• Title/Summary/Keyword: RUQ pain

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Ultrasonographic findings in Fitz-Hugh-Curtis syndrome: a thickened or three-layer hepatic capsule

  • Moon, You Ho;Kim, Jung ho;Jeong, Won joon;Park, Sin-Youl
    • Journal of Yeungnam Medical Science
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    • v.35 no.1
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    • pp.127-129
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    • 2018
  • Fitz-Hugh-Curtis syndrome (FHCS) is characterized by inflammation of the perihepatic capsules associated with the pelvic inflammatory disease (PID). FHCS is not a serious disease, but if not treated properly, it can result in increased medical costs, prolonged treatment, and dissatisfaction with treatment. However, early recognition of FHCS in the emergency department can be difficult because its symptoms or physical findings may mimic many other diseases. Although contrast-enhanced computed tomography (CECT) is the useful imaging modality for recognition of FHCS, it is available only when a high suspicion is established. We performed point-of-care ultrasonography in an 18-year-old woman who had a sharp right upper quadrant (RUQ) abdominal pain without PID symptoms and found a thickened or three-layer hepatic capsule. These findings coincided with areas showing increased hepatic capsular enhancement in the arterial phase of CECT. These results show that if the thickened or three-layer hepatic capsule without evidence of a common cause of RUQ pain is observed on ultrasonography in women of childbearing age with RUQ abdominal pain, the physician can consider the possibility of FHCS.

A Case of Biliary Ascariasis in Korea

  • Choi, Jun-Ho;Seo, Min
    • Parasites, Hosts and Diseases
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    • v.55 no.6
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    • pp.659-660
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    • 2017
  • Biliary ascariasis is still the leading cause of surgical complication of ascariasis, though its incidence has been dramatically reduced. Herein, we report a case of biliary ascariasis for the purpose of enhancing awareness of parasitic infections as a possible cause. A 72-year-old male visited the emergency room of Dankook University Hospital on 12 July 2015, complaining of right-upper-quadrant pain. By endoscopic retrograde cholangiopancreatography (ERCP), a tubular filling defect in the right hepatic duct was detected. The defect was endoscopically removed and diagnosed as an adult female of Ascaris lumbricoides worm, of 30 cm length. Upon removal of the worm, the pain subsided, and the patient was discharged without any complication. When treating cases of biliary colic, physicians should not neglect biliary ascariasis as the possible cause.

A Case Report of Abdominal Pain with Pseudo-mass of the Gallbladder treated by Oriental Internal Medicine (가성담낭종물(假性膽囊腫物)을 동반한 복통(腹痛)환자 1례(例) 보고(報告))

  • Lim, Hee-Yong;Oh, Jung-Han;Kim, Dong-Woo;Choi, Bin-Hye;Park, Song-Ki;Byun, Joon-Seok;Shim, Yun-Seub;Kim, Guk-Bum;Han, Jong-Hyun;Kim, Sun-Hong;Kim, Eun-Gon;Kim, Sang-Uk;Seong, Ki-Won;Kim, Bong-Suk
    • The Journal of Internal Korean Medicine
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    • v.25 no.2
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    • pp.329-334
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    • 2004
  • There are different kinds of the pseudo-mass of the gallbladder(GB) such as GB stones, GB polyps, GB sludge, and these can be differentiated by simple-ultrasonogram(USG). The most common symptoms of GB polyps are abdominal pain(RUQ), dyspepsia, jaundice, but usually there are no symptoms. GB polyps are commonly treated with a cholecystectomy if 10 mm or more in diameter. Pseudo-mass of the GB is regarded as products of stagnation of the Liver Ki in Oriental Medicine. The patient suffered from mild fever. abdominal pain(RUQ), and jaundice. He was diagnosed with a GB polyp(10 mm), liver cyst(12 mm) by simple USG. We treated him with Acupuncture, Herbal Medicine(Hoinsamgum-tang). After three days of treatment, the symptoms improved, and after one month the GB polyp was removed on the follow up of USG.

