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김승현 ( Seung Hyun Kim ),정창길 ( Chang Kil Jung ),허진 ( Jin Her ),허기환 ( Ki Hwan Hur ),최재혁 ( Jae Hyuc Choi ),강기훈 ( Kee Hoon Kang ),황찬희 ( Chan Hee Hwang ) 대한소화기학회 2014 대한소화기학회지 Vol.64 No.5
The main causes of biliary obstruction are stones and cancers. Fascioliasis is a very rare case which causes biliary obstruction. Fascioliasis is a zoonosis caused by Fasciola hepatica which infects herbivores like sheep and cattle. F. hepatica lives in the biliary system or the liver parenchyma of a host. In Korea, the occurrence of this infection in human is very rare and only few cases have been reported. A 32-year-old male presented with upper abdominal pain and jaundice. His laboratory finding revealed elevated liver transaminases. Abdomen CT scan showed mild left intrahepatic bile duct dilatation. On ERCP, adult F. hepatica worms were found and were thus removed. Concurrently, clonorchiasis was diagnosed by stool exam and serologic enzyme-linked immunosorbent assay test. Clonorchiasis was treated with praziquantel. Herein, we report a case of intrahepatic bile duct dilatation due to F. hepatica infection with concurrent Clonorchis sinensis infestation. (Korean J Gastroenterol 2014,64:298-301)
증례 : 순환기 ; 베흐체트병에서 폐동맥 협착에 의한 중증 폐동맥 고혈압의 풍선 성형술
김경록 ( Kyung Rok Kim ),김형준 ( Hyoung Jun Kim ),김민수 ( Min Su Kim ),배수경 ( Soo Kyung Bae ),김현수 ( Hyun Soo Kim ),허기환 ( Ki Hwan Hur ),강동우 ( Dong Woo Kang ) 대한내과학회 2013 대한내과학회지 Vol.84 No.1
선천적 원인이 아닌 성인에서의 폐동맥협착에 의한 폐고혈압은 매우 드물게 발견된다. 베흐체트병을 앓고 있는 환자에서 호흡곤란 및 안면부종을 주소로 내원, 실시한 심초음파검사와 심혈관 컴퓨터 단층촬영에서 폐동맥 근위부 협착이 동반되어 있음을 확인하였다. 혈관 풍선 성형술로 임상적인 증상완화 및 폐혈류량 증가, 폐동맥압의 감소를 유도할 수 있었다. 1년간의 경과관찰에서 경미한 폐동맥 직경의 감소 및 폐동맥압의 상승이 관찰되었으나 뚜렷한 증상의 악화는 없었다. Pulmonary artery stenosis that causes pulmonary hypertension is usually observed in congenital anomalies and is seldom observed in adults. A 47-year-old female patient came to the hospital for aggravated dyspnea and peripheral edema. Severe pulmonary hypertension was found on an echocardiography examination, along with dilation of the main pulmonary artery and alias flow at the bifurcation sites of both pulmonary arteries. Under coronary angio-computed tomography, 70% high grade stenosis was observed on both sides of the proximal pulmonary arteries without showing atherosclerotic plaque or a thrombus. The patient`s symptoms improved after performing pulmonary artery angiography and angioplasty. Thus, we report our experience of a patient with Behcet`s disease and severe pulmonary hypertension caused by pulmonary artery stenosis, which was treated with percutaneous pulmonary angioplasty. (Korean J Med 2013;84:85-90)