• Title/Summary/Keyword: 복막

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Bile Peritonitis due to Choledochal Cyst Perforation in Infants (총담관낭 환아에서의 담즙성 복막염)

  • Jung, Jae-Hee;Song, Young-Tack
    • Advances in pediatric surgery
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    • v.4 no.2
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    • pp.156-162
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    • 1998
  • Choledochal cyst is rare in the western countries, but common in oriental countries. Complicatioins include ascending cholangitis, recurrent pancreatities, progressive biliary cirrhosis, portal hypertension, stone formation and later malignant transformation. Bile peritonitis secondary to rupture is one of the rarest complications, with an incidence of 1.8 % to 18 %. The anomalous arrangement of the pancreatobiliary ductal system with a long common channel may cause inflammation leading to perforation of the cyst. The authors found 4 cases (14.2 %) of bile peritonitis among 28 cases of choledochal cyst treated from Jan. 1983 to Jan. 1998. The patients ages ranged from 6 months to 3 years and three were female. The perforation sites were located on the common bile duct at its junction with the cystic duct in 2 cases, the distal cyst wall in 1 case and the left hepatic duct at its junction with cyst in 1 case. The types of choledochal cysts by Todani's classification were Type IVa in 3 cases and type I in 1 case. By the new Komi's classification utilizing operative cholangiogram there were 2 cases of Type Ia, 1 case of type IIb and 1 case of type III. One stage cyst excision and hepaticojejunostomy(Roux-en Y type) was done in 3 cases, and two staged operation in 1 case. All patients had an uneventful course postoperatively. The average day of discharge was 9.8th postoperatively. In conclusion, primary excision of the choledochal cyst and biliary reconstruction is a safe and effective treatment of ruptured choledochal cyst in infants.

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Screening of KMU-4, 6, 7 on inflammatory responses in IFN-γ and LPS-induced mouse peritoneal macrophages

  • Na, Ho-Jeong;Jeong, Hyun-Ja;Ahn, Jong-Woong;Um, Jae-Young;Kim, Hyung-Min;Hong, Seung-Heon
    • Advances in Traditional Medicine
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    • v.8 no.2
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    • pp.125-129
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    • 2008
  • Korean Marine Plants (KMU-4, 6, 7) obtained from an herb which widely used in medicine for the treatment of a variety of pathologies. In this study, using mouse peritoneal macrophages, we have examined whether KMU-4, 6, 7 affects nitric oxide (NO) and COX-2 induced IFN-$\gamma$ and LPS and cell viability. KMU-6 inhibits IFN-$\gamma$ and LPS-induced NO. We found that KMU-6 had a little effect on COX-2 expression. These finding means that KMU-6 can be used in controlling macrophages mediated inflammatory disease. The present results indicate that KMU-6 has an inhibitory effect on the production of NO through down-regulation of COX-2 expression in LPS stimulated mouse peritoneal macrophages.

Using of Polypropylene Mesh for Peritoneal Defect induced Gossypiboma in a Shih-Tzu Dog (시츄견에서 Polypropylene mesh를 이용한 gossypiboma에 의한 복막 결손 수복 증례)

  • Kang, Eun-Hee;Chang, Hwa-Seok;Chung, Dai-Jung;Lee, Jae-Hoon;Lee, Young-Su;Yang, Wo-Jong;Kim, Dae-Hyun;Chung, Wook-Hun;Choi, Chi-Bong;Kim, Hwi-Yool
    • Journal of Veterinary Clinics
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    • v.26 no.1
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    • pp.58-61
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    • 2009
  • A 10-year-old spayed female Shih-tzu dog with a left-sided caudal abdominal swelling of 2-month clinical duration was referred to the Konkuk University Teaching Hospital (KUVTH). We confirmed the presence of an abdominal mass by radiography and ultrasongraphy. A gossypiboma was identified between bladder and small intestines at surgery and removed. The resulting peritoneal adhesion was severe. But, the peritoneal defect did not allow easy repair of the abdominal wall. Therefore, polypropylene mesh (PPM) was used in repair. The patient was good condition after surgery with no caudal abdominal swelling. We followed the patient for the next 6 months with no complication.

A Case of Primary Mucinous Cystadenocarcinoma (원발성 후복막 점액낭샘암종 1예)

  • Ji, Jun-Ho;Lee, Hwa-Jung;Park, Seung-Chan;Park, Jung-Chul;Choi, Eun-Jung;Seo, Hye-Jin;Lee, Won-Sik;Lee, Jung-Lim;Bae, Byung-Jo;Shon, Kyung-Rak;Lee, Kyung-Hee
    • Journal of Yeungnam Medical Science
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    • v.25 no.2
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    • pp.134-138
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    • 2008
  • Primary retroperitoneal mucinous cystadenocarcinoma is a very rare malignancy, and little is known concerning its pathogenesis, optimal treatment, and prognosis. A 29-year-old pregnant woman (21 weeks) presented with abdominal discomfort. CA 19-9, CA 125, and CEA were normal. Abdominal CT scanning revealed a $19{\times}15{\times}13cm$ retroperitoneal tumor. Exploratory laparotomy and tumor excision were performed. Mucinous retroperitoneal implants were removed as completely as possible. Histologically, the tumor showed focal areas of capsular invasion, but free resection margins. The uterus and both ovaries were normal in appearance. No adjuvant therapy was pursued. Six months later, peritoneal and bilateral ovarian metastases were discovered. Hence, we report the details of this case of primary retroperitoneal mucinous cystadenocarcinoma and present a review of the literature.