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A Clinical Study of the Effects of Chungganhaeju-tang on Alcoholic Fatty Liver (청간해주탕이 알코올성 지방간에 미치는 영향에 대한 임상적 연구)

  • 이장훈;박신명;김영철;우흥정
    • The Journal of Korean Medicine
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    • v.22 no.4
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    • pp.107-113
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    • 2001
  • Objectives : The aim of this study was to investigate effects of Chungganhaeju-tang on alcoholic fatty liver. Methods : Thirty patients with alcoholic fatty liver were included in this study. Chungganhaeju-tang was administered to subjects for 1 month. The changes of clinical symptoms and chemical liver function tests were evaluated before and after treatment. Results : Chungganhaeju-tang has effects on the improvement of clinical symptoms such as fatigue, anorexia, dyspepsia, nausea, and RUQ (Right Upper Quadrant) pain. On the chemical liver function test, serum AST, ALT, GGT, and TG level significantly decreased (P<0.05, by paired t-test). Conclusions : These results suggest that Chungganhaeju-tang has significant effects on the improvement of clinical symptoms and chemical liver function test with alcoholic fatty liver.

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Phylogenetic Characteristics of Fasciola hepatica Isolated from a Korean Patient

  • Jeong, Mi Jin;Park, Jae Kyun;Yu, Hak Sun
    • Parasites, Hosts and Diseases
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    • v.60 no.5
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    • pp.367-370
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    • 2022
  • Fascioliasis is a parasitic infection caused by liver flukes. Although several cases have been reported in Korea, phylogenetic analysis of isolates is lacking. In this study, a 66-year-old woman with right upper quadrant (RUQ) abdominal pain was diagnosed as fascioliasis involving abdominal muscle by imaging study. She received praziquantel treatment, but symptoms were not improved. Lateral movement of the abscess lesion was followed. Trematode parasite was surgically removed from the patient's rectus abdominis muscle. The fluke was identified as Fasciola hepatica based on sequence analysis of 18S rDNA. To determine the phylogenetic position of this Fasciola strain (named Korean Fasciola 1; KF1), the cox1 gene (273 bp) was analyzed and compared with the genes of 17 F. hepatica strains isolated from cows, sheep, goats, and humans from various countries. Phylogenetic analysis showed that KF1 was closely related with the isolates from China goat.

Clinical Characteristics in Patients with Biliary Obstruction Diagnosed by $^{99m}Tc-DISIDA$ Scan -In 9 Cases with Normal Ultrasonographic Findings- ($^{99m}Tc-DISIDA$ 간담도 스캔상 담도폐쇄로 진단된 환자의 임상적 특성 -초음파 검사상 정상 소견을 보인 9예를 중심으로-)

  • Park, Bong-Chul;Yang, Soo-Hyun;Che, Dong-Ho;Park, Sung-Ki;Byun, Jong-Hoon
    • The Korean Journal of Nuclear Medicine
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    • v.26 no.1
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    • pp.82-85
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    • 1992
  • To evaluate the role of hepatobiliary (DISIDA) scan in the diagnosis of biliary obstruction, we studied the clinical characteristics of 9 cases with biliary obstructuon, whose hepatobiliary scans and ultrasonography were not concordant (normal ultrasonography and abnormal hepatobiliary scan). The results were as follows; 1) The main chief complaints (89%) were abdominal pain, especially in RUQ area. The levels of serum bilirubin were elevated in 67% of patients $(normal\sim5.9mg/dl)$ and those of alkaline phosphatase were elevated in 78% of patients $(normal\sim724U/L)$. 2) The final diagnoses were CBD stones (67%), tumor (22%) and 3 cases were associated with C. sinensis. 3) The major obstruction sites were in distal CBD (89%). From the above results we concluded that hepatobiliary scan is a useful diagnostic method of biliary obstruction, especially in distal CBD lesion and early stage, in spite of normal ultrasonography.

