Fexuprazan, a potassium‐competitive acid blocker, is increasingly used for the treatment of gastroesophageal reflux disease in South Korea. While generally well tolerated, data regarding its hepatotoxic potential are scarce. We report a case of idiosyncratic drug‐induced liver injury in a 61‐year‐old woman following 2 months of fexuprazan therapy. She presented with fatigue and elevated liver enzymes, and liver biopsy demonstrated single‐cell necrosis, interface hepatitis and eosinophilic infiltration—features consistent with drug‐induced liver injury. Her liver function normalized after drug discontinuation. However, approximately 20 months later, the patient experienced a recurrence of liver injury after unintentionally being prescribed fexuprazan again. The second episode showed similar biochemical and histological features, fulfilling Hy's law criteria and increasing the RUCAM score from probable to highly probable . Pharmacokinetic analysis during the first episode revealed a prolonged elimination half‐life, suggestive of impaired metabolism during active hepatic injury. Pharmacogenetic testing revealed a cytochrome P450 enzyme 2C19 poor metabolizer genotype, although its clinical relevance was limited in this case. This report highlights a rare but reproducible adverse drug reaction to fexuprazan and emphasizes the importance of thorough drug history and postmarketing surveillance. To our knowledge, this is the first report of recurrent fexuprazan‐induced liver injury confirmed by unintentional re‐exposure.

The recurrence rate of choledocholithiasis in the general population has been reported to exceed 10%. The incidence of cholelithiasis was reported to be higher in patients following gastrectomy than that in the general population. However, there is no study for recurrent choledocholithiasis incidence in patients following gastrectomy. This study aimed to evaluate the recurrence rate of choledocholithiasis and identify risk factors for recurrent choledocholithiasis in patients following gastrectomy. A retrospective analysis was performed on patients with gastrectomy history who underwent choledocholithiasis removal in Kyungpook National University Hospital between January 2011 and December 2019. Choledocholithiases were treated by endoscopic retrograde cholangiopancreatography (ERCP) (n = 41) or percutaneous transhepatic biliary drainage (PTBD) (n = 90). The gastrectomy type was classified as subtotal gastrectomy with Billroth I (18.3%), Billroth II (45.0%), and total gastrectomy with Roux-en-Y (36.6%). During a median follow-up period of 31.5 (range, 6–105) months, choledocholithiasis recurrence was noted in 19 of 131 patients (14.5%). In subgroup analysis, the ERCP group (24.4%) had higher choledocholithiasis recurrence than the PTBD group (10.0%). Stone removal modality (ERCP), no use of balloon sphincteroplasty, and the presence of periampullary diverticulum were significant risk factors for recurrent choledocholithiasis. In multivariate analysis, ERCP (hazard ratio (HR), 3.597; 95% confidence interval (CI): 1.264–10.204) CBD stricture (HR, 3.823; 95% CI: 1.118–13.080) and no use of balloon sphincteroplasty (HR, 4.830; 95% CI: 1.669–13.889) were risk factors for recurrent choledocholithiasis following stone removal. The incidence of CBD stones in patients who underwent gastrectomy is similar to that of the general population. ERCP, CBD stricture, and no use of balloon sphincteroplasty are potential risk factors for recurrent CBD stones following gastrectomy. When we consider PTBD disadvantages, the ERCP procedure with active use of balloon sphincteroplasty is recommended to decrease recurrent CBD stones.

국내 장애인 보조기기의 개발은 보조기기의 기능 구현에 초점이 가 있으며 보조기기의 사용성에 대한 고려가 부족한 실정이다. 국내 영세한 보조기기 산업의 국제 경쟁력 확보를 위해서는 보조기기의 기능뿐 아니라 사용에 대한 고려가 필요할 것이다. 이러한 국제 경쟁력 확보를 위한 국가 차원의 지원 대책은 보조기기와 보조기기 산업 관련 법률과 규격에 대한 제·개정으로 부터 시작한다고 본다. 따라서 본 연구에서는 국내 장애인 보조기기 관련 법률과 보조기기 관련 규격 및 지침에 대해 사용성이라는 프레임을 통해 분석하였다. 이를 위해, 본 연구에서 사용하는 보조기기의 사용성, 사용품질을 정의하고, 관련 이론적 배경을 통해 국내 장애인 보조기기 관련 법률로 장애인복지법, 보조기기 지원법을 살펴보았다. 이러한 보조기기 관련 법률의 현황을 바탕으로 국내 장애인 보조기기 관련 규격 중 사용성과 관련이 있는 규격과 지침을 3가지를 선정하고, 그 규격과 지침의 지향성을 Hancock의 인간 공학적, 쾌락적 욕구 위계로 분석하였다. 현재 국내에는 보조기기의 특성을 고려하여 보조기기만을 위한 사용성 규격 및 지침은 없다. 하지만 장애인 사용자를 대상으로 하는 제품군인 보조기기 사용성에 대한 규격 및 지침은 그 특성에 맞는 내용으로 구성되어 만들어져야 할 것이고, 해당 법규정과 관련 가이드라인은 특히나 사용자의 특성과 사용 맥락을 고려하여 장애인 개인의 일상생활 용품으로서의 사용성 증진을 도모할 수 있는 내용으로 구성되어야 할 것이다.