Review Article 2023-12-25 2023-12-25 2 1408 951

헬리코박터 이외의 감염성 위 질환

Infectious Gastric Diseases Other than Helicobacter

조혜민, 신철민

Hyemin Jo, Cheol Min Shin

Abstract

PDF Cite Share

In addition to Helicobacter pylori, the acute bacterial causes of infectious gastritis, include phlegmonous gastritis, gastric tuberculosis, and gastric syphilis. Bacterial gastritis often improves with appropriate broad-spectrum antibiotics, emphasizing the need for prompt diagnosis and treatment based on the clinical and endoscopic findings. Among viral gastritis, cytomegalovirus gastritis, primarily occurring in immunocompromised patients, necessitates antiviral intervention, while immunocompetent individuals typically achieve amelioration by administering proton pump inhibitors. In contrast, most gastric infections caused by the Epstein-Barr virus (EBV) are asymptomatic, but an EBV infection is a cause of stomach cancer. EBV-associated gastric cancer exhibits distinct clinical, pathological, genetic, and post-genetic mutation features, making it clinically significant. The colonization of Candida albicans in the stomach is uncommon, and typical antifungal treatment is unnecessary. Candida infections in gastric ulcers can be treated with anti-ulcer treatment alone. Lastly, anisakidosis in the stomach, which occurs when consuming raw seafood, can manifest in various clinical presentations and is typically treated through endoscopic removal of the nematode. This article aims to contribute to the rapid diagnosis and treatment of rare stomach infections beyond Helicobacter pylori in real clinical situations.

Original Article 2023-12-25 2023-12-25 0 513 377

Association Preoperative Protein Adequacy and Post Elective Laparotomy Surgical Site Infection

Davie Muhamad¹, Nurul Ratna Mutu Manikam¹ , Ridho Ardhi Syaiful²

Abstract

PDF Cite Share

Background/Aims: Postoperative complications tend to occur in high-risk populations, including those undergoing major surgery. Surgical site infections (SSI) are some of the most common postoperative complications in laparotomy procedures. Surgery induces a postoperative stress response, triggering an inflammatory process that increases muscle protein proteolysis. Preoperative protein intake increases muscle protein reserves and supports postoperative wound healing and immunity. This study analyzed the association between preoperative protein adequacy and post-elective laparotomy SSI.
Methods: A prospective cohort study was conducted on 93 subjects with an adequate protein group of 48 subjects and an inadequate protein group of 45 subjects undergoing elective laparotomy at Dr. Cipto Mangunkusumo Hospital, Jakarta. The protein adequacy was analyzed using an interview method for seven days preoperatively. Patient monitoring was carried out for 30 days postoperatively to assess the complications in the form of SSIs. The association between protein adequacy and SSI was analyzed using a Chi-Square test, and multivariate analysis was performed to assess the factors most associated with post-elective laparotomy SSI.
Results: An association was observed between preoperative protein adequacy and post-elective laparotomy SSI (RR 3.413; 95% CI, 1.363–8.549; p=0.004). Multivariate analysis showed that the preoperative protein adequacy and preoperative albumin levels were strongly predictive of the occurrence of SSI.
Conclusions: The preoperative protein adequacy and albumin levels were strongly related to predicting the post-elective laparotomy SSI.

Case Report 2023-12-25 2023-12-25 0 1327 565

전이성 대장암 환자에서 Cetuximab-FOLFOX 항암 치료 후 발생한 Leucovorin에 의한 과민반응: 증례 보고

Leucovorin-induced Hypersensitivity Reaction in a Patient with Metastatic Colorectal Cancer Treated with Cetuximab Plus FOLFOX Chemotherapy: A Case Report

김민나^1,*, 김동현^1,*, 이종윤¹, 남영희², 이종훈¹

Minna Kim^1*, Dong Hyun Kim^1*, Jong Yoon Lee¹ , Young-Hee Nam², Jong Hoon Lee¹

Abstract

PDF Cite Share

The FOLFOX regimen (combination of leucovorin, 5-fluorouracil, and oxaliplatin) is the first-line treatment for high-risk stage 2 and 3 colorectal cancer patients. While hypersensitivity reactions (HSRs) caused by oxaliplatin are commonly reported, HSRs due to leucovorin have been infrequently reported. This report aims to investigate the clinical presentation, diagnosis, and management of leucovorin induced HSRs. A 60-year-old female developed generalized edema, dyspnea, and facial redness during cetuximab plus FOLFOX chemotherapy administered for management of metastatic colorectal cancer. Because HSRs induced by oxaliplatin are commonly reported, we initially presumed an oxaliplatin-induced HSR. However, despite undergoing oxaliplatin desensitization, HSRs persisted, and they were still observed when leucovorin was administered without oxaliplatin. The patient was diagnosed with leucovorin-induced HSR and underwent leucovorin desensitization. However, the reactions recurred within 30 minutes of the initiating the desensitization. Considering unsuccessful leucovorin desensitization, leucovorin was excluded. The patient received cetuximab and oxaliplatin chemotherapy without leucovorin to date without any adverse effects. While leucovorin-induced HSRs are infrequently reported, they should still be regarded as potential adverse effects.

