No abstract available.
Transplants*

No abstract available.
Transplants*

Endoscopic nasobiliary drainage(ENBD) has been developed as a safe and effective noninvasive biliary drainage method for initial decompression in the benign or malignant biliary obstruction, dissolution of biliary stones by injection of litholytic agents through the tube, and proper causative diagnosis of biliary obstruction by cytologic, bacteriologic and parasite investigation of drained bile. Generally, endoscopic sphicterotomy (EST) is performed before the insertion of an ENBD tube in order to make the procedure easy and to prevent acute pancreatitis that may develop by compression of the pancreatic orifice of the inserted tube. Nevertheless, in some cases EST is difficult to perform or should not be performed due to their coagulopathy. In such cases, ENBD without EST may be necessary. To evaluate the safety, successfullness and effectiveness of ENBD without EST, ENBD without EST using 5, 6 or 7 Fr pigtail tubes were performed in 81 cases(49 malignant, 32 benign). ENBD without EST was successfully performed in 78 out of 81 cases(96.3%). This effectiveness for decompression of bile duct, evaluated by decreasing total bilirubin values, was good in 66 out of 73 casee (90. 2%). The complications of this procedure were noted in 6 out of 78 cases(7. 7%). e. g. cholangitis in 3, migration of ENBD tube in 2, acute pancreatitis in 1 case. Particularly, regardless of our concern that ENBD without EST may develop acute pancreatitis acute panereatitis was noted in only one case. In conclusion, ENBD without EST is a safe and effective method which can be applied to the cases who have benign or malignant obstructive jaundice.
Bile ; Bile Ducts ; Bilirubin ; Cholangitis ; Decompression ; Diagnosis ; Drainage* ; Jaundice, Obstructive ; Pancreatitis ; Parasites

No abstract available.
Nifedipine* ; Vasopressins*

No abstract available.
Carcinoma, Squamous Cell* ; Lung Neoplasms* ; Lung* ; Small Cell Lung Carcinoma*

The hemostatic effect of endoscopic microwave coagulation method for upper gastrointestinal bleeding was evaluated clinically. Hemostasis over 72 hours was achieved in 18 of 20 cases (90%) with upper gastrointestinal bleeding by the endoscopic microwave coagulation method. It is noteworthy that this method was effective in all 4 cases of pulsatile bleeding from exposed vessels. We conclude that this method is useful for emergency endoscopic hemostasis on upper gastrointestinal bleeding, especially bleeding from exposed vessels.
Emergencies ; Hemorrhage* ; Hemostasis ; Hemostasis, Endoscopic ; Microwaves*

Splenic abscess is an uncommon lesion and may be present either as a localized area of infection in the spleen or as a part of generalized sepsis. The diagnosis is difficult because of the rather nonspecific clinical picture. Hence, splenic abscess has a high mortality rate and is after diagnosed only at autopsy. Computerized tomography (CT) offers the clinician a reliable tool for the diagnosis of intra-abdominal abscess. A successful outcome is dependent on an early diagnosis and prompt treatment by splenectomy with antibiotic cover. We experienced a care of splenic abscess which was diagnosed by CT and treated by splenectomy with antibiotics. Postoperative course was relatively uneventful.
Abdominal Abscess ; Abscess* ; Anti-Bacterial Agents ; Autopsy ; Diagnosis ; Early Diagnosis ; Mortality ; Sepsis ; Spleen ; Splenectomy

Leriche syndrome is a chronic disorder mostly in male and is a specific symptom complex due to thrombotic obliteration of the aortic bifurcation as result of an atherosclerotic change. The symptoms include 1) extreme liability to fatigue of both lower limbs; 2) symmetric atrophy of both lower limbs; 3) pallor of the legs and feets; 4) inability to maintain stable erection. There are several methods for surgical management of this disorder; 1) thromboendarterectomy with or without sympathectomy; 2) aortoiliac bypass graft; 3) aortofemoral bypass graft. Here we report a case of Leriche syndrome which was successfully managed with aortobifemoral bypass graft with Dacron and reviewed literatures on it briefly.
Atrophy ; Endarterectomy ; Fatigue ; Foot ; Humans ; Leg ; Leriche Syndrome* ; Lower Extremity ; Male ; Pallor ; Polyethylene Terephthalates ; Sympathectomy ; Transplants

Although endoscopic biliary drainage(ERBD) is the preferred palliative treatment for unresectable malignant obstructive jaundice, the failure of endoprosthesis insertion occurs in 15% of the cases. In most cases, technical failure results from the inability to pass either a guide wire or a stent beyond the bile duct stricture due to high grade biliary stenosis or tumorous extending down to involve the papilia so that no normal orifice can be identified. In instances of technical failure, percutaneous transhepatic biliary drainage (PTBD) can be achieved, but compared to ERBD, prolonged external decompression has important disadvantages, and the placement of large-bore endoprothetic stent is painful, requires a bougination, and has fairly high complication rate. Recently, percutaneous endoscopic biliary stent (PEBS) is more commonly used in these patients because of higher successfulness than ERBD and higher safety than PTBD. So we report a case that was performed PEBS successfully, previously failed ERBD due to high grade stenosis of extrahepatic bile duct resulting from cholangiocarcinoma.
Bile Ducts ; Bile Ducts, Extrahepatic ; Cholangiocarcinoma ; Constriction, Pathologic ; Decompression ; Drainage ; Humans ; Jaundice, Obstructive ; Palliative Care ; Stents*

A 60-year-old woman has experienced of right upper quadrant abdominal discomfort. This partient took cholecytectomy due to gall stone 15 years ago. At that time microscopic finding the neck of gallbladder showed well differentiated papillary adenocarcinoma confined to superficial part of musele layer. 3 years before admission she took T-tube drainage due to obstructive jaundice. The microscopic finding af distal common bile duct showed well differentiated adenocarcinoma. Recently she complained of pain and discomfort on T-tube site and so we perforrned endoscopic retrograde biliary drainage after removal of T-tube. The computed tomogram showed no mass in liver or lymph node enlargement. 4 months after procedure of ERBD; we changed to the new catheter for the prevention of cloggiag of prosthesis. We report here a case of longterm survival over 15 years after the diagnosis of cancer of extrahepatic bile duct.
Adenocarcinoma ; Adenocarcinoma, Papillary ; Bile Ducts, Extrahepatic ; Catheters ; Common Bile Duct* ; Diagnosis ; Drainage ; Female ; Gallbladder* ; Gallstones ; Humans ; Jaundice, Obstructive ; Liver ; Lymph Nodes ; Middle Aged ; Neck ; Prostheses and Implants