• Title/Summary/Keyword: 복막

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Malignant Retroperitoneal Paraganglioma in a Siberian Tiger (시베리아 호랑이에서 발생한 악성후복막부신경절종 증례)

  • Shin, Sang-Kyung;Park, Byung-Min;Youm, So-Young;Kim, Tae-Wang;Na, Ki-Jeong;Ahn, Byeong-Woo
    • Journal of Veterinary Clinics
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    • v.28 no.5
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    • pp.522-525
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    • 2011
  • A 14 year old female Siberian tiger presented for postmortem examination. A large mass attached to sublumbar area was found to be circumscribing aorta with metastases to mesenteric lymph nodes, uterus, kidney, adrenal gland, lung and thymus. The tumor cells were arranged in clusters or nests separated by well-developed fibrovascular stroma. The individual cells were plump and polygonal with granular eosinophilic cytoplasms and had distinct cell borders. The tumor cells were positive for synaptophysin, chromogranin A and neuron-specific enolase, and negative for cytokeratins, S100 and glial fibrillary acidic protein. The primary tumor was diagnosed as a malignant retroperitoneal paraganglioma.

Bile Peritonitis Due to Spontaneous Rupture of Choledochal Cyst Diagnosed by Hepatobiliary Scintigraphy in an Infant (영아에서 간담도 스캔으로 진단된 총 담관낭의 자연 천공에 의한 담즙성 복막염 1례)

  • Kim, Jong-Seok;Lim, Jang-Hun;Bae, Sang-Nam;Lee, Jun-Woo;Kim, In-Ju;Park, Jae-Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.5 no.2
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    • pp.186-191
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    • 2002
  • Choledochal cyst is a congenital anomaly with classic triad of abdominal pain, jaundice and right upper abdominal mass. Bile peritonitis caused by cyst rupture is relatively not rare in infancy. The mechanism of rupture must be epithelial irritation of the biliary tract by refluxed pancreatic juice caused by pancreatico-biliary malunion associated with mural immaturity in infancy, rather than an abnormal rise in ductal pressure or congenital mural weakness at a certain point. We experienced a case of bile peritonitis caused by spontanenous rupture of choledochal cyst in a 10-month-old girl presented with abdominal distension, persistent fever, diarrhea, irritability and intractable ascites. She was presumed as having bile peritonitis by bile colored ascitic fluid with elevated bilirubin level and diagnosis was made by $^{99m}Tc$ DISIDA hepatobiliary scan showing extrahepatic biliary leak. The perforated cyst was surgically removed and the biliary tree was reconstructed with a Roux-en-Y hepaticojejunostomy.

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Can Peritoneal Dialysis Remove Endothelin-1 after Cardiopulmonary Bypass for Repair of Congenital Heart Disease? (체외순환을 이용한 선천성 심장수술 후에 시행한 복막투석이 내피의존성 혈관 활성 물질인 Endothelin-1을 제거할 수 있는가?)

  • Chang, Yun-Hee;Ban, Ji-Eun;Lee, Hyoung-Doo;Lee, Sun-Hee;Rhym, Byuong-Yong;Sung, Si-Chan
    • Journal of Chest Surgery
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    • v.40 no.4 s.273
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    • pp.247-255
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    • 2007
  • Background: Lung injury that follows bypass has been well described. It is manifested as reduced oxygenation and lung compliance and, most importantly, increased pulmonary vascular resistance reactivity; this is a known cause of morbidity and mortality after repair of congenital heart disease. Injury to the pulmonary vascular endothelium, and its associated alterations of endothelin-1, is considered to be a major factor of bypass-induced lung injury. Removing endothelin-1 after bypass may attenuate this response. This study measured the concentration of serum and peritoneal effluent endothelin-1 after performing bypass to determine if endothelin-1 can be removed via peritoneal dialysis. Material and Method: From March 2005 to March 2006, 18 patients were enrolled in this study Peritoneal catheters were placed at the end of surgery. Serum samples were obtained before and after bypass, and peritoneal effluents were obtained after bypass. Endothelin-1 was measured by enzyme linked immunosorbent assay (ELISA). Result: In the patients with a severe increase of the pulmonary artery pressure or flow, the mean preoperative plasma endothelin-1 concentration was significantly higher than that in the patients who were without an increase of their pulmonary artery pressure or flow (4.2 vs 1.8 pg/mL, respectively, p<0.001). The mean concentration of plasma endothelin-1 increased from a preoperative value of $3.61{\pm}2.17\;to\;5.33{\pm}3.72 pg/ml$ immediately after bypass. After peritoneal dialysis, the mean plasma endothelin-1 concentration started to decrease. Its concentration at 18 hours after bypass was significantly lower than the value obtained immediately after bypass (p=0.036). Conclusion: Our data showed that the plasma endothelin-1 concentration became persistently decreased after starting peritoneal dialysis, and this suggests that peritoneal dialysis can remove the circulating plasma endothelin-1.

