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JYMS : Journal of Yeungnam Medical Science

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2 "Hyun Lim"
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Case Reports
Gastroenterology and Hepatology
Massive bleeding from a rectal Dieulafoy lesion in a patient with alcoholic cirrhosis
Young Hoon Choi, Jong Ryeol Eun, Jae Ho Han, Hyun Lim, Jung A Shin, Gun Hwa Lee, Seung Hee Lee
Yeungnam Univ J Med. 2017;34(1):88-90.   Published online June 30, 2017
DOI: https://doi.org/10.12701/yujm.2017.34.1.88
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AbstractAbstract PDF
Although Dieulafoy lesion can occur in any part of the gastrointestinal tract, its occurrence in the rectum is rare. Rectal Dieulafoy lesions have been associated with advanced age, renal failure, burns, liver transplantation and cirrhosis. Here, we report on a case of massive bleeding from a rectal Dieulafoy lesion after lung decortication surgery in a 57-year-old male patient with alcoholic cirrhosis. Although rare, a rectal Dieulafoy lesion should be included in the differential diagnosis of massive lower gastrointestinal bleeding in a patient with cirrhosis.
Nephrology
Metformin induced acute pancreatitis and lactic acidosis in a patient on hemodialysis.
Yeon Kyung Lee, Kihyun Lim, Su Hyun Hwang, Young Hwan Ahn, Gyu Tae Shin, Heungsoo Kim, In Whee Park
Yeungnam Univ J Med. 2016;33(1):33-36.
DOI: https://doi.org/10.12701/yujm.2016.33.1.33
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  • 22 Download
  • 1 Crossref
AbstractAbstract PDF
Metformin, commonly prescribed for type 2 diabetes, is considered safe with minimal side-effect. Acute pancreatitis is rare but potentially fatal adverse side-effect of metformin. We report a patient on hemodialysis with metformin-related acute pancreatitis and lactic acidosis. A 62-year-old woman with diabetic nephropathy and hypertension presented with nausea and vomiting for a few weeks, followed by epigastric pain. At home, the therapy of 500 mg/day metformin and 50 mg/day sitagliptin was continued, despite symptoms. Laboratory investigations showed metabolic acidosis with high levels of lactate, amylase at 520 U/L (range, 30-110 U/L), and lipase at 1,250 U/L (range, 23-300 U/L). Acute pancreatitis was confirmed by computed tomography. No recognized cause of acute pancreatitis was identified. Metformin was discontinued. Treatment with insulin and intravenous fluids resulted in normalized amylase, lipase, and lactate. When she was re-exposed to sitagliptin, no symptoms were reported.

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