3) 간암 (HCC, Hepatic cellular carcinoma)
1. 원인 및 병태생리
-만성B형간염이나 C형 간염, 지속적인 과량의 음주, 간경변 등
2. 증상 및 징후
-간이 있는 오른쪽 윗배에 덩어리 촉진됨
-간암이 빠르게 커질 때는 같은 부위에 통증이 발생, 황달현상
3. 치료 및 환자관리
-수술: 간 절제술, 간이식, 경동맥 화학
lower esophageal sphincter (LES) pressure, and impaired esophageal motility
Considerable morbidity and complications (such as esophageal ulcerations, peptic strictures, and Barrett's esophagus)
Heartburn is the 5th most common gastrointestinal complaint
The 2nd leading outpatient/ 7th most common inpatient gastrointestinal diagnosis
The most costly gastrointestinal disease in 2000 (
gastric neoplasms
Gastric cancer incidence has decreased worldwide high : in Japan, China
The risk of gastric cancer is greater among lower socioecomomic classes.
Cancer risk : increases with age
Peak age : 65~74
Male>Female
usually no symptoms
Weight loss
Abdominal pain
Nausea and anorexia
Dysphagia
Continuous abdominal pain
free perforation - peritonitis
lower than that in highly sensitive organs such as the skin and because the innervation of most viscera is multisegmental. The pain is generally described as cramping, burning, or gnawing. Secondary autonomic effects such as sweating, restlessness, nausea, vomiting, perspiration, and pallor often accompany visceral pain. The patient may move about in an effort to relieve the discomfort.
증례에 대한 전체적인 분석
환자는 58세 남자로
양쪽 하지에 피부 발진과 복통, 소화불량, 혈변 및 흑색변을 주소로 내원.
과거력으로는 20년 전 B형 간염 보균자이었다는 점과 20pac/years의 흡연력을 지니고 그 밖의 특이적인 병력 및 수술력은 없음.
진단을 위해 시행한 검사 결과, CBC에서 경도의 anemia