• 제목/요약/키워드: Melena

검색결과 57건 처리시간 0.03초

캡슐내시경으로 발견된 공장의 위장관 간질성 종양 2 예 (Two Cases of Jejunal Gastrointestinal Stromal Tumor Diagnosed by Capsule Endoscope)

  • 최재원;문희정;장병익;김태년;송선교;배영경
    • Journal of Yeungnam Medical Science
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    • 제23권1호
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    • pp.131-137
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    • 2006
  • Small bowel tumors have been difficult to diagnose because of low incidence and absence of specific symptoms. There are no efficient and accurate tests available for diagnosis. Capsule endoscopy is an efficient diagnostic tool for small bowel disease and obscure gastrointestinal bleeding. We diagnosed two cases of small bowel gastrointestinal stromal tumor (GIST) diagnosed by capsule endoscopy that were treated by surgery. A 68 year old male presented with abdominal pain. The capsule endoscopy showed fungating ulcer mass at the jejunum. A 55 year female presented with melena. The capsule endoscopy showed an intraluminal protruding mass with a superficial ulcer at the jejunum. Two cases were diagnosed with GIST after surgery. We report these two case diagnosed by capsule endoscopy and review the medical literature.

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Portal Hypertension of a Delayed Onset Following Liver Abscesses in a 12-Month-Old Infant: A Case Report and Review of the Literature

  • Al-Qurashi, Faisal Othman;Aladsani, Ahmed Abdullah;Qanea, Fatema Khalil Al;Faisal, Sarah Yousef
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제22권4호
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    • pp.400-406
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    • 2019
  • We report a 12-month-old female infant who had a history of neonatal sepsis with liver micro-abscesses that resolved with intravenous antibiotics during neonatal period. During her neonatal admission period, no umbilical vein catheter was inserted. Also, she did not undergo any abdominal surgeries or had a postnatal history of necrotizing enterocolitis. However, the child developed upper gastrointestinal bleeding in form of hematemesis and melena secondary to esophageal varices at the age of 12 months with an extra-hepatic portal vein obstruction with cavernous transformation and portal hypertension subsequently. The child underwent a successful endoscopic injection sclerotherapy. She is now 20-month-old and has portal hypertension but otherwise asymptomatic. We are proposing the possibility of a delayed-onset portal hypertension as a complication of liver abscess and neonatal sepsis.

Rehabilitation of an Amur Leopard Cat (Prionailurus bengalensis) with Complex Injury by a Road Accident

  • Sungryong Kim;Sungin Lee;Ok-Joo Lim;Ki-Jeong Na;Dong-Hyuk Jeong
    • 한국임상수의학회지
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    • 제39권6호
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    • pp.411-416
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    • 2022
  • A 2.2 kg adult female Amur leopard cat (Prionailurus bengalensis) injured in a road accident was rescued. Severe abrasions on the left chin were washed daily with an antiseptic and silver sulfadiazine ointment was applied. Corneal edema of the oculus sinister (OS) was treated with ofloxacin and 5% sodium chloride eye drops. The skin wounds gradually improved, but the eye condition did not improve and the lens was also found to be detached. In addition, on the 6th day of hospitalization, melena was observed. On radiographic examination, foreign bodies in the stomach and a fracture of the sternum were confirmed. Subsequently, endoscopic removal of foreign bodies and enucleation of the OS using an electrothermal vessel sealer were performed sequentially over several days. However, corrective surgery of the fractured sternum was not carried out because a natural union of the fracture had occurred, which was found to be fairly stable. The patient completely recovered on the 83rd day and was successfully released into the wild on the 97th day, after two weeks of adaptation training in a natural environment. This report describes the rehabilitation of a wild Amur leopard cat injured in a road accident through a series of diagnostic and treatment steps until its eventual return to the wild and highlights some improvements needed in the process.

위에 발생한 악성 횡문근양 종양의 영상 소견: 증례 보고 (Imaging Findings of a Malignant Rhabdoid Tumor in the Stomach: A Case Report)

  • 윤혜란;박동희;공준석
    • 대한영상의학회지
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    • 제82권2호
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    • pp.493-497
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    • 2021
  • 악성 횡문근양 종양은 주로 영유아의 신장에서 발생하는 공격적인 종양이다. 신장 이외의 조직에서 발생한 경우 신외성 악성 횡문근양 종양이라 하고 중추신경계, 간, 뇌, 피부, 연조직 등에서 드물게 보고되었다. 위에서 발생한 악성 횡문근양 종양은 매우 드물다. 저자들은 흑색변을 주소로 내원한 72세 남자의 위에서 발견된 악성 신외성 횡문근양 종양이 림프종과 유사한 영상 소견을 보인 예를 경험하여 보고한다.

