• Title/Summary/Keyword: 개복술

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Extraluminal Form of Vaginal Leiomyoma : Two Case Reports (질 외벽 기원 평활근종에 대한 두 증례)

  • Lee, Sang-Ho;Park, Chul-Ho;Park, Jun-Tae;Kim, Yong-Min;Oh, Ki-Seok;Son, Chang-Ho
    • Journal of Veterinary Clinics
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    • v.31 no.6
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    • pp.539-543
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    • 2014
  • Vaginal tumors are the second most common types of tumor in canine female reproductive tract, and most of these tumor are diagnosed as leiomyoma. These tumors are categorized by intraluminal or extraluminal form, and tend to develop as hormone dependent manner. In this report, we describe two cases of extra-luminal form of vaginal tumor. Both tumors were located in abdominal cavity, and adhered to entire surrounding internal organs, including urinary bladder, rectum, and particularly a part of ureter. Surgical excision was performed via laparotomy without damage to the surrounding internal organs and ovariohysterectomy, as well. A diagnosis of vaginal leiomyoma was established based on histopathology.

A Case of Ruptured Ovarian Cyst in a Newborn (신생아에서 발생한 파열된 난소 낭종 1례)

  • Oh, Ki-Won;Kim, Joon-Sung;Bae, Hwa-Young;Kim, Ja-Hyeong;Jeong, Jin-Young;Nam, Chang-Woo;Choi, Seong-Hoon;Park, Sang-Kyu
    • Neonatal Medicine
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    • v.15 no.1
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    • pp.100-104
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    • 2008
  • Ovarian cysts are the most common cystic abdominal masses in female newborns. It is believed to be derived from an overstimulation of the ovarian follicles by maternal, placental, and fetal hormones. Although most ovarian cysts resolve spontaneously, surgical management is mandatory for life-threatening, complicated cases, including torsion, intracystic hemorrhage, and rupture of the cyst. Rupture of ovarian cysts is thought to be exceedingly rare, but can lead to severe hemorrhagic ascites or peritonitis. We managed a case of a ruptured ovarian cyst in a female newborn who presented with mild abdominal distension and two episodes of gross hematuria. Exploratory laparotomy revealed a right ovarian cyst with torsion and rupture. She was successfully treated with a right salpingo- oophorectomy with no sequelae.

Analysis of prognostic factors of laparotomy for necrotizing enterocolitis in extremely low birth weight infants (괴사성 장염으로 수술한 초극소저체중출생아(<1,000 g)의 예후인자 분석)

  • Kim, Jin Kyu;Kim, Yi Sun;Yoo, Hye Soo;Ahn, So Yoon;Seo, Hyun Ju;Choi, Seo Heui;Park, Soo Kyung;Jung, Yu Jin;Kim, Myo Jing;Jeon, Ga Won;Koo, Soo Hyun;Lee, Kyung-Hoon;Chang, Yun Sil;Park, Won Soon
    • Clinical and Experimental Pediatrics
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    • v.53 no.2
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    • pp.167-172
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    • 2010
  • Purpose : With improved survival of extremely low birth weight infants (ELBWI), there is an increase in the incidence of necrotizing enterocolitis (NEC) requiring laparotomy, and the risk of morbidity and mortality in these ELBWI is increased. Thus, we determined the prognostic factors in ELBWI who underwent laparotomy for NEC. Methods : We retrospectively reviewed the medical records of 35 ELBWI who underwent laparotomy for NEC from January 2001 to December 2008 at Samsung Medical Center. Results : Of 480 ELBWI, 35 required laparotomy for NEC; the mortality rate was 20% (Alive group n=28, Dead group n=7). The values of preoperative score for neonatal acute physiology-II (P =0.022) and fraction of inspired oxygen (P <0.001) were significantly higher in the dead group and values of base excess (P =0.004) were significantly lower in the dead group. Values of preoperative heart rate, respiration rate, mean blood pressure, pH, $CO_2$, and potassium ion were not significantly different between the study groups. Intraoperative fluid volume was significantly higher in the alive group than in the dead group (P =0.045). Postoperative infusion rate was significantly lower in the alive group than in the dead group (P =0.022). Conclusion : Good preoperative condition, more intraoperative fluid infusion, and stable postoperative hemodynamic condition were factors associated with favorable prognosis of laparotomy for NEC in ELBWI.

