• Title/Summary/Keyword: 복부수술

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A Case of Complete Response with FOLFOX Based Neo-adjuvant Chemotherapy in Advanced Gastric Cancer with Lymph Node Metastasis (림프절 전이가 동반된 진행성 위암 환자에서 수술 전 항암요법으로 시행한 FOLFOX 치료로 완전 관해를 보인 1례)

  • Myung Hee Kim;Hyun Yong Jeong;Hee Seok Moon;Jae Kyu Sung;Sun Hyun Kang;Ju Seok Kim
    • Journal of Digestive Cancer Research
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    • v.6 no.1
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    • pp.40-44
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    • 2018
  • A 77-year-old man presented with abdominal discomfort and was diagnosed as Borrmann type 3 advanced gastric cancer with multiple lymph node metastases. An abdominal computed tomography (CT) and positron emission tomography-computed tomography (PET-CT) showed AGC, clinical stage IIIC (T4aN3M0). We started neo-adjuvant chemotherapy with FOLFOX (5-fluorouracil (5-FU))+Leucovorin+Oxaliplatin). After 3 cycles of FOLFOX chemotherapy, follow-up endoscopy showed remarkable improvement. Primary lesion and metastatic lymph nodes decreased size on follow up computed tomography (CT). The patient underwent radical total gastrectomy with esophagojejunostomy and histopathology revealed no remnant malignant cells at previous primary cancer lesion. The patient has currently completed his 3 cycle of adjuvant chemotherapy without recurrence. After an abdominal CT response assessment, further course of therapy will be decided.

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Results of Surgical Management in Patients with Cardiac and Arterial Manifestations of Behcet's Syndrome (심장 및 동맥계를 침범한 베체트씨 증후군 환자의 수술 후 결과)

  • 원종윤;장병철;이도연;박상준
    • Journal of Chest Surgery
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    • v.35 no.1
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    • pp.36-42
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    • 2002
  • Background: To evaluate the efficiency of surgical treatment in patients with cardiac valvular and arterial involvement of Behcet's syndrome. Material and Method: 12 patients underwent surgical treatment due to the valvular heart diseases and the various arterial diseases associated with Behest's syndrome over 7 years; 6 with valvular heart disease, 1 with annuloaortic ectasia, 1 with ascending aortic aneurysm, 4 with pseudoaneurysms in abdominal aorta(n=2), carotid artery(n=1), and popliteal artery(n=1). All 12 patients had received valvular replacement(n=6) and the artificial(n=5) or autologous(n=1) graft interposition. We followed the results of these surgical treatments. Result: Operations were technically successful in all 12 patients and peri-operative complication was not demonstrated. However, 10 patients had recurrences; 6 with valvular dehiscence, 3 with pseudoaneurysm at anastostomosis site, and 1 with aorto-duodenal fistula. The duration of recurrence was 1 to 55 months(mean: 15.7$\pm$ 16.2 months). 7 patients underwent the second operation and among them, 4 patients showed repeated recurrences. Overall, 5 patients died 2 to 25 months after the operation(mean: 13.6 months), because of the bleeding at the anastomosis site Five patients did not present recurrence after the first(n=2) or the second operation(n=3) and their follow up duration was 5 to 60 months(mean: 45.8$\pm$41.7 months). Five patients received immune-suppressive therapy after the first(n=2) and second operation(n=3). Three did not shown recurrence for the 13, 29 and 33 months. Conclusion: Post-operative prognosis of arterial manifestation of Behcet's syndrome was not encouraging and if possible, other treatment strategy should be considered.

A Case of Spontaneous Perforation of the Common Bile Duct in Infant (영아에서 발생한 총담관 자연 천공 1례)

  • Nam, Ki Se;Kim, Jong Min;Chung, Ki Sup;Han, Seok Joo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.2
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    • pp.284-288
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    • 2004
  • Spontaneous perforation of the biliary duct is a rare disease that must be treated immediately when diagnosed in infancy. This disease must be suspected in a previously healthy infant who suddenly has abdominal distension, ascites, and intermittent jaundice. The best way to diagnose the leakage of bile in a clinically stable infant is to use radionuclide hepatobiliary scan. In most cases, however, the diagnosis of the perforation of common bile duct is frequently made during the procedure of operative cholangiogram. The prognosis is usually good with early diagnosis. We experienced an infant of 4 months of age who presented with sudden abdominal distension, jaundice and acholic stool, and confirmed the diagnosis of perforation of common bile duct through operative cholangiogram with t-tube insertion. We report a case of spontaneous perforation in an infant with review of the literatures.