Gastric cancer presenting with ramucirumab-related gastrocolic fistula successfully managed by colonic stenting: a case report

  • Hiroki Fukuya;Yoichiro Iboshi;Masafumi Wada;Yorinobu Sumida;Naohiko Harada;Makoto Nakamuta;Hiroyuki Fujii;Eikichi Ihara
    • Clinical Endoscopy
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    • 제56권6호
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    • pp.812-816
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    • 2023
  • We report a rare case of gastric cancer presenting with a gastrocolic fistula during ramucirumab and paclitaxel combination therapy that was successfully managed with colonic stenting. A 75-year-old man was admitted to our hospital with the chief complaint of melena. Esophagogastroduodenoscopy revealed a large ulcerated tumor in the lower stomach, judged by laparoscopy as unresectable (sT4bN1M0). After four cycles of first-line chemotherapy with S-1 plus oxaliplatin, the patient showed disease progression, and second-line therapy with ramucirumab and paclitaxel was started. At the end of the third cycle, the patient had gastric antral stenosis, which necessitated the placement of a gastroduodenal stent. When the patient complained of diarrhea 10 days later, esophagogastroduodenoscopy revealed a fistula between the greater curvature of the stomach and the transverse colon. The fistula was covered by double colonic stenting, with a covered metal stent placed within an uncovered metal stent, after which leakage from the stomach to the colon stopped.

케토프로펜 플라스터 독성에 의한 개에서의 위장관 출혈 (Ketoprofen Plaster Toxicity Induced Gastrointestinal Hemorrhage in a Dog)

  • 박형진;최준혁;이우남;송근호;서경원
    • 한국임상수의학회지
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    • 제31권3호
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    • pp.220-222
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    • 2014
  • 14년령의 Shih-Tzu 개가 이물섭취 및 구토를 주 증으로 본원에 내원하였다. 구토물은 인의에서 사용되는 부착형 제제인 ketoprofen plaster 였다. 대증치료로 위장관 보호제 투여와 수액요법을 실시하였다. 하지만 임상증상은 점점 악화되어 빈혈 및 흑색변, 백혈구 증가증, 고지혈증이 관찰되었다. 환자는 위장관 출혈이 있는 것으로 평가되었고, 수혈 및 위장관 보호제로 바륨제제를 도포하였다. 바륨제제를 위장관 보호제로 사용한 후 임상증상의 개선이 확인 되었다.

동의보감(東醫寶鑑) 신문(神門)과 혈문(血門)의 경혈(經穴) 선택(選擇)에 대한 형상론적(形象論的)인 연구(硏究) (The Study on 'Hyung-Sang' Theory of Acupuncture Points in Each Chapter on 'Shin' and 'Hyul' in Dong-Eui-Bo-Gam)

  • 박용환;송춘호;김경철
    • Korean Journal of Acupuncture
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    • 제21권4호
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    • pp.157-165
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    • 2004
  • Objectives : First, we analyze the contents of Dong-Eui-Bo-Gam. Second, from the view of the 'Hyung-Sang(形象:body form)' theory, we try to interpret the acupuncture points chosen in each chapter with a base on the contents of the book. Methods : We study on the on 'Hyung-Sang(形象: form)' theory of acupuncture points in each chapter on 'Shin(神)' and 'Hyul(血)' in Dong-Eui-Bo-Gam(東醫寶鑑). Results & Conclusions : The acupuncture points on epilepsy in 'Shin(神)' chapter are come from the purview of 'Shin(神)' type, fire-form, bird-form & the flushing and feeble of lower-abdomen. The acupuncture points on amnesia in 'Shin(神)' chapter are come from the purview of the powerful intestines and deficient heart-lung. The acupuncture points on dementia in 'Shin(神)' chapter are come more from the purview of 'Shin(神)' type, fire-form, bird-form. And the acupuncture points on sudden palpitation in 'Shin(神)' chapter are come from the purview of phlegen form syndromes. As the epistaxis and hematemesis on 'Hyul(血)' happen more the heat of fire than extravasated blood, the acupuncture points on epistaxis and hematemesis in 'Hyul(血)' chapter are come from the purview of 'Shin(神)' type, fire-form, bird-form and Yang-Myeong body. And as well as the acupuncture points on hematemesis in 'Hyul(血)' chapter are come possibly from the purview of 'Wind-form'. The acupuncture points on feeble hematemesis in 'Hyul(血)' chapter are come from the purview of 'The body form on the deficiency of medium energy'. And the acupuncture points on melena in 'Hyul(血)' chapter are come from the purview of 'Hyul(血)' type.

