• Title/Summary/Keyword: 복부수술

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Carcinoma of the Colon and Rectum : Sonographic Findings and usefulness (Cases Review) (결직장암의 초음파검사 소견 및 유용성(증례 중심으로))

  • Jung, Hong-Ryang;Kim, Myeong-Soo;Sim, Hyun-Sun
    • Journal of radiological science and technology
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    • v.26 no.2
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    • pp.43-47
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    • 2003
  • Colorectal cancer produce focal mass or segmental thickening which can be detected with sonography. The purpose of this study was to describe sonographic findings of colorectal cancer. we reviewed sonograms of 51 patients with colorectal cancer in whom sonography was performed before colon study. In 51 patients who had more common coloretal cancer 27cases(53%) had 40 to 50 years of age(60%). Sonographic findings included segmental thickening 42cases, or irregular mass 9 cases. With careful examination, these findings can be detectable, and therefore bowel should be carefully examination in patients with sign and symptoms suggesting carcinoma of the colon and rectum.

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Association of visceral fat obesity and other lifestyle factors with prostate cancer (비만으로 인한 전립선암 발생의 영향연구 : 복부비만도 측정과 그 외 생활 요인)

  • Kim, Myeong-Seong
    • Korean Journal of Digital Imaging in Medicine
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    • v.17 no.1
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    • pp.19-31
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    • 2015
  • 최근 우리나라의 암 발생률은 꾸준히 증가추세에 있고 그 중에서도 전립선암은 갑상선암을 제외했을 때 남성에서 가장 높은 증가 추세를 보이고 있는 암이다. 전립선암은 그 동안 선진국에서 주로 발병하는 것으로 알려진 암 종이지만 서구화된 식습관과 생활 행태 변화로 인하여 국내에서도 발생률이 증가하는 것으로 추정하고 있다. 따라서 국내 환경에 맞는 내장 지방 분포와 같은 정확한 비만도 측정을 통해 우리나라에서 증가율 1위를 보이고 있는 전립선암 발생의 원인 관계를 찾고자 한다. 본 연구는 환자와 정상군 비교를 하는 환자-대조군 연구이고 본 연구를 위하여 임상시험 윤리위원회 (IRB) 승인을 받았다 (NCC2014-0124). 환자군은 2014년 8월 1일부터 2015년 1월 6일 까지 국립암센터를 방문하여 전립선암을 진단받고 수술과 항암치료 그리고 방사선 치료를 시작하지 않은 초진을 대상으로 하였고, 정상군은 2009년 11월부터 2014년 9월 30일까지 공단검진을 목적으로 국립암센터를 방문한 정상인을 대상으로 하였다. 전립선암 연구는 환자 총 52명에 평균 66세 (51 - 82세)이고 정상군은 총 50명에 평균 64세 (59 - 75세) 이다. 모든 연구 대상자들의 생활 요인 평가를 위하여 암 가족력, 흡연, 음주 상태, 운동, 등을 추가적으로 설문 조사하였다. MRI 영상의 배꼽 주위에서의 내장 지방과 피하지방을 전용 분석 컴퓨터를 활용하여 측정 하였다. 복부비만율은 환자군과 정상군에서뿐만 아니라 (p = 0.03), 전립선암 악성도와 (Gleasonscore; p = 0.001)도 통계적 차이를 나타냈다. 하지만 BMI 결과와는 전립선암 발생과 악성도에서 무관함을 보인 것에 반해 허리둘레는 전립선암의 발생에 영향을 미치는 결과를 나타났다. 한편 전립선암의 또 다른 악성도 지표인 PSA는 비만 측정치와의 상관성이 Gleason score와 보다 대체적으로 낮게 나타났다. 학력, 운동량, 흡연, 음주 상태와 같은 생활 특성에 따른 전립선암 발생의 영향 관계는 뚜렷하지 않았다. 결론적으로 본 연구를 통해서 전립선암의 발생 위험도와 악성도 지표로 복부 비만도가 유용함을 나타냈고 간단한 신체 계측 지표 활용으로는 BMI보다 허리둘레 측정치가 더 암 발생의 연관성이 높음을 보였다.