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Clinical Presentation of Paraganglioma in Orthopaedics - Report of Two Cases - (정형외과 영역에서의 부신경절종의 임상 양상 - 2례 보고 -)

  • Lee, Sang-Lim;Oh, Joo-Han;Lee, Sang-Hoon;Kim, Han-Soo;Kim, Hyung-Ho;Kim, June-Hyuk
    • The Journal of the Korean bone and joint tumor society
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    • v.11 no.1
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    • pp.94-99
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    • 2005
  • Paraganglioma is a neoplasm consisting of sympathetic neuroendocrine cells, which arise from neural ectoderm of extra-adrenal paraganglia. It often occurs in thyroid, carotid body, mediastinum, lung, duodenum, the retroperitoneal area and periaortic area. Malignant paraganglioma is defined not by the histological diagnosis, but by spread to regional lymph nodes or distant metastasis. Rare bone metastasis mostly occurs in the base of skull or spine, and even it rarely metastasizes to pelvis or femur. We would like to report two cases of paraganglioma; one in the subcutaneous fat layer that was mistaken for a vascular tumor, and the other in the retroperitoneal space with early bone metastasis.

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Factors Influencing the Occurrence of Peritonitis in Patients on CAPD (복막투석 환자의 복막염 발생 영향요인)

  • Kim, Young-Hae;Kim, Yo-Na;Lee, Nae-Young
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.15 no.2
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    • pp.206-212
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    • 2008
  • Purpose: This study was done to identify the effects of self-care behavior, self-efficacy and family support on the occurrence of peritonitis in patients on CAPD (Continuous Ambulatory Peritoneal Dialysis). Methods: Data were collected from 81 patients on CAPD either as out-patients or in-patients between July and September 2004. Data were analyzed to identify relevant frequencies, percentages, averages, and standard deviations, and t-test and logistic regression were done using SPSS WIN 10.0 Results: a) Mean score for self-care behavior was 2.9 (of a possible 4.0), for general self-efficacy, 3.2 (of a possible 5.0), for specific self-efficacy 3.5 (of a possible 5), and for family support, 3.7 (of a possible 5). Family support generally showed the most positive results. b) Occurrence of peritonitis was not affected by general characteristics. c) There was a significant difference in the occurrence of peritonitis in terms of self-efficacy. Patients with peritonitis had lower self-efficacy than those who did not. 4) Of the four factors reviewed in relation to peritonitis, only self-efficacy was statistically significant: an increase in self- efficacy by 1 point increased the occurrence of peritonitis by 0.90. Conclusion: Among the four factors potentially affecting peritonitis in CAPD patients, general self-efficacy was found to be the main factor influencing the occurrence of peritonitis.

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The Usefulness of Serum Tumor Markers as a Predictor of Peritoneal Metastasis in Patients with Gastric Carcinoma: CA 19-9 and CEA (위암 환자에서 수술 전 복막전이 예측을 위한 혈청 종양 표지자의 유용성: CA 19-9와 CEA)

  • Cheong, Oh;Joo, Jae Kyun;Park, Young Kyu;Ryu, Seong Yeop;Jeong, Mi Ran;Kim, Ho Koon;Kim, Dong Yi;Kim, Young Jin
    • Journal of Gastric Cancer
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    • v.8 no.3
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    • pp.129-135
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    • 2008
  • Purpose: The usefulness of serum tumor markers for assessing gastric carcinoma is very limited compared to that for neoplasms in other digestive organs. Many reports have shown that serum tumor markers are closely associated with the prognosis and tumor recurrence in gastric cancer patients. However, little is known about the usefulness of serum tumor markers as a predictor of distant metastasis for gastric carcinoma. Materials and Methods: With excluding the non-specific causes of elevated tumor markers, a total of 788 patients with gastric carcinoma and who were seen at our hospitals between 2004 and 2006 were included in this study. The correlation between the preoperative level of tumor makers and the clinicopathological features was analyzed. Results: CEA was significantly correlated with age, gender and nodal metastasis, but not with the depth of tumor. The CEA level was not correlated with distant metastasis, such as peritoneal or hematogenous metastasis. In contrast, the CA 19-9 level was significantly correlated not only with the depth of tumor and nodal metastasis, but also with peritoneal metastasis. Especially, the patients with over 500% elevation of the CA 19-9 level had a significant risk of peritoneal metastasis. Conclusion: CA 19-9 is useful for predicting peritoneal metastasis in gastric cancer patients. It can be used efficiently in making the diagnostic and the treatment plan, in combination with other diagnostic tools, for gastric cancer patients.