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A case of midgut volvulus due to mesenteric lymphangioma, not associated with malrotation in a 13-year-old boy (13세남아에서 발견된 창자 회전이상이 동반되지 않은 낭성 림프관종에 의한 창자꼬임 1례)

  • Lee, Jung Ho;Choi, Seok Ju;Kim, Tae Yoon;Kim, Young Tong;Cho, Hyun Deuk;Park, Joon Soo
    • Clinical and Experimental Pediatrics
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    • v.51 no.4
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    • pp.431-434
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    • 2008
  • A 13-year-old boy, complained of an intermittent suddenly aggravated severe abdominal pain and diarrhea, was diagnosed as a small bowel volvulus without an intestinal malrotation, due to mesenteric lymphangioma. He took abdominal ultrasonography, abdominal CT scanning, upper gastrointestinal study and got an operation. The small bowel volvulus with cystic lymphangioma was confirmed by gross and pathologic findings.

Validation of a Translated Guideline on Pain Assessment and Management: Focused on Abdominal Surgery Patients (통증관리 근거중심 가이드라인의 국내 타당성 검증 - 복부수술 환자를 대상으로 -)

  • Hong, Sung Jung;Lee, Eunjoo
    • Journal of Korean Clinical Nursing Research
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    • v.18 no.1
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    • pp.159-170
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    • 2012
  • Purpose: This study was designed to examine the validity of the evidence-based guideline on pain developed by Registered Nurses Association of Ontario(RNAO) translated into Korean based on the experts' opinions. Methods: The panel consisted of experts of 60 registered nurses in surgical units, medical doctors and nursing managers who were experts in pain assessment and management. The validity of translated RNAO guideline was evaluated in terms of appropriateness, applicability, and utilization in current practice. Appropriateness and applicability of each recommendation were measured with 9 point scale, whereas utilization was measured by yes/no question. Data were analyzed by mean, standard deviation, and percent. The experts' opinions were analyzed by content analysis method. Results: In general, most of the recommendations in the guideline received above 7 point in appropriateness and applicability. However, above 20% of recommendations showed less than 50% of utilization rates in current practice. Conclusion: The reasons for low utilization of recommendations in current practice are in need for investigation. This study can be used for the development of guideline more acceptable in Korean health care settings and improve the quality of care for the abdominal surgery patients suffering from pain in Korea.

A Case of Ileoileocolic Type Intussusception Presented with Hematemesis Due to Meckel's Diverticulum (토혈이 동반된 멕켈 게실에 의한 회회맹장형 장중첩증 1례)

  • Bae, Soon Ho;Kwon, Young Dae;Kang, Ho Seok;Hwang, Su Kyung;Ko, Joon Tae
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.8 no.1
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    • pp.56-59
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    • 2005
  • Intussusception is the most common cause of intestinal obstruction in early childhood and characterized by periodic colicky abdominal pain or irritability, vomiting, current jelly stool, and sausage-like abdominal mass. Meckel's diverticulum is common intestinal anomaly presenting with painless rectal bleeding during first 2 year of age. It is recognized as a common leading point of intussusception in childhood. Hematemesis is the rare clinical manifestation of both intussusception and Meckel's diverticulum. A 7-year-old girl presented with hematemesis was diagnosed as having intussusception by abdominal ultrasonography. Meckel's diverticulum was the leading point of intussusception in this case.

