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An Unusual Cause of Acute Pancreatitis 一种罕见的急性胰腺炎病因
Pub Date : 2021-12-01 DOI: 10.52927/jdcr.2021.9.2.75
J. Choe
createctomy to treat T2N1M0 pancreatic tail cancer. After six weeks of surgery, the patient’s general condition was good, and a total of six cycles of primary adjuvant chemotherapy with 5-fluorouracil (5-FU) (425 mg/m) and folic acid (20 mg/m) every four weeks was planned. After the end of the third cycle of chemotherapy, the patient visited the emergency room with epigastric pain and mild fever. The blood tests revealed 635 IU/L amylase and 559 IU/L lipase. The other laboratory results were within the normal ranges. Abdominal computed tomography (CT) revealed fluid collection at the pancreatic resection margin with diffuse mesenteric and omental infiltration in the pericolic (hepatic flexure colon, transverse colon), perigastric, and periduodenal regions (Fig. 1). There was no evidence of postoperative leakage of pancreatic juice, recurring pancreatic cancer, or gallstones. He had not taken any over-the-counter drugs and had no history of alcohol consumption or other risk factors commonly associated with pancreatitis. The diagnosis of acute pancreatitis was made without a definite etiology. During the next two weeks, he received conservative care and bowel rest with intravenous hydration. The complaint symptoms were diminished and pancreatic enzyme levels were also normalized. He was discharged from the hospital and planned to be admitted again on his next scheduled chemotherapy day. However, a recurrent pancreatitis episode occurred two days following the completion of the 5-FU infusion in the next (fourth) cycle. At that time, severe abdominal pain persisted, and the serum amylase and lipase levels had increased to 419 IU/L and 393 IU/L, respectively. A CT scan was performed and revealed that inflammatory infiltration into the mesentery and omentum had progressed more extensively than in the previous examination. Multiple large pseudocysts were observed around the pancreas (Fig. 2). However, the cause of recurrent pancreatitis was not clearly determined in the CT scan or the following magnetic resonance imaging. All the possible common causes of acute pancreatitis were excluded. Moreover, considering the relationship between the time of administration of the chemotherapeutic agents and the recurrence of pancreatitis follow-
胰腺切除术治疗T2N1M0型胰腺癌。手术6周后,患者总体情况良好,计划每4周以5-氟尿嘧啶(5-FU) (425 mg/m)和叶酸(20 mg/m)为主辅助化疗共6个周期。第三周期化疗结束后,患者因上腹疼痛和轻度发热来到急诊室。血液检测淀粉酶635 IU/L,脂肪酶559 IU/L。其他化验结果均在正常范围内。腹部计算机断层扫描(CT)显示胰腺切除边缘有积液,并在肠系膜和大网膜弥漫性浸润(肝弯曲结肠、横结肠)、胃周和十二指肠周围区域(图1)。术后无胰液漏、复发胰腺癌或胆结石的证据。他没有服用任何非处方药,也没有饮酒史或其他与胰腺炎相关的危险因素。急性胰腺炎的诊断没有明确的病因。在接下来的两周内,他接受了保守治疗和肠道休息,静脉补水。主诉症状减轻,胰酶水平也恢复正常。他出院了,并计划在他的下一个化疗日再次入院。然而,在下一个(第四个)周期中,5-FU输注完成后2天,复发性胰腺炎发作。此时,严重腹痛持续,血清淀粉酶和脂肪酶水平分别升高至419 IU/L和393 IU/L。CT扫描显示炎症浸润到肠系膜和网膜的进展比之前的检查更广泛。胰腺周围可见多个较大的假性囊肿(图2)。然而,在CT扫描或随后的磁共振成像中,胰腺炎复发的原因尚不明确。排除所有可能引起急性胰腺炎的常见原因。此外,考虑到化疗药物给药时间与胰腺炎复发的关系
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引用次数: 0
Recent Advance in the Management of Dysplasia in the Ulcerative Colitis 溃疡性结肠炎发育不良的治疗进展
Pub Date : 2021-12-01 DOI: 10.52927/jdcr.2021.9.2.50
Dong-Hoon Yang
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引用次数: 0
Update of Korean Standard Classification of Diseases for Rectal Carcinoid and Its Clinical Implication 韩国直肠类癌疾病标准分类的更新及其临床意义
Pub Date : 2021-12-01 DOI: 10.52927/jdcr.2021.9.2.57
Eun Soo Kim
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引用次数: 0
Postoperative Clinical Outcomes of Colonic Stent Placement as Bridge-to-surgery vs. Emergency Surgery in Left-sided Malignant Colonic Obstruction 结肠支架置入术与急诊手术治疗左侧恶性结肠梗阻的术后临床效果对比
Pub Date : 2021-12-01 DOI: 10.52927/jdcr.2021.9.2.43
Eun Ju Choe, Yong Kang Lee, H. Jeon, Jongwon Choi, B. Park, S. Won, J. Seo, C. Lee, Yong Suk Cho
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引用次数: 0
Premalignant Lesions of the Small Intestine 小肠癌前病变
Pub Date : 2021-12-01 DOI: 10.52927/jdcr.2021.9.2.60
S. Kim, Ji Won Kim
Tumors of the small intestine are rare and generally asymptomatic or with nonspecific symp-toms. The small intestine is difficult to approach using conventional endoscopy, and early diagnosis of the small intestinal tumors is difficult. Therefore, many of the small intestinal tumors are diagnosed at an advanced stage, which makes the prognosis poor. Premalignant lesions of the small intestine or known risk factors of small bowel cancer are sporadic adenoma, adenoma associated with familial adenomatous polyposis, hamartomatous polyp associated with Peutz-Jeghers syndrome, Crohn’s disease, and celiac disease. Therefore, it is necessary to recognize that the small bowel cancer can occur in these patients with premalignant lesions or risk factors of small bowel cancer. To reduce the possibility of small bowel cancer or to detect at an earlier stage, attention should be paid to screening and surveillance of these patients with premalignant lesions or risk factors of the small bowel cancer.
小肠肿瘤是罕见的,通常无症状或有非特异性症状。传统的内镜很难接近小肠,小肠肿瘤的早期诊断也很困难。因此,许多小肠肿瘤都是在晚期诊断出来的,这使得预后很差。小肠癌前病变或已知的小肠癌症危险因素包括散发性腺瘤、与家族性腺瘤性息肉病相关的腺瘤、与Peutz-Jeghers综合征相关的错构瘤性息肉、克罗恩病和乳糜泻。因此,有必要认识到癌症可能发生在这些具有癌前病变或小肠癌癌症危险因素的患者身上。为了减少患癌症的可能性或早期发现,应注意对这些有癌前病变或癌症危险因素的患者进行筛查和监测。
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引用次数: 1
Immune Checkpoint Inhibitors in Advanced Colorectal Cancer 免疫检查点抑制剂在晚期结直肠癌中的应用
Pub Date : 2021-12-01 DOI: 10.52927/jdcr.2021.9.2.71
J. Cheon
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引用次数: 0
Multiple Rectal Neuroendocrine Tumor 直肠多发性神经内分泌肿瘤
Pub Date : 2021-12-01 DOI: 10.52927/jdcr.2021.9.2.68
Sojung Han, Jun Yong Kim, Jae Jun Park
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引用次数: 0
The United States System for Training of Gastroenterologists in Oncology. 美国肿瘤胃肠病学家培训系统。
Pub Date : 2014-01-01
John M Carethers