Case Report 2023-12-25 2023-12-25 1 835 505

혈관플러그를 이용한 역행성 경정맥 폐색술에 의한 십이지장 정맥류 출혈의 치료: 증례 보고

Plug-Assisted Retrograde Transvenous Obliteration for the Treatment of Duodenal Variceal Bleeding - A Case Report and Literature Review

이경규¹, 박재용¹, 최우선², 조영윤¹

Kyung Kyu Lee¹, Jae Yong Park¹ , Woo Sun Choi², Young Youn Cho¹

Abstract

PDF Cite Share

Duodenal varices are uncommon complications of portal hypertension. Although duodenal variceal bleeding is infrequent, it is a life-threatening condition with a high mortality rate. Non-surgical methods for duodenal variceal bleeding include endoscopic band ligation, endoscopic sclerotherapy, transjugular intrahepatic portosystemic shunt, and retrograde transvenous obliteration. On the other hand, an optimal treatment strategy for this rare condition has not been established. A 38-year-old male with a history of alcoholic liver cirrhosis presented with hematemesis. An emergency esophagogastroduodenoscopy (EGD) revealed large, multiple varices in the second portion of the duodenum, and plug-assisted retrograde transvenous obliteration (PARTO) was performed accordingly. Gastrointestinal bleeding was resolved after the procedure. Follow-up EGD conducted after 11 weeks revealed complete obliteration of the previously observed duodenal varices. PARTO may be considered a viable option for treating duodenal variceal bleeding.

Case Report 2023-12-25 2023-12-25 0 483 342

Unique Case of Severe Sepsis and Acute Respiratory Failure in the Setting of Aseptic Epiploic Appendagitis of the Descending Colon

Nathaniel J. Leavitt¹ , Usman S. Kazi¹, Ryan Cromwell¹, Fagunkumar Modi²

Abstract

PDF Cite Share

Epiploic appendagitis (EA) is an uncommon intraabdominal pathology resulting in transient, localized pain. The condition is caused by ischemia of one of the epiploic appendages, which are distributed axially along the length of the colon. EA is often mistaken for other more common etiologies of an acute abdomen. Generally, the patients experience focal abdominal pain with no further symptoms or laboratory abnormalities. The authors encountered a 79-year-old male with severe sepsis and acute respiratory failure requiring intubation. He recovered rapidly after the identification and removal of a single EA. This paper reports the first case of EA leading to the systemic dysregulation of sepsis.

Case Report 2023-12-25 2023-12-25 1 655 403

간경변 환자에서 소장 정맥류 출혈의 경동맥 색전술 치료: 증례 연구

Small Bowel Variceal Bleeding in Patients with Liver Cirrhosis Treated with Transarterial Embolization: Case Series

서보람¹, 이주호¹, 장은정¹, 박상운¹, 박주상¹, 박상종¹, 김상중¹, 연재우², 이아영³, 서준영¹

Boram Seo¹, Ju Ho Lee¹, Eun Jeong Jang¹, Sang Woon Park¹, Ju Sang Park¹, Sang Jong Park¹, Sang-Jung Kim¹, Jae Woo Yeon², Ah Young Lee³, Jun-young Seo¹

Abstract

PDF Cite Share

Small bowel variceal bleeding is a rare cause of gastrointestinal hemorrhage, with clinical manifestations ranging from asymptomatic incidental findings to life-threatening conditions. The diagnosis and management of small bowel bleeding are challenging because of the localization of the lesion and the difficulty of the procedure. Trans-arterial embolization (TAE) is a secure and straightforward method for treating ectopic varices. On the other hand, there have been limited local studies on the outcomes of TAE for patients with small bowel variceal hemorrhage. This paper reports patients diagnosed with small bowel variceal bleeding and treated with TAE.

Image of the month 2023-12-25 2023-12-25 0 484 460

면역 글로불린 G4 연관 질환

Immunoglobulin G4-related Disease

문성훈

Sung-Hoon Moon

PDF Cite Share

Research update 2023-12-25 2023-12-25 0 315 280

면역관용기에서 면역활동기로 접어드는 HBeAg 양성인 만성 B형간염 환자에서 간세포암종의 발생에 대한 예측모델 개발

PAGE-B with Moderate HBV DNA Levels Predicts Risk of Hepatocellular Carcinoma among Patients at Phase Change from Immuno-tolerant Phase to Immune-active Phase in HBeAg-Positive Chronic Hepatitis B

이민종^1,2

Minjong Lee^1,2

PDF Cite Share