1.Gastric Ulcer Perforation in Heart-Lung Transplant Patient: A Successful Case of Early Surgical Intervention and Management.
Hyo Chae PAIK ; Do Hyung KIM ; Doo Yun LEE ; Dong Sup YOON ; Jae Hoon LEE
Yonsei Medical Journal 2003;44(6):1094-1097
Gastrointestinal complications may follow organ transplantation. A patient who underwent heart lung transplantation due to patent ductus arteriosus and Eisenmenger's syndrome had an episode of acute cardiac rejection and was treated with a bolus injection of methylprednisolone followed by a high oral dose of prednisone. On the 22nd postoperative day, the patient complained of acute abdominal pain with muscular rigidity and a plain chest x-ray showed free air in the right subdiaphragmatic area. Under the suspicion of bowel perforation, an emergency laparotomy was performed and the perforated stomach had a wedge-shaped resection that included the perforation. Following the laparotomy, the postoperative course was uneventful and the patient was discharged on post-laparotomy day 10.
Adult
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Heart-Lung Transplantation/*adverse effects
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Human
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Male
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Peptic Ulcer Perforation/*etiology/*surgery
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Stomach Ulcer/*surgery
2.Surgical treatment of giant cavernous hemangiomas of the liver: analysis of 7 patients.
Jae Kwan SEO ; Byung Ki LEE ; Kwang Hee KIM ; Man Ha HUH
Journal of Korean Medical Science 1991;6(2):127-133
Seven patients with giant cavernous hemangioma of the liver were treated surgically with success at Pusan Gospel Hospital, Kosin Medical College, Pusan, from 1980 through 1989. They were 3 males and 4 females, and their ages ranged from 6 to 59 years. The tumors were located on the right lobe of the liver in 5 patients and on the left lobe in 2. The lesions were solitary in all patients, and their sizes varied from 4cm to 15cm in diameter. All patients underwent hepatic resection: 1 right hepatic lobectomy and 4 partial resections for tumors on the right lobe, and 1 left lobectomy and 1 left lateral segmentectomy for tumors on the left lobe. There was no surgical death, but 1 patient had a postoperative complication: multiple stress ulcers on the stomach and ileum. The pathologic diagnosis was cavernous hemangioma in all cases. In the long-term follow-up, there was no recurrence of preoperative symptoms in any patient.
Adult
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Child
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Female
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Hemangioma, Cavernous/*surgery
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Humans
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Ileal Diseases/etiology
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Liver Neoplasms/*surgery
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Male
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Middle Aged
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Postoperative Complications/etiology
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Prognosis
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Stomach Ulcer/etiology
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Stress, Physiological/etiology
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Ulcer/etiology
3.Gastropericardial Fistula as a Complication in a Refractory Gastric Ulcer after Esophagogastrostomy with Gastric Pull-Up.
Semi PARK ; Jie Hyun KIM ; Yong Chan LEE ; Jae Bock CHUNG
Yonsei Medical Journal 2010;51(2):270-272
A gastropericardial fistula, defined as penetration of a gastric lesion into the pericardium, is a rare occurrence. Such a fistula is usually associated with a huge ulcer in the gastric fundus, an ulcer within a hiatus hernia, a history of esophagogastric surgery, the concurrent use of non-steroidal anti-inflammatory drugs (NSAIDs), or Zollinger-Ellison syndrome. The patient in this case presented with shoulder pain and melena, caused by a gastropericardial fistula that had occurred as a late complication of postoperative esophagogastrostomy and a refractory gastric ulcer. Despite the severity of the condition, the patient showed great improvement after medical treatment and the fistula was cured at the end.
Esophagectomy/*methods
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Gastric Fistula/*diagnosis/*etiology
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Humans
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Male
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Middle Aged
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Pericardium/*pathology
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Stomach Ulcer/*complications/*surgery
4.Gastrectomy for the treatment of refractory gastric ulceration after radioembolization with 90Y microspheres.
Sun Young YIM ; Jin Dong KIM ; Jin Yong JUNG ; Chang Ha KIM ; Yeon Seok SEO ; Hyung Joon YIM ; Soon Ho UM ; Ho Sang RYU ; Yun Hwan KIM ; Chong Suk KIM ; Eun SHIN
Clinical and Molecular Hepatology 2014;20(3):300-305
Transcatheter arterial radioembolization (TARE) with Yttrium-90 (90Y)-labeled microspheres has an emerging role in treatment of patients with unresectable hepatocellular carcinoma. Although complication of TARE can be minimized by aggressive pre-evaluation angiography and preventive coiling of aberrant vessels, radioembolization-induced gastroduodenal ulcer can be irreversible and can be life-threatening. Treatment of radioembolization-induced gastric ulcer is challenging because there is a few reported cases and no consensus for management. We report a case of severe gastric ulceration with bleeding that eventually required surgery due to aberrant deposition of microspheres after TARE.