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Intravenous Iron Supplementation in Korean Children on Chronic Dialysis (한국 만성 투석 소아 환자에서 정맥용 철분 제제 투여에 관한 연구)

  • Cho, Hee-Yeon;Hahn, Hye-Won;Ha, Il-Soo;Cheong, Hae-Il;Choi, Yong
    • Childhood Kidney Diseases
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    • v.13 no.2
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    • pp.197-206
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    • 2009
  • Purpose : Limited information is available on experiences of intravenous iron treatment in children. In this study, iron sucrose was administered intravenously to determine its effect, the factors predicting outcome, and safety in children on chronic dialysis. Methods : Twenty-one children whose serum ferritin levels were less than 100 ng/mL or transferrin saturations (TSAT) were less than 20% were enrolled. In 12 children on peritoneal dialysis (PD), the drug was infused intravenously as 200 mg/$m^2$ ($\leq$200 mg) at week 0, 2, 4, and 6. In 9 children on hemodialysis (HD), it was given intravenously as 8 weekly doses of 3 mg/kg ($\leq$100 mg) through week 0-7. Results : After treatment, serum ferritin levels increased significantly in both groups, and TSAT rose significantly in PD group. However, hemoglobin level did not rise significantly in both groups. Children with baseline hemoglobin less than 10 g/dL or baseline TSAT less than 20% showed significantly higher rise of hemoglobin after intravenous iron treatment. To the contrary, those with higher baseline hemoglobin and TSAT levels displayed higher rise in serum ferritin after the treatment. Although no serious adverse event occurred, TSAT levels exceeding 50% were noted in 6 patients in PD group. Conclusion : This suggests that 3 mg/kg/week of intravenous iron sucrose can be used safely in children on chronic HD, but 200 mg/$m^2$ every other week may incur excessive TSAT level in some patients on chronic PD.

A Case of Abdominal Tuberclosis Mimicking Ovarian Cancer (난소 종양의 임상적 양상을 보인 소아 복막 결핵)

  • Yeom, Jung Sook;Kim, Jae Hui;Cho, Jae Min;Lee, Jeong Hee;Park, Eun Sil;Seo, Ji Hyun;Lim, Jae Young;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.238-242
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    • 2005
  • We report the case of a girl with peritoneal tuberculosis (Tb) who presented with mimicking features of ovarian cancer including massive ascites, elevation of CA-125 and ovarian masses. These ovarian masses cannot be ruled out malingnacy with image study. Gram stain, acid-fast stain, bacteriological and mycological culture of centrifuged ascites cells were negative. Tumor markers revealed an elevated CA-125 level of 112 U/mL and adenosine deaminase level were significantly high with 118 U/L. Diagnostic laparoscopy was done. The histology of the peritoneum and the ovary showed multiple granulomatous nodules with epithelioid cells and multi-nucleated giant cells. And there were no evidence of malignancy. Furthermore acid-fast bacilli (AFB) was identified in this specimen. Peritoneal Tb was difficult to diagnosis in our patient because it mimicked ovarian cancer. And this is the first case of abdominal Tb mimicking ovarian cancer in children in Korea.

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Peritonitis Secondary to Pyometra & Ovarian Bursal Abscess in a Dog (개에서 자궁축농증 및 난소간막 농양에 의한 복막염)

  • Park, Eunjeong;Park, Jiyeong;Jeong, Seongmok;Choi, Hojung;Lee, Youngwon;Song, Kunho;Park, Seongjun;Yoon, Kiyoung;Chung, Taeho;Shin, Sangtae;Cho, Jongki
    • Journal of Veterinary Clinics
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    • v.30 no.5
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    • pp.387-389
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    • 2013
  • An 8-years-old intact female shih tzu was referred to the Veterinary Medical Teaching Hospital Chungnam National University for treatment of suspected pyometra. This dog had clinical symptoms of vaginal bleeding, vulvar discharge, polyphagia, polyuria/polydipsia and vomiting. In hematologic examinations, complete blood count (CBC) revealed mild leucopenia and a serum biochemistry profile revealed increased ALP, decreased GLU values. Diagnosis was made by radiographic examination, ultrasonographic examination, abdominocentesis. Peritonitis secondary to pyometra was tentative diagnosed. Surgical treatment was proceeding for ovariohysterectomy and peritoneal saline irrigation. It was confirmed that severe necrotized enteritis and pus leakage to ovarian bursa with pyometra. In this report, secondary severe disease also must be considered in diagnosis of pyometra because septic peritonitis could be occurred by pus leakage from uterus with pyometra.