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Heoclipped Dieulafoy`s Lesion in Giant Duodenal Diverticulum Mimicking a Polyp: A Case Report
진석재,김호동,김도현,박창국,황유정 대한내과학회 2015 대한내과학회 추계학술대회 Vol.2015 No.1
Duodenal diverticula are commonly observed in thegeneral population. Although they are usually asymptomatic, complications (inflammation, bezoar, bleeding, perforation) occasionally develop. Massive bleeding should be diagnosed and treated promptly. A 75-year-old man presented with melena. Endoscopy showed fresh blood clots filled the giant diverticulum at the second portion of the duodenum. We removed the fresh blood clots and repeatedly washed with water, and a nonpulsatile but continuous flow of blood on a polypoid lesion like a peanut was seen with no visible ulcer. Endoscopic hemoclipping was performed successfully without complications after the removal of a polypoid lesion. Finally, we considered the lesion was Dieulafoy’s lesion. Dieulafoy’s lesion as a cause of bleeding is quite rare in the duodenal diverticulum. We report here a case of a bleeding Dieulafoy’s lesion mimicking a polyp in the duodenal giant diverticulum treated by endoscopic hemoclipping after the removal of it.
증례 : 순환기 ; 대동맥-우심방 터널에 동반된 감염성 심내막염 1예
진석재 ( Suk Je Jin ),김동한 ( Dong Han Kim ),정용진 ( Yong Jin Jeong ),김병기 ( Byung Ki Kim ),장승재 ( Seung Jae Jang ),방준희 ( Jun Hee Bang ),정영곤 ( Young Gon Jung ) 대한내과학회 2016 대한내과학회지 Vol.90 No.2
저자들은 대동맥-우심방 터널과 감염성 심내막염이 동반된 환자를 수술적 치료한 증례 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Aorta-right atrial tunnel is a vascular anomaly that originates from the aortic sinus and terminates in either the superior vena cava or the right atrium. The patency of the tunnel can result in volume overload in both ventricles, bacterial endocarditis, aneurysm formation, and spontaneous rupture. Transesophageal echocardiography was performed in a 42-year-old male patient diagnosed with infectious endocarditis, and vegetation of the mitral and aortic valves, right atrial enlargement, and an extracardiac blood vessel connecting the aorta to the right atrium were discovered. Therefore, we were able to diagnose an aorta-right atrial tunnel leading to infectious endocarditis and proceeded with surgical treatment. Together with a review of the literature, we present a case report of a patient with aorta-right atrial tunnel accompanied by infectious endocarditis. (Korean J Med 2016;90:140-143)
보디빌딩 선수에서 발생한 영양재개 증후군에 의한 횡문근 융해증
김주영,김병기,정용진,진석재,정종혁 조선대학교 의학연구원 2014 The Medical Journal of Chosun University Vol.39 No.4
Refeeding syndrome is defined as a potentially fatal shift in fluids and electrolytes, which may occur in malnourished patients receiving rehabilitative refeeding. A young man presented with muscle weakness and leg pain. He had adhered to a strict low-carbohydrate, low-calorie diet for five months in preparation for a bodybuilding competition. He ate a large amount of carbohydrate rich foods and consumed water immediately after the competition. Laboratory findings showed hypophosphatemia, hypokalemia, and elevated levels of serum creatine phosphokinase. This case of rhabdomyolysis was caused by refeeding syndrome in a young man who had followed a strictly controlled diet.
갑상선에 발생한 급속하게 자라는 미분화된 고등급의 다형성 육종
나상돈,김병기,진석재,정용진,강미연,김정민 조선대학교 의학연구소 2014 The Medical Journal of Chosun University Vol.39 No.3
Undifferentiated high grade pleomorphic sarcoma of the thyroid gland is very rare. A 70-year-old woman was referred to our hospital for evaluation of a rapidly growing mass in the right lobe of the thyroid gland. At the first visit, she had no symp-toms. Fine-needle aspiration cytology revealed an atypia of undetermined significance. She revisited our hospital after 17 days. At that time the mass had become more enlarged and she complained of dyspnea. The next day, surgery was performed and the diagnosis was undifferentiated high grade pleomorphic sarcoma of the thyroid. The patient died 119 days after sur-gery.
