• Title/Summary/Keyword: 개복술

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Treatment of Ongoing Bleeding after a Damage Control Laparotomy for a Pelvic Bone Fracture: Arterial Embolization -A Case Report- (골반골 골절에서 손상 제어 개복술 후 지속적인 출혈의 치료: 동맥 색전술 -증례보고-)

  • Kim, Ki-Hoon;Kyung, Kyu-Hyouk;Kim, Jin-Su;Park, Sung-Jin;Nam, So-Hyun;Kim, Woon-Won;Kim, Yong-Han
    • Journal of Trauma and Injury
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    • v.24 no.2
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    • pp.159-163
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    • 2011
  • Massive bleeding due to traumatic pelvic bone fracture is a leading cause of death. Thus, several methods to control bleeding have been attempted, but none of these has yet been clearly established. After an automobile accident, a 34-year-old motorist was admitted to the Emergency Department for right hip,leg and abdominal pain. Because the patient's pressure remained consistently low and pelvic bone fracture and abdominal bleeding were found on radiologic examination, an explorative laparotomy was performed. After pelvic packing and bleeding control, bleeding still continued, so Angiography was performed, and arterial embolization for bleeding was performed.

A Case of Intussusception Caused by Meckel's Diverticulum in a Newborn (신생아에서 멕켈게실에 의해 유발된 장중첩증 1례)

  • Yu, Seung Taek;Oh, Yeon Kyun;Park, Won Churl;Kim, Eun A;Lee, Chang Woo;Yoon, Hyang Suk
    • Clinical and Experimental Pediatrics
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    • v.48 no.8
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    • pp.907-910
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    • 2005
  • Intussusception and Meckel's diverticulum are very rare disorders in intrauterine or neonatal periods, which are causes of intestinal obstruction. We experienced a case of intussusception due to Meckel's diverticulum which caused intestinal obstruction in the neonate who had bilious vomiting a few hours after birth. We report this case with a brief review of the literature.

A Case of Congenital Chloride Diarrhea in Premature Infant (Congenital Chloride Diarrhea 1례)

  • Yoon, Sung Kwan;Kim, Eun Young;Moon, Kyung Rye;Park, Sang Kee
    • Clinical and Experimental Pediatrics
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    • v.46 no.3
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    • pp.308-311
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    • 2003
  • Congenital chloride diarrhea is a serious autosomal recessive disease, and defect of intestinal electrolyte absorption that involves, specifically, $Cl^-/{HCO_3}^-$ exchange in the distal part of the ileum and colon. The clinical feature is dominated by profuse, watery diarrhea containing high concentrations of chloride(>90 mmol/L) and sodium. The chloride loss results in severe dehydration with a hypochloremic alkalosis. The molecular pathology involves an epithelial $Cl^-/{HCO_3}^-$ exchanger protein. Mucosal ion transport is affected to differing degrees and the severity of the disease may thus vary. Recently, a gene defect on chromosome 7 has been identified. However, there was a deficit in replacement of fluid and electrolyte, abdominal distension remained and the character of stools was watery. We report a case of congenital chloride diarrhea in a premature female who presented with watery diarrhea containing high concentrations of chloride and abdominal distension.

Factors Affecting Intraoperative Body Temperature in Surgical Patients with Laparotomy under General Anesthesia (전신마취하 개복술 환자의 수술중 체온에 영향을 미치는 요인)