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Diagnostic Performance of Blood Culture Bottles for Abscess Culture in Patient with Abdominal Soft Tissue Abscess (복부 연조직 농양 환자에서 농양 배양을 혈액배양병으로 했을 때의 성과 1예)

  • Jo, Kyo Jin;Chang, Chulhun L.;Hwang, Jae-Yeon;Park, Su Eun
    • Pediatric Infection and Vaccine
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    • v.28 no.2
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    • pp.118-123
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    • 2021
  • Culture tests are very important in choosing the appropriate antibiotics for bacterial infections. In some cases, bacteria that could not be identified in standard culture bottles could be detected using blood culture bottles. A previously healthy 13-year-old boy visited our emergency room. He experienced pain, redness, and hardness of periumbilical skin and a fever for five days. There was no history of abdominal surgery and penetrating trauma. Computed tomography showed abscess with cellulitis at the periumbilical soft tissue with no congenital anomaly. Ultrasonography-guided aspiration was performed, and about 8.5 mL of the purulent abscess was aspirated. The abscess was cultured using blood culture bottle. The pus grew Actinomyces radingae and Clostridium ramosum. When performing the pus culture, using blood culture bottles can be more effective and rapid than the standard culture method for the detection of bacterial pathogens.

Endovascular Treatment for Arterioureteral Fistula of the Abdominal Aorta: A Case Report and Literature Review (복부 대동맥에 발생한 동맥-요관 누공의 혈관 내 치료: 증례 보고와 문헌고찰)

  • Hyoung Nam Lee;Woong Hee Lee
    • Journal of the Korean Society of Radiology
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    • v.81 no.4
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    • pp.953-957
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    • 2020
  • We present a rare case demonstrating successful endovascular management of an arterioureteral fistula involving the abdominal aorta. Arterioureteral fistulas are rare but life-threatening, with mortality rates ranging from 7% to 23%. Early recognition and prompt management are essential for preventing catastrophic consequences, including hypovolemic shock. However, recognition of an arterioureteral fistula requires a high index of clinical suspicion due to its rarity and the lack of a sensitive diagnostic method. Arterioureteral fistulas could be induced by traumatic events in patients who have a history of pelvic surgery, radiation, and prolonged placement of a ureteral stent. Endovascular stent graft placement could be a valid treatment option for arterioureteral fistulas involving the abdominal aorta.

Contrecoup Injury associated with Fatal Portal Vein Bleeding: A Case Report (반충손상 기전에 의한 간문맥손상에 대한 증례 보고)

  • Joonghyun Yoo;Sung-Joon Park;Seung Hwa Lee;Hwan Hoon Chung
    • Journal of the Korean Society of Radiology
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    • v.82 no.6
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    • pp.1594-1599
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    • 2021
  • A 64-year-old male visited our emergency department due to severe right flank pain after falling from a 2-meter height. Contrast-enhanced CT revealed a right hemothorax with multiple fractures in the right ribs and iliac bone. A small hematoma in the right perihepatic space was noted, but there was no hepatic laceration on CT. Initial surgical management led to continuous uncontrolled bleeding around the porta hepatis, and subsequent arterial angiography could not demonstrate a bleeding focus. However, immediate follow-up CT showed contrast extravasation on the left side of abdomen, and a percutaneous transhepatic portal venogram revealed active bleeding from the left portal vein. Although the wound was embolized with a glue, the patient suffered from a cardiac arrest and finally expired. In conclusion, during evaluation of abdominal trauma patients, portal vein bleeding and contrecoup injuries should be considered when hepatic arteriography findings are unremarkable.