김병기,김수현,진석재,정용진,장승재,방준희,정영곤,강순형,김성택,최종인,조장현 대한노인병학회 2015 Annals of geriatric medicine and research Vol.19 No.3
Background: Elderly patients usually have comorbid and poor general conditions. They are more likely to have complex coronary lesions with cardiac dysfunction. Percutaneous coronary intervention (PCI) in octogenarians remains controversial. In this study, we determined the safety after PCI for octogenarians and their younger counterparts with coronary artery disease. Methods: We reviewed 1,057 patients (110 octogenarians vs. 947 younger counterparts) who underwent PCI for coronary artery disease at Saint Carollo Hospital. We analyzed the baseline characteristics, angiographic findings, in hospital mortality, and post procedural complications between the two groups. Results: The mean ages of octogenarians and younger counterparts were 83.1±4.5 years and 62.6±10.3 years, respectively. The octogenarian group had a significantly (p<0.001) higher ratio of female patients compared to their younger counterpart group (57.3% vs. 27.5%). However, the octogenarian group had a significantly (p=0.035) lower ratio of patients with history of diabetes mellitus compare to their younger counterpart group (22.7% vs. 32.6%). Incidence of acute myocardial infarction in octogenarians was significantly (p<0.001) higher than that in the younger counterparts (43.7% vs. 18.0%). There was no significant difference in admission duration, major complication, or in-hospital mortality between two groups. Conclusion: Our results revealed that hospital mortality and incidence of major complications in octogenarians who underwent invasive PCI were not higher than those in their younger counterparts, suggesting that PCI could be safely used in patients aged 80 years or older. However, long-term follow-up data are needed.
황유정 ( Yu Jeong Hwang ),진석재 ( Suk Je Jin ),정용진 ( Yong Jin Jeong ),명형준 ( Hyung Joon Myung ),신혜영 ( Hae Young Shin ),김호동 ( Ho Dong Kim ),주영은 ( Young Eun Joo ) 대한소화기학회 2021 대한소화기학회지 Vol.78 No.5
A 54-year-old man was transferred from another hospital due to a hematoma in the third portion of the duodenum on abdomen CT. He had been admitted for 2 weeks due to vomiting at another hospital. He had abdominal discomfort and nausea without abdominal pain when he visited the Gwangyang Sarang Hospital. Other than a distended abdomen and mild general abdominal tenderness, the results of physical examination were unremarkable. Abdominal CT revealed an approximately 9 cm thick walled hematoma at the anteroinferior site of the duodenal third portion. Upper endoscopy revealed stenosis of the third portion of the duodenum without mucosal lesions. The endoscope was not advanced through the narrowed duodenal lumen. A retroperitoneal hematoma was diagnosed, and his state was classified as subacute rather than acute based on the duration. The surgeon did not recommend surgical treatment. Urgent treatment was unnecessary; he was managed conservatively. The size of the hematoma decreased from 9.0 cm to 5.8 cm on the following CT. He could begin to eat food on the 26th admission day, and he was discharged on the 31st admission day. The hematoma disappeared entirely on the following CT. This paper describes a rare case of idiopathic retroperitoneal hematoma with a spontaneous resolution. (Korean J Gastroenterol 2021;78:295-299)
박창국,김호동,김주영,진석재,김병기,황유정,김도현 대한상부위장관ㆍ헬리코박터학회 2015 Korean Journal of Helicobacter Upper Gastrointesti Vol.15 No.2
Plastic wires are uncommonly swallowed and subsequently may be tangled in the stomach. Although endoscopy with accessories is effective for removal of most wires, sometimes it is hard to remove tangled plastic wires. Early diagnosis and immediate retrieval of ingested wires are important. Mentally impaired adults have a relatively high rate of surgical intervention and complications due to delayed diagnosis. A twenty-one year old woman visited our hospital with foreign bodies in the stomach. She was mentally retarded and had swallowed plastic wires frequently. Esophagogastro-duodenoscopy revealed tangled plastic wires. We cut three wires with argon plasma coagulation and endoscopic scissors to unwind the bundle of wires. We removed the remaining 17 wires one by one. The total length of the wires were 496 cm. We report this unusual case of tangled plastic wires in the stomach removed endoscopically without surgical intervention.