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The Effect of Debriefing using Reflective Questions and Writing in Simulation Training - Post Operative Care of Abdominal Surgery (시뮬레이션 교육에서 성찰질문과 글쓰기를 이용한 디브리핑의 효과 - 복부수술 후 환자 간호에서)

  • Bang, SulYeong;Eun, Young
    • The Journal of Korean Academic Society of Nursing Education
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    • v.23 no.4
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    • pp.463-473
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    • 2017
  • Purpose: The purposes of study was to evaluate the effect of debriefing using reflection questions and writing on the critical thinking disposition, self-efficacy, and clinical judgement ability in simulation of post-operative care of abdominal surgery. Methods: The research method was a nonequivalent control group no-synchronized design. The study period was from August 22 to 30, 2016. The subjects were comprised of 34 people in the experimental group and 36 in the control group. In a simulation session for post-operative care of abdominal surgery, the treatment of the experimental group was to debrief for 30 minutes using Lasater's reflection questions and writing. For the control group, a typical debriefing was conducted in the same environment. Results: Critical thinking disposition, self-efficacy, and clinical judgement were significantly higher in the experimental group than the control group. Conclusion: To enhance the critical thinking disposition, self-efficacy, and clinical judgement of nursing students in simulation, it is recommended to debrief using reflection questions and writing.

Clinical Role of Interventional Radiology in Abdominal Solid Organ Trauma (복부 고형 장기 외상에 대한 인터벤션의 임상적 역할)

  • Hyun Seok Jung;Chang Ho Jeon;Sang Hyun Seo
    • Journal of the Korean Society of Radiology
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    • v.84 no.4
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    • pp.824-834
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    • 2023
  • Interventional management is commonly used for traumatic injuries to the abdominal solid organs. The American Association for the Surgery of Trauma (AAST) and the World Society of Emergency Surgery (WSES) recently published guidelines for the management and treatment of liver, spleen, and kidney injuries, emphasizing the importance of interventions. Here, we discuss the characteristics of each organ and the procedure method for each organ that interventional radiologists need to know when treating trauma patients.

The Effects of Low-Frequency Electrical Stimulation on Abdominal Core Muscle Activity and Thickness (저주파 전기자극이 복부 중심근육 활성도 및 두께에 미치는 영향)

  • Lee, H.J.;Lee, J.Y.;Tae, K.S.
    • Journal of rehabilitation welfare engineering & assistive technology
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    • v.7 no.2
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    • pp.85-90
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    • 2013
  • Core muscle is the most crucial for rehabilitation of patients with musculoskeletal and nervous problem, there is pain, imbalance and functional movement disorder of upper and lower extremities. In this study, low-frequency electrical stimulator was developed for the purpose increasing the activity of rectus abdominis (RA) and the thickness of transverse abdominis (TrA), internal obliquus abdominis (IO), and external obliquus abdominis (EO). Fifteen female in their 20's was divided into a experiment groups (traditional electrical stimulation group, developed electrical stimulation group) and control group. Low-frequency electrical stimulation was performed in experimental groups for 4 times a week, 4 weeks. The muscle activities (RA) by EMG and muscle thickness (TrA, IO, EO) by Ultrasonogrphy imaging were measured, respectively. In the result, the muscle activity of RA and muscle thickness of TrA and EO were significantly increased at developed electrical stimulation group (p<.05). Therefore, the developed low-frequency electrical stimulation is useful for rehabilitation with CNS and PNS subjects.

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A Case of Sigmoid Volvulus in a Child (소아에서 발생한 S상 결장 염전증 1예)

  • Lee, Dong-Han;We, Ju-Hee;Park, Hyun-Seok;Kim, Hae-Young;Park, Jae-Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.13 no.2
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    • pp.199-203
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    • 2010
  • Sigmoid volvulus may cause acute or subacute colonic obstruction. Excessive length of the sigmoid colon may be a contributing factor. Typically, the patient develops bilious vomiting and marked gaseous abdominal distension. We report a case of sigmoid volvulus in a 9-year-old boy who presented with recurrent, sudden onset abdominal pain, abdominal distension, and vomiting for 1 year, which was diagnosed by simple abdominal X-ray, barium enema, computed tomography, and colonoscopic examination. Colonoscopic reduction failed and a sigmoid colectomy with primary repair was performed. The intra-operative findings showed that the sigmoid colon was noted to be dilated, and redundant with a lax mesentery. Two clear areas of compression (proximal and distal) were present. After sigmoidectomy, the symptoms resolved. After 5 years of follow-up, he had no new symptoms.