A Case of Primary Epiploic Appendagitis (원발성 복막수염 1례)

  • Ha, Tae Young;Kim, Chi Kwan;Jeong, Jin Young;Lee, Jong Hwa
    • Clinical and Experimental Pediatrics
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    • v.45 no.8
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    • pp.1024-1027
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    • 2002
  • Epiploic appendages are small, 0.5-5 cm long, peritoneal pouches containing small vessels and fat, located on the serous surface of the colon, from the cecum to the rectosigmoid junction. Pathologic states are rare in these appendages, the most frequent being is infarction either due to torsion or spontaneous. As a result of subsequent inflammatory reaction, the condition has been termed primary epiploic appendagitis. The condition is manifested by localized abdominal pain, which is often mistaken for appendicitis or diverticulitis and is usually diagnosed at surgery. With the aid of comtemporary imaging modalities, however, the diagnosis of epiploic appendagitis need no longer hinge on the pathologic specimen but may be established by the clinician. As this disorder recently has been demonstrated to be predominantly self-limited, laparotomy is no longer considered necessary. Conservative management has been shown to be safe. We report a 5-year-old male patient with epiploic appendagitis who presented with acute abdominal pain.

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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The Role and Efficacy of Diagnostic Laparoscopy to Detect the Peritoneal Recurrence of Gastric Cancer (복막 전이가 의심되는 위암 환자에서 진단적 복강경 검사의 의의와 역할)

  • Song, Sun-Choon;Lee, Sang-Lim;Cho, Young-Kwan;Han, Sang-Uk
    • Journal of Gastric Cancer
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    • v.9 no.2
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    • pp.51-56
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    • 2009
  • Purpose: Peritoneal recurrence has been reported to be the most common form of recurrence of gastric cancer. Peritoneal recurrence can generally be suggested by several types of image studies and also if there is evidence of ascites or Bloomer's rectal shelf. It can be confirmed by explorative laparotomy, but diagnostic laparoscopy is a good alternative method and laparoscopic surgery has also been widely used. We reviewed and analyzed the ability of diagnostic laparoscopy to detect peritoneal recurrence or carcinomatosis, and especially for gastric cancer. Materials and Methods: We performed a retrospective review the 45 gastric cancer patients who were operated via diagnostic laparoscopy between 2004. 2. and 2009. 3. We analyzed the perioperative clinical characteristics and the accuracy of the diagnostic methods. Results: The study groups included 14 patients who had confirmed gastric cancer, but they suspected to have carcinomatosis, and 31 patients who had previously underwent gastric resection, but they suspected to have recurrence. The mean operation time was $44.1\pm26.9$ minutes and the mean postoperative hospital stay was $2.7\pm2.8$ days. There was one case of operation-related complication and no postoperative mortality occurred. The sensitivities for detecting peritoneal recurrence or carcinomatosis were 92.1% for diagnostic laparoscopy, 29.7% for detecting ascites and rectal shelf on the physical examination, 86.5% for abdominal computed tomography, 69.2% for PET CT and 18.8% for CEA. Conclusion: Diagnostic laparoscopy does not require a long operation time or a long hospital stay, and it showed a low complication rate in our study. It has high sensitivity for detecting peritoneal recurrence of gastric cancer. It can be an alternative diagnostic confirmative method and it is useful for deciding on further treatment.

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