 no.2
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    • pp.360-366
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    • 1996
  • Pure primary hepatic rhabdomyosarcoma in adult is very uncommon. There have been only five previous case of primary rhabdomyosarcoma of the adult liver. A case of hepatic rhabdomyosarcoma was diagnosed in a 52 year-old female. She was admitted to the hospital due to the epigastric pain and weight loss. A CT scan of the abdomen showed a large hypodense mass with focal calcification occupies most of the both lobes of the liver. The liver biopsy showed massive liver tumor composed entirely of oval shaped cells showing light microscopic and immunohistochemical evidence of rhabdomyoblastic differentiation. We report a case of hepatic rhabdomyosarcoma with review of literature.

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Fine Needle Aspiration Cytology of Osteoclast-like Giant Cell Tumor of the Liver (간의 파골세포모양 거대세포 종양의 세침흡인 세포학적 소견)

  • Park, Chan-Sik;Kim, Ji-Eun;Chang, Mee-Soo
    • The Korean Journal of Cytopathology
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    • v.10 no.1
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    • pp.79-84
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    • 1999
  • Osteoclast-like giant cell tumor of the liver is an extremely rare malignancy with poor prognosis. To our knowledge, 5 cases have been reported in English literatures, but there was no report about fine needle aspiration cytologic(FNAC) features. We experienced a case of osteoclast-like giant cell tumor of the liver obtained by computed tomography(CT)-guided FNAC and needle biopsy. The cytologic findings mimicked slant cell tumor of the bone. A large hepatic mass of the left lobe with abdominal wall invasion was found by CT in a 46- year-old female complaining of epigastric pain. The FNAC showed moderately cellular smears consisting of osteoclast-like giant cells and mononuclear cells, which were individually scattered or intermingled in clusters. The osteoclast-like giant cells had abundant cytoplasms and multiple small round nuclei with fine chromatin and distinct nucleoli. The mononuclear cells had moderate amount of cytoplasm and relatively bland-looking oval nuclei with single small nucleoli. All of the cytologic features recapitulated the histologic findings of bland-looking osteoclast-like multinucleated giant cells evenly dispersed throughout the background of mononuclear cell. The immunohistochemical study showed positive reaction for CD68 and vimentin, but negative for cytokeratin in both osteoclast-like slant cells and mononuclear cells.

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Prolapse Gastropathy Presenting with Hematemesis in a 3-year-old Child - A Case Report (3세 소아에서 토혈을 주소로 내원한 위식도 탈출증 1례)

  • Cho, Jin-Seong;Ryoo, Eell;Lee, Gun;Kim, Jae-Kwang
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.6 no.2
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    • pp.183-186
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    • 2003
  • Prolapse gastropathy is not uncommon in adult, but is not reported yet in previously healthy children. A 3-year-old child came to our emergency room after a 1-day history of emesis episodes with coffee-ground hematemesis. During the endoscopic procedure, and the process of retching and vomiting was observed and a tense knuckle of gastric mucosa was seen to be forcefully and repeated prolapsed into the distal esophageal mucosa, and mucosal hematoma was found in the gastric fundus. Upper gastrointestinal study revealed no abnormality and 24 hour pH monitoring revealed no pathologic gastroesophageal reflux. Retching is thought to cause the forceful prolapse and induce subsequent trauma of gastric mucosa. This case illustrates that the episodes of vigorous retching and resultant gastric mucosa are now considered to be the cause of the hematemesis and epigastric pain in children.

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The Effects of Maitland Orthopedic Manual Physical Therapy on the Digestive System

  • Koo, Ja Pung;Kim, Nyeon Jun
    • Journal of International Academy of Physical Therapy Research
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    • v.6 no.1
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    • pp.802-808
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    • 2015
  • The purpose of the present study is to apply Maitland orthopedic manual physical therapy to patients to examine the effects of the therapy on the digestive system through serum gastrin tests that can identify the motility of the digestive system and dyspepsia symptoms and can provide basic data for internal medicinal physical therapy. Maitland orthopedic manual physical therapy was implemented on 20 subjects in total, with 10 in a dyspepsia group and 10 in a control group, for 20 minutes per day, three days per week for three weeks, and the following results were obtained. In the control group, serum gastrin values significantly decreased between before and after treatment(p<.01), and among questionnaire items regarding dyspepsia, those regarding epigastric pain and belching showed significant decreases in these symptoms(p<.05). In the dyspepsia group, serum gastrin values significantly decreased between before and after treatment(p<.01) and all questions regarding dyspepsia showed significant decreases in all symptoms(p<.01). According to the analysis, the dyspepsia group decreased significantly more than the control group in serum gastrin values and all dyspepsia symptoms, except for belching(p<.001). Through the present study, it was identified that Maitland orthopedic manual physical therapy can improve dyspepsia symptoms and is an effective treatment method for internal diseases, such as dyspepsia, by improving gastric motility to become close to the normal state.

Helicobacter pylori Associated Lymphocytic Gastritis in a Child

  • Kim, Min Jeong;Eom, Dae Woon;Park, Kieyoung
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.17 no.3
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    • pp.186-190
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    • 2014
  • Lymphocytic gastritis (LG) is a rare subtype of chronic gastritis. It is defined as dense proliferation of intraepithelial lymphocytes (IELs) more than 25 lymphocytes per 100 epithelial cells. The known major causes of LG are celiac disease and Helicobacter pylori infection. H. pylori associated LG (HpLG) has more enhanced cytotoxic and apoptotic tendencies than chronic H. pylori gastritis. A 12-year-old girl with postprandial epigastric pain was diagnosed HpLG on endoscopic biopsy. After the 1st eradication therapy, H. pylori bacilli were still found, and urea breathing test was positive. Although the endoscopic finding was partially improved, clinical symptoms and histologic finding were persisted. We could achieve the improvement of clinical symptoms and disappearance of IELs after the 2nd eradication. The discordant of histopathologic and endoscopic improvement occurred after the 1st eradication therapy of HpLG. Therefore the clinical and histopathologic evaluation should be considered as well as endoscopic findings.

