• Title/Summary/Keyword: 급성복증

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Imaging Findings of Gastrointestinal Emergency in Infants and Young Children (영유아 환자 위장관 응급 질환의 영상 소견)

  • Ji Young Kim
    • Journal of the Korean Society of Radiology
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    • v.81 no.4
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    • pp.794-805
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    • 2020
  • Acute abdomen is a condition with sudden abdominal pain that may require immediate surgical treatment. The causes of acute abdomen in pediatric patients are diverse, and can be categorized in broad range from diseases requiring surgery to diseases requiring medication or clinical observation only. The role of the imaging study in children with acute abdomen is to distinguish between patients who need medication and patients who need surgery by identifying diseases that cause abdominal pain, if possible. Since intussusception and appendicitis are the leading causes of acute abdomen requiring surgical treatment in children, it is important to exclude intussusception in young infants complaining of acute abdominal pain and exclude acute appendicitis in older children with acute abdomen. In this paper, we introduce intussusception, acute appendicitis, midgut volvulus, Meckel's diverticulum and duplication cyst, which has characteristic imaging finding of the disease that can cause acute abdomen in pediatric patients.

A Case of Meckel's Diverticulum Presented with Acute Abdomen in a Newborn (신생아에서 급성 복증으로 발현된 Meckel 게실 1예)

  • Lim, Jae Young;Jang, Sun Hwa;Cho, Jae Min;Ko, Gyung Hyuck;Park, Eun Sil;Seo, Ji Hyun;Park, Chan Hoo;Woo, Hyang Ok;Youn, Hee Shang
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.8 no.2
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    • pp.222-225
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    • 2005
  • Meckel's diverticulum is generally acknowledged to be the most prevalent congenital anomaly of the gastrointestinal tract. The preoperative diagnosis of Meckel's diverticulum is difficult, especially in neonates, because of the lesions ability to masquerade as one of a variety of much more common abdominal pathologies. Recently we experienced a case of perforated Meckel's diverticulum with mild inflammatory reaction, intestinal adhesion, and small bowel obstruction in a previous healthy 9-day-old neonate. The spontaneous perforation of Meckel's diverticulum in neonate is very rare but serious entity. The course was rapid and progressed to sepsis. So despite its varied presentation, Meckel's diverticulum should be kept in mind as a cause of acute abdomen in neonates.

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Analysis of The Delayed Time in Patients with Acute Appendicitis (급성 충수 돌기염 환자의 대기시간 분석)

  • Park, Seung-Ik;Kim, Kwang-Beak
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2013.10a
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    • pp.889-892
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    • 2013
  • 본 논문에서는 급성 복증을 주소로 야간 응급실 내원 시 영상의학과 전문의 부재 등과 관련된, 급성 충수 돌기염 진단을 위한 복부 초음파 검사의 환자 대기 시간과 충수 돌기 절제술 시행까지 환자 대기 시간을 분석한다. 응급실 내원 환자 41.5%에서 초음파 검사 대기 시간은 10시간 이상으로 나타났고, 외래 내원 환자의 45.2%는 수술 대기 시간이 18시간 이상으로 나왔다. 이는 초음파 검사의 대기 시간이 수술 대기 시간에 영향을 미치는 것으로 카이제곱검증에서 유의하게 나왔다(p<0.05). 따라서 본 논문에서는 환자들의 대기 시간을 감소시키기 위한 방법으로 응급실 의료진의 초음파 검사 시행에 따른 유익성과 급성 충수 돌기염의 특징을 이용한 의료 영상 분석, 연구의 필요성을 제안한다.

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Perforated Duodenal Diverticulum after Distal Subtotal Gastrectomy and Billorth II Gastrojejunostomy (위아전절제술 및 위공장 문합술 후 생긴 십이지장 게실 천공 환자 1예)

  • Jee, Sung-Bae;Kim, Sin-Sun;Jun, Kyong-Hwa;Kim, Wook;Park, Kyong-Sin;Jeon, Hae-Myung
    • Journal of Gastric Cancer
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    • v.6 no.1
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    • pp.52-56
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    • 2006
  • A 69-year old man presented with severe epigastric pain for 1 day. He had early gastric cancer at the antrum and underwent a distal subtotal gastrectomy and Billorth II gastrojejunostomy one month later without any post-operative complications. Radiologic examination revealed a large amount of retroperitoneal free air formation. Because of unremitting pain and unstable vital sign, exploratory laparotomy was followed. During the operation, a perforated duodenal diverticulum at the posterior wall of the 2nd portion of the duodenum was identified. He underwent diverticulectomy and primary closure. He was discharged on the 18th post operative day and has been followed up without any evidence of comlpication for several months.