Early Results in Surgical Treatment of Thoracic Aortic Aneurysm (흉부 대동맥류의 외과적 치료)

  • An, Byeong-Hui;Sin, Seong-Hyeon;Na, Guk-Ju
    • Journal of Chest Surgery
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    • v.30 no.7
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    • pp.686-692
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    • 1997
  • This study represents an attempt to present an analysis of early surgical results in 15 cases of aortic surgery conducted at Chonnam University Hospital between February 1994 to August 1995. The subject, 9 males and 6 females, ranged in age from 32 to 73 years with a mean age of 55.07$\pm$ 1176 years. The patients were treated for dissecting aortic aneurysm in nine, atherosclerotic aneurysm in 4, and traumatic aortic aneurysm in two. There were 9 cases of median stemotomy, 4 cases of posterolateral thoracotomy, and 2 cases of thoracoabdominal incision. Graft replacement of ascending aorta andfor partial or total aortic arch were performed in 9 patients, descending aorta andfor t oracoabdominal aorta in 3 and total aorta in 1, Two traumatic aortic aneurysms were closed directly. Associate procedures were resuspension of aortic valve in three patients and elephant trunk procedure, coronary reimplantation and aortic valve replacement in one patient. Nine patients underwent operation for ascending aorta andfor aortic arch with retrograde cerebral perfusion during deep hypothermia and circulatory arrest. Perfusion pressure was maintained below 25 mmHg and the mean duration of circulatory arrest was 56.67 $\pm$ 29.25 minutes. Three patients underwent graft replacement of desending thoracic and thoracoabdominal aorta during deep hypothermia and circulatory arrest. Three patients died of traumatic bile peritonitis, multioragn failure, and rupture of residual dissecting aortic aneurysm by malignant hypertension. Postoperative complications included reoperation for bleeding in 4 patients, temporary confusion in 3, pulmonary complication in 3, and pericardial effusion in .

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Diagnostic Imaging of Lipoma in the Retroperitoneum and Pelvic Cavity in a Dog (개의 후복강과 골반강에 발생한 지방종의 진단영상 증례)

  • Lee, Nam-Soon;Kim, Jun-Young;Na, Eung-Sic;Kim, Mi-Eun;Lee, Hye-Yeon;Choi, Mi-Hyun;Kim, Wan-Hee;Kim, Dae-Yong;Choi, Min-Cheol;Yoon, Jung-Hee
    • Journal of Veterinary Clinics
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    • v.27 no.1
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    • pp.88-92
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    • 2010
  • An 11-year-old, spayed female, weighing 10 kg miniature Schnauzer was admitted for abdominal distension, anorexia, pollakiuria, and constipation. A large, homogeneous fat opacity mass was identified in the retroperitoneum and pelvic cavity on the abdominal survey radiography. The mass displaced the descending colon peripherally and ventrally, and the urinary bladder ventrally. On the abdominal ultrasonographic examination, the mass was uniformly hyperechoic with a coarse internal echo texture and had outer hyperechoic capsule, and it showed homogeneously same attenuation (-180 ~ -110 HU) as adjacent fat on the computed tomography. There was no evidence of invasion into the surrounding structures or organs. Cytological findings from fine needle aspirates were numerous sheets and clusters of adipocytes. The dog showed complete resolution of clinical signs after surgical resection of the mass. The mass was confirmed as simple lipoma through histopathological examination.

Outcome of typhlitis in children with cancer (소아암 환자에서 발생한 막창자염(typhlitis)의 치료성적)