Aged
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Carcinoma, Hepatocellular/*diagnosis/radiotherapy
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Embolization, Therapeutic/*adverse effects
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Gastrectomy
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Gastrointestinal Hemorrhage/etiology
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Gastroscopy
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Humans
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Liver Neoplasms/*diagnosis/radiotherapy
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Magnetic Resonance Imaging
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Male
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*Microspheres
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Radiopharmaceuticals/therapeutic use
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Stomach/pathology
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Stomach Ulcer/*etiology/surgery
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Yttrium Radioisotopes/chemistry
5.Non-healing Iatrogenic Gastric Ulcers after Endoscopic Mucosal Resection for Gastric Epithelial Neoplasia: Report of Two Cases.
Soo Hyeon LEE ; Jae Hee CHEON ; Jie Hyun KIM ; Jong Pill PARK ; Sang Kil LEE ; Yong Chan LEE
The Korean Journal of Gastroenterology 2008;51(2):127-131
Endoscopic mucosal resection (EMR) is widely accepted as a standard treatment for early gastric cancer or gastric adenoma. However, EMR inevitably results in the formation of large iatrogenic ulcer at the resected area. Although the characteristics of EMR-induced ulceration are not fully understood, this type of ulcer is thought to heal faster and to recur less often than non-iatrogenic gastric ulcer. Current available evidences have suggested that EMR-induced ulcers heal within 2-3 months. Herein, we report two cases of non-healing persistent gastric ulcers after EMR. One is a case of gastric carcinoma which developed at the same site of previous EMR site for the low grade dysplasia. The other is a case in which persistent EMR-induced ulcer was healed in the long run after Helicobacter pylori eradication therapy.
Aged
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Endoscopy, Gastrointestinal
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Gastric Mucosa/pathology/*surgery
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Helicobacter Infections/complications/drug therapy
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Helicobacter pylori
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Humans
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Iatrogenic Disease
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Male
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Middle Aged
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Stomach Neoplasms/complications/diagnosis/*surgery
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Stomach Ulcer/diagnosis/*etiology/pathology
6.A Case of Subcapsular Liver Abscess Secondary to Perforating Ulcer of Gastric Cancer.
Do Hyeong KIM ; Chang Hun LEE ; Hyun Gwang JUNG
The Korean Journal of Gastroenterology 2010;56(2):109-112
Intrahepatic abscess is an unusual complication of peptic ulcer disease. We present a case of gastric cancer in which the ulcer penetrated into the left lobe of liver with subsequent abscess and fistula formation. Esophagogastroduodenoscopy confirmed ulcers and a fistula opening in the antrum. Abdominal computed tomogram showed a subcapsular liver abscess adjacent to the gastric antrum. Subtotal gastrectomy with curettage of the fistulous tract was performed. The final diagnosis was the signet ring cell gastric carcinoma complicating subcapsular liver abscess. To our knowledge, this is the first reported case in Korea.
Endoscopy, Gastrointestinal
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Female
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Humans
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Klebsiella pneumoniae/isolation & purification
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Liver Abscess/diagnosis/*etiology/microbiology
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Middle Aged
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Peptic Ulcer Perforation/*complications/diagnosis
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Stomach Neoplasms/complications/*diagnosis/surgery
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Tomography, X-Ray Computed
7.Guidelines for the Diagnosis and Treatment of Helicobacter pylori Infection in Korea, 2013 Revised Edition.
Sang Gyun KIM ; Hye Kyung JUNG ; Hang Lak LEE ; Jae Young JANG ; Hyuk LEE ; Chan Gyoo KIM ; Woon Geon SHIN ; Ein Soon SHIN ; Yong Chan LEE
The Korean Journal of Gastroenterology 2013;62(1):3-26
Since the Korean College of Helicobacter and Upper Gastrointestinal Research has first developed the guideline for the diagnosis and treatment of Helicobacter pylori infection in 1998, the revised guideline was proposed in 2009 by the same group. Although the revised guideline was made by comprehensive review of previous articles and consensus of authoritative expert opinions, the evidence-based developmental process was not applied in the revision of the guideline. This new guideline has been revised especially in terms of changes in the indication and treatment of H. pylori infection in Korea, and developed by the adaptation process as evidence-based method; 6 guidelines were retrieved by systematic review and the Appraisal of Guidelines for Research and Evaluation (AGREE) II process, 21 statements were made with grading system and revised by modified Delphi method. After revision, 11 statements for the indication of test and treatment, 4 statements for the diagnosis and 4 statements for the treatment have been developed, respectively. The revised guideline has been reviewed by external experts before the official endorsement, and will be disseminated for usual clinical practice in Korea. Also, the scheduled update and revision of the guideline will be made periodically.
Amoxicillin/therapeutic use
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Anti-Bacterial Agents/therapeutic use
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Aspirin/therapeutic use
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Bismuth/therapeutic use
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Breath Tests
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Clarithromycin/therapeutic use
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Gastroesophageal Reflux/etiology
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Gastroscopy
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Helicobacter Infections/complications/*diagnosis/drug therapy
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*Helicobacter pylori
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Humans
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Lymphoma, B-Cell, Marginal Zone/complications
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Metaplasia/complications
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Metronidazole/therapeutic use
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Peptic Ulcer/complications/drug therapy
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Proton Pump Inhibitors/therapeutic use
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Republic of Korea
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Stomach Neoplasms/complications/surgery
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Tetracycline/therapeutic use