Hepatic Cirrhosis Secondary to chronic Hepatitis in an English Cocker Spaniel (ECS) Dog (잉글리쉬 코커스파니엘 견에서 발생한 만성 간염 및 간경화 증례)

  • Park Chul;Yoo Jong-Hyun;Jung Dong-In;Kim Ha-Jung;Kang Byeong-Teck;Lim Chae-Young;Yoon Hun-Young;Jeong Soon-Wuk;Sur Jung-Hyang;Park Hee-Myung
    • Journal of Veterinary Clinics
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    • v.23 no.1
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    • pp.72-76
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    • 2006
  • A 1-year-old, female English cocker spaniel (ECS) dog was presented with 3-month history of vomiting and retaking of the vomitus, and chronic weight loss. The client had noticed mild abdominal distension 10 days before. The dog was diagnosed as chronic hepatitis with hepatic cirrhosis based on complete blood count (CBC), serum chemistry profiles, radiography, ascites assessment, bile acid evaluation, and liver biopsy through exploratory laparotomy and necropsy. CBC and serum chemistry profiles revealed mild anemia, slightly elevated hepatic enzymes (ALT and AST), increased creatinine kinase (CK), hyperammonemia, and hypoproteinemia with hypoalbuminemia. Ascites was transudate according to analysis of components. Bile acid assessment (fasting; $174.4{\mu}mol/L$ and postprandial; $198.4{\mu}mol/L$) showed strongly suspected hepatic insufficiency. On radiological findings, ascites was evident. Atrophied liver (especially left side lobes) and distended mesenteric vasculatures were observed by exploratory laparotomy. Histopathological examination of marginal lesion of left lateral lobe of liver by biopsy revealed the necrosis of hepatic cells, dilation of sinusoids, infiltration of neutrophils in sinusoids, and vacuolation of hepatic cytoplasm. The patient had been managed with careful low protein diet and specific supportive therapy (ursodeoxycholic acid, prednisolone, vitamine E, and interferon). Vomiting and ascites disappeared with medical management. The dog was monitored periodically by CBC, serum chemistry and radiographic examination. The dog survived more 18 months with medical therapy. After spontaneous death, necropsy and histopathologic examination were performed.

Severe Focal Cystic Endometrial Hyperplasia in a Bitch (개에서 발생한 국소성 거대 낭상자궁내막증식증 1예)

  • Lee, Jae-Yeon;Shin, Beom-Jun;Park, Ji-Young;Lee, Young-Won;Park, Seong-Jun;Cho, Sung-Whan;Kim, Myung-Cheol;Jeong, Seong-Mok
    • Journal of Veterinary Clinics
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    • v.28 no.6
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    • pp.610-612
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    • 2011
  • A 9-years-old female Collie dog was presented with history of abdominal enlargement, anorexia and constipation. On radiographic and ultrasonographic examinations, intra-abdominal mass was identified. On cytologic findings of the mass, no cancer cell was observed. Exploratory laparotomy was performed to diagnose and remove the mass. A large, single, spheroid mass weighing 9.5 kg ($40{\times}25{\times}18$ cm) was located in the middle section of the right uterine horn. Based on the results of histopathological examination, the mass was diagnosed as a cystic endometrial hyperplasia (CEH). This is rare case of severe focal CEH without pyometra in a bitch.

Clinical Evaluation of Traumatic Diappragmatic Injuries (외상성 횡격막 손상에 대한 임상적 고찰)

  • 이성주;구원모
    • Journal of Chest Surgery
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    • v.30 no.10
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    • pp.1005-1009
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    • 1997
  • Diaphragm injuries are very important because, if both thoracic and abdominal viscera are damaged, a combination of shock and acute respiratory distress may develop. It can be highly lethal. This evaluation was based on the reviews of 17 cases of traumatic diaphragm injuries treated at the Department of Cardiovascular Surgery, Seoul Adventist Hospital during 5 years from March 1993 to February 1997. The mean age of the patients was 37.2 years and sex ratio was 3.2:1 with male dominance. Blunt trauma(N=5, Rt.=4, Lt.= 1) was 29.5%, penetrating trauma(N= 12, Rt.=5, Lt.=7) was 70.5%. Dyspnea(76%) was the most common symptom. Blunt trauma(9.8$\pm$3.7 Cm) was larger than the penetrating trauma(3.2$\pm$ 1.3 Cm)(P<0.05) in the size(mean$\pm$SD) of the injury. All of the patients had associated injuries and repaired immediatley with thoracic approach 11 cases(64%), abdominal approaih 3 cases(18%) and thoracoabdominal approach 3 cases(18%). f cases of penetrating diaphragmatic t auma was diagnosed on the operation of other organ injury Now we suggest that diaphragmatic injury should be suspected in all patients with penetrating as well as blunt injury of the chest and abdomen to protect the patient from its late complications.