  • Lee, Seohyun;Yoon, Haesang
    • Journal of Korean Biological Nursing Science
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    • v.17 no.3
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    • pp.236-244
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    • 2015
  • Purpose: The study was conducted to identify factors affecting the intraoperative core body temperature (CBT) of surgical patients under general anesthesia. Methods: This study was performed through a prospective descriptive research design. The sample consisted of 138 patients who had undergone elective laparotomy surgery. Age, weight, height, the basal preoperative CBT, blood pressure, and heart rate were collected. CBT was again measured at induction of anesthesia, 1 hour, 2 hours, and 3 hours following induction of general anesthesia. Results: Factors affecting intraoperative hypothermia < $36^{\circ}C$ at 1 hour following induction, were CBT at induction and total body fat (TBF) ($R^2=.569$, p<.001); at 2 hours after induction, CBT at induction and TBF ($R^2=.507$, p<.001); at 3 hours after induction, CBT at induction (${\beta}=0.34$), TBF, age and the ambient temperature in the operating room ($R^2=.449$, p<.001). Conclusion: CBT at induction and TBF appear to be factors affecting intraoperative CBT within 2 hours after induction of anesthesia; CBT at induction, TBF, advanced age and the ambient temperature after 3 hours following induction. We recommend keeping surgical patients warm before induction of anesthesia and providing intraoperative warming for surgical patients of advanced age with low TBF and when the duration of general anesthesia will last more than 3 hours.

A Case of Intestinal Hemangioma Complicated with Thrombocytopenia (Kasabach-Merritt syndrome) in Premature Infant (미숙아에서 혈소판 감소증에 의해 발견된 장 혈관종(Kasabach-Meritt 증후군) 1례)

  • Lee, Young-Jin;Bae, Sul-Hee;Song, Eun-Song;Choi, Soo-Jin-Na;Kim, Yoon-Ha;Choi, Young-Youn
    • Neonatal Medicine
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    • v.17 no.1
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    • pp.116-122
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    • 2010
  • Kasabach-Merritt syndrome is a rare thrombocytopenic consumptive coagulopathy associated with a giant hemangioma. We experienced a case of unexplained ascites with thrombocytopenia in a 32 week premature infant. An exploratory laparotomy was performed to determine the cause of the refractory ascites and thrombocytopenia. An intestinal hemangioma was found, but, surgical removal was not performed due to the extensive involvement. Hemangioma was confirmed by SPECT (single-photon emission computed tomography) and the thrombocytopenia was treated with steroid therapy. It is recommended that hemangioma of the visceral organs should be suspected when unexplained thrombocytopenia and disseminated intravascular coagulopathy persist.

Primary Segmental Volvulus of the Small Bowel -Report of 2 Cases- (소장의 국한적 원발성염전 2례 보고)

  • Lee, Myung-Duk
    • Advances in pediatric surgery
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    • v.2 no.1
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    • pp.46-52
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    • 1996
  • Primary segmental volvulus of the small intestine is not associated with malrotation, malfixation of the midgut, nor other primary small bowel lesions such as small bowel tumors. This entity is known to be more prevalent in adult and in certain global areas associated with particular diet habits. There have been very few reports in neonates, but not in this country so far. The author reports two cases of primary segmental volvulus. Case 1 was a septic 4-day-old girl with hematochezia due to jejunal volvulus with partial necrosis and panperitonitis. Resection of the segment and Bishop-Koop enterostomy were successful. Case 2 was a 3-day-old boy, who had ileal volvulus with ultra-short length of ileal atresia, probably due to intrauterine segmental volvulus. Limited resection of the atresia and spreading of the mesenteric base were enough to recovery. The rarity of the pathognomonic findings and limitation of the diagnostic workup due to rapid progression limit early diagnosis and good survival rate in this particular condition.

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A Case of Tuberculous Peritonitis Mimicking Surgical Abdomen (외과적 복부질환으로 오인된 결핵성 복막염 1례)

  • Kim, Hyun-Jin;Kim, Hae-Soon;Seo, Jeong-Wan;Choi, Kum-Ja;Lee, Sun-Wha;Sung, Sun-Hee
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.5 no.2
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    • pp.181-185
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    • 2002
  • Childhood tuberculous peritonitis is difficult to diagnose especially in cases without pulmonary involvement. It may present as mechanical ileus, perforation, simulating acute appendicitis, enterocolitis or intusussception. Early diagnosis in children may be difficult, largely because of variable vague symptoms and nonspecific signs. Surgery has often been required for pathologic confirmation. We have experienced a case of tuberculous peritonitis presenting with abdominal pain, abdominal distension and persistent high fever in a 10-year-old boy who was diagnosed by explo-laparotomy and pathologic confirmation from biopsy specimen from omentum. The patient was treated with antituberculous drugs and recovered uneventfully.