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A Case of Henoch-Sch$\"{o}$nlein Purpura with Acute Pancreatitis and Hypovolemic Acute Renal Failure (급성 췌장염과 저혈량성 급성 신부전이 동반된 Henoch-Sch$\"{o}$nlein 자반증 1예)

  • Oh, Ki-Won;Park, Sang-Kyu;Kim, Joon-Sung
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.12 no.2
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    • pp.226-229
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    • 2009
  • Gastrointestinal involvement in Henoch-Sch$\"{o}$nlein purpura (HSP) is common. However, both acute pancreatitis and acute renal failure appear to be very rare complications of HSP. We describe a case of HSP with acute pancreatitis and hypovolemic acute renal failure in a 7-year-old girl who presented with a vasculitic purpuric rash involving the lower extremities, abdominal pain, hematochezia, vomiting, and oliguria. Laboratory findings showed increased serum levels of amylase, lipase, and creatinine. An abdominal CT scan revealed diffuse enlargement of the head and body of the pancreas. The patient was successfully managed with conservative treatment, including corticosteroids, and then her pancreatic enzymes and renal function returned to normal. Acute pancreatitis should be differentiated from other causes of acute abdomen in HSP to avoid unnecessary surgery.

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Intraabdominal Complications after Cardiac Surgery (심장수술후 복부장기의 합병증)

  • 김양원;조용길
    • Journal of Chest Surgery
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    • v.29 no.1
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    • pp.38-42
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    • 1996
  • Intraabdominal complications after cardiac surgery are infrequent, but often fatal. From 1985 to 1993, a total of 1241 cardiovascular operations requiring cardiopulmonary by pass were performed at Pusan Paik Hospital. A total of 16 intraabdominal complications occurred, represe ting a 1.3% incidence. Complications included enterocolitis in six, hepatitis in three, gastric bleeding in two, erosive gastritis in one, cholecystitis in one, spleen rupture in one, epididymitis in one, inguinal hernia in one patient. The overall mortality rate was 12.5% (2 of 16). Three of the 16 patients underwent surgical intervention, and one died. We concluded that intraabdominal complications after cardiac surgery are associated with a high mortality rate, so when evidence of an acute abdominal symptom is observed or conservativi medical treatment fails to improve symptoms, prompt early surgical intervention should be performed.

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A Human Case Infected by the Larva of Terranova type A in Korea (Terrunoua type A 유촉에 의한 인체감염 1예)

  • 서병설;채종일이순형홍성함
    • Parasites, Hosts and Diseases
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    • v.22 no.2
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    • pp.248-252
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    • 1984
  • A human case infected with Terranova type A larva was found in Korea. The patient was a 23-year old soldier of the Korean Army and the chief complaint was acute abdominal pain. The pain was chiefly at right lower quadrant. Appendectomy was performed under the clinical impression of acute appendicitis. However, during the surgery, a nematode larva was found moving on the serosal surface of terminal ileum. The worm was 25.76mm long and O. 66mm -wide, and had the intestinal cecum reaching to anterior one-third level of ventriculus and a mucron at posterior end. Therefore, it was diagnosed as Terranova type A larva. This is the first human case of Terranova type A larva infection in Korea.

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Limitations of 99mTc-DMSA scan in diagnosing acute pyelonephritis in children (이해관계 선언)

  • Kim, Byung Gee;Kwak, Jae Ryoung;Park, Ji Min;Pai, Ki Soo
    • Clinical and Experimental Pediatrics
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    • v.53 no.3
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    • pp.408-413
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    • 2010
  • Purpose : We aimed to prove the relative limitation of $^{99m}Tc-DMSA$ scintigraphy (DMSA) compared to computed tomography (CT) in diagnosing acute pyelonephritis (APN) in children. Methods : Since September 2006, after a 64-channel CT was imported, 10 DMSA false-negative patients have been identified: these patients underwent a CT scan for acute abdomen or acute febrile symptoms and were diagnosed as having APN; however, their DMSA scans were clear. We focused on these 10 DMSA false-negative patients and analyzed their clinical findings and CT results. We used Philips Brilliance Power 64-channel CT scanner for the CT scan and Siemens Orbitor Nuclear Camera 60 Hz for the DMSA scan. Results : The 10 DMSA false-negative patients were mostly males (80%) and infants (80%). They had fever for a mean of 1.1-day duration before admission and showed increase in acute reactants: leukocyte, erythrocyte sedimentation rate, and C-reactive protein. The CT findings of renal lesions were focal in 6 (60%) cases and diffuse in 4 (40%) cases, and most of the lesions were unilateral in 80% of patients. CT proved that 22 renal lesions were neglected by DMSA. Differential renal function test by DMSA was also of no use in the evaluation of renal lesions. Conclusion : In this study, DMSA scan showed limitation in finding renal cortical lesions of CT-proven APN patients. DMSA false-negative results seem to occur at early-phase disease of infantile age, but more prospective studies are needed to determine the reasons and their prevalence.