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( Sang Seon Lee ),( Seon Tae Hwang ),( Nam Gil Jang ),( Hann Tchah ),( Duk Young Choi ),( Hyun Young Kim ),( Eell Ryoo ) 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 2011 Gut and Liver Vol.5 No.1
A 35-month-old girl visited our hospital with repetitive vomiting and abdominal distention; this was especially aggravated after the introduction of solid and semisolid foods. At 5 months of age, the patient, who had Down`s syndrome, had undergone surgery for ventricular septal defect, atrial septal defect, and patent ductus arteriosus, and had subsequently been frequently hospitalized for respiratory infections and other viral infectious diseases. After her admission, the abdominal distension improved with fasting and intravenous fl uid therapy. Radiograph from a small-bowel series revealed a thin fi lling defect with a dilated duodenal bulb in the distal region of the second portion of the duodenum, suggesting a duodenal web, and endoscopy revealed duodenal stenosis. We therefore performed endoscopic resection with an insulated-tip knife because of the history of prior operations, fasting problems after operations, and respiratory infections. Seven days later, scar formation was noted on the second portion of the duodenum, the scope passed well at the excision site, and no retained food material was noted on the follow-up endoscopy. After the procedure, the patient`s abdominal distention and repetitive vomiting subsided, and she was discharged with the ability to eat eat an ageappropriate normal diet. There were no specifi c symptoms or other complications for 1 year after the procedure. (Gut Liver 2011;5:105-109)
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서백종,장기육,박용근,채현석,한석원,이창돈,정인식,차상복,박두호 대한내과학회 1997 대한내과학회지 Vol.53 No.3S
저자들은 만성췌장염환자에서 지속적인 오심과 구토를 주소로 내원하여 십이지장협착으로 진단된 1예를 경험하였기에 보고하는 바이다. Duodenal stenosis resulting from fibroinflammatory process is a rare complication of chronic pancreatitis. The mechanism of duodenal stenosis seems to be related to ischemia and edema caused by persistent inflammation, which results in irreversible change of duodenal wall structure. We experienced a chronic alcoholic male patient with duodenal stenosis who had a history of choledochojejunostomy to relieve distal bile duct stenosis several years ago. He had suffered persistent postprandial nausea and vomiting for several months. Barium study of upper gastrointestinal tract and repeated endoscopy show narrowing lumen of duodenum with coarse nodular surface due to reactive inflammatory change.
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박강진,정조윤,송영아,김상훈,박정수,조성범,이완식,주영은 대한소화기내시경학회 2011 Clinical Endoscopy Vol.42 No.6
회충은 가장 흔한 장관 내 기생충 감염의 원인으로 대개는 별다른 증상을 일으키지 않으나 위장관의 여러 부위에 이소미입이 일어날 수 있고 이로 인해 장폐쇄, 췌담관질환, 맹장염, 복막염 등의 여러 가지 위장관질환을 유발할 수 있다. 국내의 경우 성공적인 기생충 관리로 회충 감염률이 낮은 상태이나, 최근 기생충감염의 증가 가능성이 제기되고 있으며 이와 관련된 증례도 드물게 보고되고 있다. 상부소장폐쇄의 경우 회충의 종괴형성에 의한 완전 또는 불완전 폐쇄에 대한 보고가 2예 있었으나, 회충증에 의한 십이지장 협착을 보고한 예는 없었다. 저자들은 지속적인 상복부 통증과 구토를 주소로 내원한 환자에서 총담관내 회충미입증과 동반된 십이지장 협착을 진단하고 치료한 1예를 경험하여 보고한다. Infestation with Ascaris lumbricoides is one of the most common helminthic diseases in humans. The highly motile mature worm can cause intestinal obstructions, pancreaticobiliary diseases, appendicitis, and peritonitis. However, biliary ascariasis associated with duodenal stenosis is extremely rare. We report a case of biliary ascariasis with duodenal stenosis in a 70-year-old man. The patient was admitted to our hospital with a 2 month history of epigastric pain and vomiting. An esophagogastroduodenoscopy showed stenosis of the second portion of the duodenum and an impacted living round worm in the ampulla of Vater. The round worm was extracted with a snare without any complications, and the patient received albendazole treatment. A pathological examination of the stenotic portion of the biopsy specimen revealed chronic inflammation with eosinophilic infiltration throughout the mucosa. The patient remained asymptomatic at a follow-up examination. Duodenal stenosis should be considered in the complications of ascariasis, particularly in areas where this parasitic infestation is endemic.
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김상우,정풍만,Kim, Sang-Woo,Jung, Poong-Man 대한소아외과학회 1997 소아외과 Vol.3 No.2
Seventy neonates with congenital intestinal atresia and stenosis who were treated at pediatric surgical service. Hanyang University Hospital from September 1979 to December 1996 were analyzed retrospectively. The lesion occurred in 27 cases at the duodenum, in 26 cases at the jeiunum, in 13 cases at the ileum and in 2 cases at the pylorus and colon each. There were 10 multiple atresias and 7 apple-peel anomaly cases. The atresia predominated over the stenosis by the ratio of 4 : 1. Male to female ratio was 1.3 : 1. The average gestational age was 38 weeks, and the average birth weight was 2,754 grams. Though 22.9 % were borne prematurely and 34.3 % had low birth weight, 92.3 % of them had a weight appropriate for gestational age. Polyhydramnios(40 %) was more frequently observed in duodenal and jeiunal atresia while microcolon in ileal atresia(58.3 %). Weight loss and electrolyte imbalance occurred more frequently in the duodenal stenosis cases because of delayed diagnosis. Twenty(55.6 %) of 37 jeiunoileal atresia cases had evidence of intrauterine vascular accident : 4 intrauterine intussusception, 3 intrauterine volvulus and 3 strangulated intestine in gastroschisis, and 10 cases of intrauterine peritonitis. There were one or more associated anomalies in 45 patients (64.3 %). Preoperatively proximal loop volvulus developed in 3 cases and proximal loop perforation in 5 cases and one case each of distal loop perforation, duodenal perforation and midgut volvulus occurred in the jeiunoileal atresia. Overall mortality rate was 20 %.
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