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Diagnostic Imaging of Isolated Splenic Torsion in a German Shepherd Dog (독일셰퍼드 견에서 단독으로 발생한 비장 염전의 영상진단)

  • Lee, Ki-Ja;Jeong, Seong-Mok;Choi, Ho-Jung;Lee, Young-Won
    • Journal of Veterinary Clinics
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    • v.28 no.6
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    • pp.613-616
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    • 2011
  • A 5-year-old male German shepherd dog was presented with a 4 day-history of anorexia and depression. Abdominal radiographs showed a large soft tissue mass and loss of serosal detail. Ultrasonographs revealed splenomegaly with the lacy pattern parenchyma, perivenous hyperechoic region at the splenic hilum, and loss of splenic venous flow. Computed tomographic findings included the enlarged non-enhanced spleen except perivenous region at the splenic hilum and a whirled soft tissue mass at the splenic hilum. Exploratory laparotomy confirmed the diagnosis of splenic torsion. Ultrasonographic findings including lacy appearance, hyperechoic perivenous echogenicity and absence of splenic blood flow and CT findings including no or minimal enhancement of the spleen and a whirled appearance of splenic pedicle could be useful for diagnosing isolated splenic torsion in the dog.

A Case of Uterine Adenocarcinoma in A Spayed Female Dog (중성화된 암캐에서 발생한 자궁 선암종 증례)

  • Choi, Ul Soo
    • Journal of Veterinary Clinics
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    • v.30 no.1
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    • pp.53-56
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    • 2013
  • A 10-year-old spayed female Pekinese dog was referred to veterinary medical teaching hospital of Chonbuk National University with signs of dysuria, abdominal distension, and hematuria. Abdominal radiography revealed a large oval soft tissue mass in cranial abdomen, which was a fluid filled cyst containing a round mass by ultrasonography. Exploratory laparatomy found a 4 cm cyst containing reddish brown fluid and a 1.5 cm small round mass attached to the wall. Cytological impression of the imprint smears of the resected mass were highly malignant adenocarcinoma, which was confirmed by histopathology of the mass and the cyst. After the surgery the patient recovered uneventfully and discharged. The tumor recurred about one year after surgery, and second surgery performed at the owner's request. However the tumor recurred in two months with metastatic disease in the lung and the dog survived three more months after surgery.

Extrahepatic Biliary Obstruction Secondary to Traumatic Diaphragmatic Hernia in Dog (개에서의 횡격막 탈장에 의한 간외담도폐색)

  • Yoon, Young-Min;Jeong, Dong-In;Yeon, Seong-Chan;Lee, Hee-Chun
    • Journal of Veterinary Clinics
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    • v.31 no.6
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    • pp.531-534
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    • 2014
  • A 3-year-old intact mixed hunting dog was referred to Gyeongsang Animal Medical Center with the clinical signs of vomiting, dyspnea, anorexia. The dogs had traumatic history that wounded at abdominal wall during the wild boar hunting 2 week ago. The dogs was diagnosed as extrahepatic biliary tract obstruction (EHBO) secondary to traumatic hernia. Diagnosis was based on radiographic features of a diaphragmatic hernia on survey radiography, dilated bile duct in abdominal ultrasonography and complete recovery due to the return of displaced organs into the peritoneal cavity and repair of the diaphragmatic rent. Diagnostic imaging and surgical intervention may result in a favorable outcome in dog with post hepatic obstruction secondary to diaphragmatic hernia. This case emphasizes the strangulation of bile duct by diaphragmatic rupture could be the cause of EHBO.