Competency for practicing gastroenterology in the United States requires accredited training in Internal Medicine, followed by accredited training in gastroenterology and hepatology. The structured training encompasses a 3-year period after graduation with a medical degree for internal medicine, followed by a 3-year period for gastroenterology and hepatology. Within the gastroenterology training period, competency in oncology knowledge and procedural approaches to luminal and solid gastrointestinal organ cancers is required, whereas knowledge competency but not procedural competency is required in areas of advanced endoscopic procedures for cancer care. Only general knowledge, but not competency, is required for areas such as chemotherapy, which can be obtained with further optional training in a structured 2-year oncology fellowship program. Although there is no standardization to date for including full oncology training within a gastroenterology training program in the United States, there is great interest from gastroenterology professional societies to include a pathway for trainees within the gastroenterology training program.

在美国,胃肠病学的执业能力需要经过内科的认证培训,然后是胃肠病学和肝病学的认证培训。有组织的培训包括内科医学学位毕业后的3年时间,然后是胃肠病学和肝病学的3年时间。在胃肠病学培训期间,需要具备肿瘤学知识和管腔和实体胃肠道器官癌症的程序方法的能力,而在癌症护理的高级内窥镜手术领域,只需要知识能力而不需要程序能力。化疗等领域只需要一般知识,而不需要能力,这可以通过为期两年的结构化肿瘤学奖学金项目的进一步选修培训获得。尽管到目前为止,在美国胃肠病学培训计划中还没有包括完整的肿瘤学培训的标准化,但胃肠病学专业协会对在胃肠病学培训计划中包括培训人员的途径非常感兴趣。
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引用次数: 0
Current and Future Role of the Gastroenterologist in GI Cancer Management. 胃肠病学家在胃肠道癌症管理中的当前和未来角色。
Pub Date : 2013-11-01
John M Carethers

With advances in technology, advances in the understanding of biology of cancer, and the advent of improved and novel therapies, the role of the gastroenterologist has been modified greatly over the past 2 decades, and continues to be shaped by the knowledge, skill, and opportunity to capitalize on the unique position that gastroenterologists hold in the patient care continuum. The gastroenterologist is evolving from a "pure" diagnostician to an endoscopic surgeon, a geneticist, a nutritionist, an immunologist and chemotherapist, and palliative care physician.

随着技术的进步,对癌症生物学的理解的进步,以及改进的新疗法的出现,在过去的20年里,胃肠病学家的角色已经发生了很大的变化,并继续受到知识、技能和机会的影响,以充分利用胃肠病学家在病人护理连续体中的独特地位。胃肠病学家正在从一个“纯粹的”诊断医师发展成为内窥镜外科医生、遗传学家、营养学家、免疫学家和化疗师,以及姑息治疗医师。
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引用次数: 0
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Journal of digestive cancer reports
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