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Clinical Study of Chronic Hepatitis and Liver Cirrhosis Treated with Sodalgeonbitang-gamibang (소달건비탕가미방 투약 후 호전된 만성간염을 동반한 간경변 환자 1례)

  • Baek Dong Gi;Hwang Sang Il;Rhim Eun Kyung;Lee Yun Jae;Kim Dong Woung;Shin Sun Ho;Kim Hong Jun;Moon Goo
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.18 no.1
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    • pp.306-309
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    • 2004
  • Liver cirrhosis is caused by virus, alcohol, toxins, drugs and chronic hepatitis. Clinical symptoms of liver cirrhosis are severe fatigue, nausea, fever, dyspepsia, anorexia, RUQ pain, jaundice, ascites. We applied oriental medicines to patient who had chronic hepatitis and liver cirrhosis. Sodalgeonbitang-gamibang has been used to treat hepatitis and liver cirrhosis because of its beneficial effects. The patient symptoms began to improve after about one month of treatment. After medication we could find remarkable effect on clinical symptoms and blood test. So we hope that this clinical study is helpful in treat a patient with hepatic disease.

Epidemiological Changes and Clinical Features of Hepatitis A in Children, Living in Kyung-gi Province, Since 1988 to 1998 (최근 10년간(1988~1998) 경기지역 소아에서 A형 간염의 역학적 변화 및 임상에 관한 연구)

  • Kim, Hyun;Kim, Jong Hyun;Kim, Dong Un;Hur, Je Kyun;Lee, Won Bae;Seo, Byung Kyeu;Kang, Jin-Han
    • Pediatric Infection and Vaccine
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    • v.5 no.2
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    • pp.230-238
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    • 1998
  • Purpose : Worldwidely, the incidence of the hepatitis A has been markedly decreased in the past years. Also in Korea, there has been only a few sporadic cases without evidence of epidemics since the mid 1980s. However, the incidence of the hepatitis A in young adults and childen has been in trends of increasing since 1996. So, we retrospectively performed the study on the epidemiolgical changes and the clinical feature of hepatitis A in childen, living in Kyung-gi province, since 1988 to 1998. Methods : The four affiliated hospitals of the Catholic University of Korea, Our lady of Mercy's hospital, Holy family hospital, Eui-Jung-bu St. Mary's hospital, and St. Vincent hospital, were enrolled in this study. We conducted statistical analysis on the incidence of hepatitis A since 1988 to 1998, concerning with the period (monthly, annually), age, sex and related epidemiological property, by reviewing the hospital records of the patients with hepatitis A. We simultaneously performed the study concerning with the clinical characteristics of hepatitis A. Results : 1) During the study period, 46 children was diagnosed as hepatitis A, and among them 28 children (60.1%) developed sporadically in the 1998. And sex ratio was 1.2(male):1(female). 2) Most of the patients developed between March and July, and hepatitits A were mainly developed in the patients above the 10 year old ages(37 patients; 80.4%). 3) The socioeconomic and educational status of the patient's parents was almostly below the middle and low class. Although, we could not find the etiological factors in most cases, but we found the evidence of interfamilial transmission in one family. 4) The patients complained the symptoms of nausea and vomiting, jaundice, poor appetite, mild fever, fatigueness, abdominal pain, URI symptom, dyspepsia, dark urine, headache and diarrhea in order, and findings of jaundice, hepatomegaly, RUQ tenderness, splenomegaly and LLQ tenderness in order were seen. 5) All patients showed abnormal findings of the liver function tests, and the pattern of cholestatic hepatitis were seen in most cases, but these findings were normalized within the 2~4 weeks. The findings of the gall bladder wall thickening, hepatomegaly, splenomegaly and ascites were seen on abodominal sonogram. 6) The prognosis of all patients were good without complications, except in one case who had the episode of transient recuurence. And the mean hospitalization dates were 11.1 days. Conclusion : We found that the incidence of hepatitis A showed the increasing trend, and peaked in the 1998 in Kyung-gi province children. And hepatitis A mainly developed in children above the 10 year old ages. The scioeconomic and educational status of patient's family was almostly below the middle class. All of them showed abnormal liver function, and clinically cholestatic hepatitis features were seen in most cases. But, the prognosis was excellent without complication in all cases.

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