Chronic Gastric Volvulus with Laparoscopic Gastropexy after Endoscopic Reduction: A Case Report

  • Lee, Hye Yeon;Park, Jung Hyun;Kim, Sung Geun
    • Journal of Gastric Cancer
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    • v.15 no.2
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    • pp.147-150
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    • 2015
  • Gastric volvulus is an uncommon clinical entity. There are three types of gastric volvulus; organoaxial, mesenteroaxial and combined type. This condition can lead to a closed-loop obstruction or strangulation. Traditional surgical therapy for gastric volvulus is based on an open approach. Here we report a successful case of a patient with chronic gastric volvulus with a laparoscopic treatment. A 79-year-old woman came to the emergency department with epigastric pain accompanied by nausea for 2 weeks. Abdominal computed tomography revealed markedly distended stomach with transposition of gastroesophageal Junction and gastric antrum. Barium meal study revealed presence of the antrum was folded over 180 degrees that was located above gastroesophageal junction. We attempted an endoscopic reduction, but it was unsuccessful. The patient got laparoscopic anterior gastropexy. Based on our result, laparoscopic gastropexy can be considered as a good choice of the treatment for gastric volvulus.

A study on Intractable disease in the sight of Lee Je Ma (이제마(李濟馬)의 난치병(難治病)에 대(對)한 시각(視角)에 관(關)한 연구(硏究))

  • Jang, Hyun Jin
    • Journal of Sasang Constitutional Medicine
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    • v.7 no.2
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    • pp.129-134
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    • 1995
  • Lee Je Ma (1837~1900) wrote the DongEuSuSeBoWon in 1894. Constitutional Medicine what is called Sasang Medicine has originated from him. In this book he refers to mild, serious, intractable, incurable and fatal disease. In the sight of his Medical theory each state of disease deserves to be researched. 1. In the case of Soumin exhaustion of Yang, Taeyang-Kwolum, noxious Yin, Yang is kept in the exterior by excessive Yin in the interior, middle diabetes and swelling belong to intractable disease and solid mass in the right epigastric zone belongs to fatal disease. 2. In the case of Soyangin exhaustion of Yin, lower diabetes, afternoon fever due to deficiency of Yin, spitting blood and swelling belong to intractable disease and distention of abdomen with gas or fluid belongs to fatal disease. 3. In the case of Taeumin syncope due to chills, dryness-heat, diabetes, pain of chest and abdomen and swelling belong to intractable disease and apoplexy with dosed eyes belongs to fatal disease. 4. In the case of Taeyangin vertebral disease makes flaccidity of lower limbs and dysphagia with vomiting of frothy fluid belongs to fatal disease.

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Effectiveness of Abdominal Manipulation Therapy in Functional Dyspepsia Patients (기능성 소화불량증 환자에 대한 복부(腹部) 수기치료의 효과)

  • Maeng, Tae-Ho;Lee, Jong-Soo
    • Journal of Korean Medicine Rehabilitation
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    • v.25 no.4
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    • pp.113-121
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    • 2015
  • Objectives Functional dyspepsia is a type of disease characterized by bothersome postprandial fullness, early satiation, epigastric pain and burning without structural gastrointestinal disorders. The aim of this study was to evaluate changes in symptoms, quality of life, HRV (Heart Rate Variability) before and after abdominal manipulation therapy in functional dyspepsia patients. Methods We recruited twenty functional dyspepsia patients from the volunteers who applied for this clinical trial. State of Patients were assessed by NDI-K (Nepean Dyspepsia Index Korean Version), HRV (Heart Rate Variability) before treatment. After 4 times of abdominal manipulation therapy for 2 weeks, state of patients were assessed by the same methods. Results Total symptom score and total quality of life score of NDI-K were significantly improved by the abdominal manipulation therapy. After the treatment, the number of subjects within normal range of LF/HF ratio was significantly increased. Although the median of LF/HF ratio did not significantly changed, interquartile range was reduced. Conclusions Abdominal manipulation therapy possibly can be an effective treatment for functional dyspepsia patients, but further studies are needed to demonstrate the effectiveness of abdominal manipulation therapy for functional dyspepsia patients.

A Case of Multi-Organ Macronodular Tuberculosis (다기관성 대결절성 결핵 1예)

  • Lim, Kyoung-Ree;Kang, Myung-Ho;Kim, Tae-Suk;Moon, Ki-Won;Ryu, Dong-Ryeol;Lee, Hui-Young;Han, Seon-Sook
    • Tuberculosis and Respiratory Diseases
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    • v.72 no.1
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    • pp.88-92
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    • 2012
  • A 37 year old female presented with epigastric pain and weight loss over a period of 3 months. Her abdominal CT finding showed a 4.5 cm size hepatic mass and 4.3 cm size pancreatic head mass with multiple macronodules in the liver. At the same time, her chest CT revealed a 5 cm size necrotic mass in the left lower lobe of the lung with multiple bilateral pulmonary nodules. We diagnosed these lesions as tuberculosis through multiple biopsies. She was treated with anti-tuberculous medication. After taking the medications, her symptoms were improved. Twelve months later, imaging studies indicated an improvement in the patient's health. Here we report a case report of multi-organ macronodular tuberculosis in lung, liver and pancreas.