  • Lee, Jae Min;Choi, Kwang Hae;Hah, Jeong Ok
    • Clinical and Experimental Pediatrics
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    • v.51 no.2
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    • pp.156-161
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    • 2008
  • Purpose : Neutropenic enterocolitis is an acute, life-threatening inflammation of the small and large bowel, often seen in children with malignancies during periods of prolonged or severe neutropenia. The optimal management for typhlitis in pediatric oncology patients has been debateful between operative and nonoperative approaches. The purpose of this study was to review the outcome of medical management of patients who were diagnosed as typhlitis. Methods : The records of 207 pediatric cancer patients who were diagnosed and treated at the pediatric department of Yeungnam University Hospital for cancer between August, 2002 and July, 2007 were reviewed. Results : Among 207 patients, 12 (5.7%) children aged 9 to 14 years, were diagnosed clinically to have typhlitis. Clinical symptoms and signs of patients were fever, abdominal pain and tenderness, diarrhea, vomiting and rebound tenderness. Bowel-wall thickening (> 4mm) was seen on CT or ultrasonography. All patients were treated with antibiotics combinations of teicoplanin, carbapenem, aminoglycoside, or other third generation cephalosporin and metronidazole or clindamycin. Eight patients were treated with additional antifungal agents. Other supportive management included bowel rest, total parenteral nutrition, and G-CSF administration. All patients recovered completely and did not need any surgical management. Conclusion : Early diagnosis and aggressive supportive treatment appears to be important for complete recovery and survival of typhlitis.

Usefulness of a Alvarado Scoring System for the Diagnosis of Acute Appendicitis in Children (소아 충수돌기염 진단에서 Alvarado Scoring System의 유용성)

  • Yang, Eun Seok;Yoon, Sung Kwan;Kim, Eun Young;Rho, Young Il;Park, Sang Kee;Park, Yeong Bong;Mun, Gyeong-Rae
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.1
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    • pp.1-7
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    • 2004
  • Purpose: Alvarado scoring system was evaluated regarding its usefulness for the early diagnosis of acute appendicitis in adult and in reduction of the incidence of negative appendicectomies. To evaluate the accuracy of diagnosing appendicitis using the Alvarado score in children. Methods: Prospectively, we surveyed 122 patients (male 67, female 55) suffering from abdominal pain, who had visited to the emergency department of Chosun University Hospital from June 2002 to May 2003. The Alvarado score has been computed from the white blood cell count, neutrophil count, body temperature, resistance in the right lower quadrant, length of symptoms, nausea and vomiting. Each patient was evaluated by a pediatric resident and then by a general surgeon independently. Results: Out of 170 total children who visited to the emergency department due to abdominal pain, 122 patients were associated with appendicitis. A total of 122 patients (67 male and 55 female) were visited to the emergency room with suspected appendicitis. From 105 operated patients, 92 (87.6%) were diagnosed acute appendicitis and erronous diagnostic rate was 12.4%, pathologically. Mean alvarado score of appendicitis group was $5.40{\pm}1.24$ whereas those of non-appendicitis group was $3.73{\pm}1.82$ (p<0.05). From 6 Alvarado score high sensitivity (86.4%) and high specificity (80.0%) were observed. Sensitivity of ultrasonography or computed tomography was 92.5%. Conclusion: We found that Alvarado score system is a noninvasive, safe diagnostic method, which is simple, reliable and repeatable. Alvarado score is useful system for a first, rapid and economic evaluation for the appendicitis in children.

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Duodenal Complication After Open Heart Surgery Report of Three cases (개심술후 발생한 십이지장궤양 합병증 -3례 보고-)

  • Heo, Jae-Park;Kim, Gi-Bong
    • Journal of Chest Surgery
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    • v.30 no.12
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    • pp.1251-1253
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    • 1997
  • Gastrointestinal complications, especially duodenal complication after cardiopulmonary bypass are rare, but often fatal. We experienced 1 case of duodenal ulcer bleeding and 2 cases of duodenal ulcer perforation developing after cardiopulmonary bypass from August 1994 to April 1996. In the case of duodenal ulcer bleeding, palpitation, dizziness, tachycardia and melena were the clues leading to diagnosis, and in the cases of perforation, abdominal distension with pain, tachycardia, hypotension, oliguria were the clues. Duodenal perforations were diagnosed by abdominal paracentesis. The patient with duodenal bleeding was treated by H-2 receptor antagonist, antacids and transfusion. And emergency laparotomy was required for the patients with duodenal perforation. In addition to ulcer prophylaxis including H-2 receptor antagonist and antacids, a high index of suspicion and timely surgery are necessary for early diagnosis and appropriate treatment of duodenal complication developing af er cardiopulmonary bypass.

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