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변혈(便血)에 대한 문헌적(文獻的) 고찰(考察) (A Literature Study on Stercoremia(Fecal blood))

  • 장규태;김장현;김희은
    • 대한한방소아과학회지
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    • 제18권1호
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    • pp.105-129
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    • 2004
  • Methods: It was studied on the 47 kinds of oriental medical literature for fecal blood. Results: Fecal blood means bleeding with faces from anus and indicates all the three cases such as blooding before and after evacuation, evacuation of feces mixed with blood, and simple melena. The main causes are fire(火) and deficiency of spleen qi (脾氣虛). According to the color of fecal blood and the region of the bleeding, first, if the blood color is dark-red and blood discharges after emptying the bowels, it is called deposited poison into Jang(臟毒) or distant bleeding(遠血), and if the color of blood is clear and bowel emptying occurs after bleeding, it is bloody stool due to intestinal wind(腸風) or nearby bleeding(近血). For treating methods(治法). removing heat from the blood and stopping bleeding(淸熱凉血止血), removing dampness and stopping bleeding(淸熱除濕止血), invigorating Ki for promoting Hul-controJ(益氣攝血), warming the spleen and stomach to dispel cold and stopping bleeding(溫中散寒止血) etc are applied. As for the treating prescriptionl(治法), a Hwangtotang(黃土湯). Jeoksodudanggwitang(赤小豆當歸散). Gwihwasan(槐花散). Wipungtang(胃風湯). Hwangnyeonhwan modifying(黃連丸加減). Samultang modifying(四物湯加減). Paedoksan modifying(敗毒散加減) etc are used. As for acupuncture and moxibustion(鍼灸療法). if etiology(病因) is damp-heat(濕熱), acupuncture(刺鍼) at Janggang(長强); Charyo(BL 32); Sangeoheo(ST 37)(上巨虛); Seungsan(BL 57)(承山穴), and in case of deficiency of spleen Gi(脾氣虛), acupunture(刺鍼) with tonification(補法) at I Baek(EX-UE 2)(二白); Gwanwon(CC 4)(關元); Joksamni(ST 36)(足三里) Taebaek(SP 3)(太白); Hoeeum(CC 1)(會陰穴), or mxibuston(灸) at Baekoe(GC 2O)(百會); Myeongmun9GC (命門) or the point of opposite to umbilicus among spinal vertebrae(脊中對臍穴) are used. The external treatment(外治療法) was consisted of plastering umbilicus therapy(敷臍法) and enema therapy(灌腸法).

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Successful removal of a foreign body by endoscopic balloon dilatation at the colonic stricture

  • Im, Chang Jo;Na, Ji Hoon;Kim, Hyun Sik;Ha, Sung Sam;Lim, Yoo Li;Lee, Ji Hyeon;Choi, Hee Kyoung;Kim, Hee Man
    • Journal of Yeungnam Medical Science
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    • 제33권1호
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    • pp.29-32
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    • 2016
  • Most ingested foreign bodies pass readily throughout intestinal tract if they reach the stomach. In some cases, foreign bodies may be impacted behind a luminal constriction but are rare in colon. Here, we report the case of a 59-year-old man who did laparoscopic anterior resection due to sigmoid colon cancer 2 years ago and ischemic colitis was repeated on the anastomosis site. He initially presented with symptoms of abdominal pain 3 months before and melena 1 day before admission. Abdomen computerized tomography showed a 3.2 cm segment of luminal narrowing of the proximal colon involving upstream foreign material stasis. Sigmoidoscopic approaches revealed near complete obstruction on the anal verge of 20 cm and scope passing failed. Balloon dilatations were done on the obstruction site four times all and a foreign body impacted above the obstruction site was removed by an alligator without any complications. The foreign body removed looks like plastic or a shell, about 20 mm in size.

다발전이성 위장관 간질종양을 동반한 제 1형 신경섬유종증 1예 (A Case of Type 1 Neurofibromatosis Associated with Multiple Metastatic Gastrointestinal Stromal Tumors)

  • 장효진;고성애;정다은;정지윤;구은주;이경희;최준혁;현명수
    • Journal of Yeungnam Medical Science
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    • 제30권2호
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    • pp.105-108
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    • 2013
  • Type 1 neurofibromatosis (von Recklinghausen's disease, NF-1) is an autosomal-dominant neurocutaneous-disorder characterized by systemic cafe'-au-lait spots, multiple cutaneous neurofibromas, axillary or inguinal freckling, and Lisch nodules (pigmented iris hamartomas). Approximately 10-25% of NF1 patients have gastrointestinal neoplasms. Gastrointestinal stromal tumor (GIST) in patients with neurofibromatosis is most commonly found in the small bowel and the stomach, and approximately 60% of such patients have multiple tumors or multiple tumor sites. Although, the increased incidence of GIST in patients with neurofibromatosis is well documented in pathology literature in English, but has rarely been documented in Korea. Here, we report a case of multiple GISTs in a 48-year-old woman accompanied by NF1. She was admitted to Yeung-nam University Hospital with complaints of melena and dyspnea. A contrast-enhanced computed tomography (CT) scan revealed that multiple soft tissue masses were occupying the entire peritoneal cavity. An ultrasonogram- guided biopsy was performed and the tumors were found to have been composed of tumor cells that were positive for c-kit protein. The patient was put on Imatinib mesylate treatment, and further follow-up will be carried out.