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Prognosis and Surgical Treatment of the Urethra Embedding Leiomyosarcoma in a Dog (개에서 요도를 포매한 평활근육종의 수술적 처치 및 예후)

  • Kim, Ji-Hyun;Lee, Jun-Am;Kim, Ill-Hwa;Jang, Dong-Woo;Kang, Hyun-Gu
    • Journal of Veterinary Clinics
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    • v.31 no.4
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    • pp.307-312
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    • 2014
  • A 16-year-old female Shih-Tzu, weighing 5 kg, presented with clinical symptoms of abdominal distension and urinary and fecal incontinence. Abdominal palpation detected a large mass. According to the radiographic findings, the bladder had been moved to the umbilicus by the mass and a large abdominal mass was confirmed in the lower abdominal area. Ultrasonography indentified a large heterogeneous mass with heterogeneous parenchyma and a focal anechoic area in the lower abdominal area. The complete blood count abnormalities suggested thrombocytosis and mild neutrophilia, and the serum chemistry indicated an elevated alkaline phosphatase value. During laparotomy, a firm mass that measured $10.5{\times}9.6cm$ was found between the uterine cervix and urinary bladder. The urethra was embedded in the mass. A diagnosis of leiomyosarcoma was established based on histopathology and histochemistry. One week after surgery, urinary retention symptoms that did not appear to be related to mechanical obstruction presented suddenly, but they did not respond to several drug treatments, thus long-term conservative therapy was adopted. The urinary symptoms disappeared on day 27 and the patient started to void large quantities of urine in a smooth and frequent manner. This case report describes the serial changes in the patient's status and the response after surgical remove of the urethra embedding leiomyosarcoma.

Emergency preoperative angioembolization without computed tomography to treat unstable pelvic fractures with bowel perforation (장 천공을 동반한 혈역학적으로 불안정한 골반골 골절에서 전산화 단층촬영 전 시행한 혈관색전술의 지혈효과: 증례보고)

  • Park, Chan-Yong;Kang, Wu-Seong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.3
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    • pp.417-422
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    • 2019
  • Hemodynamically unstable pelvic fractures show a remarkably high mortality rate of 40% to 60%. However, their standard of care remains controversial. We report here a case of a 78-year-old woman who was admitted to the Emergency Department with pelvic pain following a fall. Based on pelvic radiography, she was diagnosed with an unstable pelvic fracture. Her blood pressure was 60/40 mmHg, and owing to her unstable vital signs, emergency angiography was performed without computed tomography (CT). Both internal iliac arteries were embolized without sub-branch selection for prompt control of pelvic bleeding. Following embolization, her vital signs were stabilized. Subsequent CT revealed free intra-abdominal air, suggesting bowel perforation had occurred and necessitating emergency laparotomy. An approximately 1 cm-sized free perforation of the small intestine was identified intraoperatively, and primary closure was performed. A retroperitoneal hematoma identified intraoperatively was not explored further because it was a non-expanding and non-pulsatile mass. The patient was admitted to the Intensive Care Unit and transferred to the general ward on postoperative day 3. In this case, the hemodynamically stable pelvic fracture with bowel perforation was successfully and safely treated by prompt angioembolization without conducting CT.

Application of Intraoperative Neurophysiological Monitoring in Aortic Surgery (대동맥수술에서의 수술 중 신경계감시의 적용)

  • Jang, Min Hwan;Chae, Ji Won;Lim, Sung Hyuk
    • Korean Journal of Clinical Laboratory Science
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    • v.54 no.1
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    • pp.61-67
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    • 2022
  • Intraoperative neurophysiological monitoring (INM) ensures the stability and safety of specific surgeries in high-risk groups. As part of INM, intensive tests are conducted during the surgical process. When INM tests are applied during surgery, a delay in notifying the operating surgeon in cases of neurological defects can cause serious irreversible sequelae to the patient. Aortic replacement, which is necessitated due to aortic aneurysms and aortic dissection, is a complicated procedure that blocks the blood flow to the heart. When arteries that branch out from the aorta and supply blood to the spinal cord are replaced, blood flow to the spinal cord decreases, resulting in spinal ischemia. In aortic surgery, INM plays an important role in preventing spinal ischemia and serious complications by quickly detecting the early signs of spinal ischemia during cross-clamping and reporting it to the surgeon. Therefore, this paper was prepared to help examiners who conduct INM by detailing the process, method, time, and warning criteria for INM. This paper identifies the need for INM in aortic surgery and the process flow for a smooth test, accurate and rapid examination, and subsequent reporting.

Pharyngoesophageal Reconstruction (경부식도의 재건)

  • Cha, Gyu-Ho;Kim, Jeong-Cheol;Lee, Kyung-Ho;Suh, Dong-Bo;Suh, Jang-Su
    • Journal of Yeungnam Medical Science
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    • v.9 no.1
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    • pp.167-174
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    • 1992
  • Microvascular tissue transfers have facilitated primary closure of various complex defects after radical ablation of head and neck cancers. From Oct 1991 to Feb 1992, we used forearm free flap in two patients and delto-pectoral flap in one patient who had preoperative irradiation for pharyngoesophageal reconstruction. The stricture and fistular formation were most troublesome complication in forearm free flap, so we designed as lazy S shape in distal flap margin to prevent circular contraction and longitudinal margin was deepithelized(5mm) and sutured double layer to withstand fistular formation and this can be considered useful in place of a free jejunal transfer.

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