• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• 제7권1호
• /
• pp.1-7
• /
• 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.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• 제13권1호
• /
• pp.30-35
• /
• 2010

Purpose: Infectious ileocecitis is an infection confined to the ileocecal area and one of the most common causes of pediatric abdominal pain. This study was performed to demonstrate the clinical features of infectious ileocecitis in children. Methods: The medical records and radiologic findings of 37 patients with ileocecitis diagnosed by ultrasonography and/or computed tomography, who were admitted to Pusan National University Hospital from January 2004 and July 2008, were reviewed retrospectively. Viral gastroenteritis and secondary ileocecitis were excluded. Results: The mean age of the patients was 4.8${\pm}$3.4 years. One-half of the patients were preschool children. The chief complaint was abdominal pain (75.7%), diarrhea (10.8%), and vomiting (8.1%). Accompanying symptoms were fever (56.8%), vomiting (21.6%), and diarrhea (16.2%). The mean duration of abdominal pain, fever, diarrhea, and vomiting was 3.8${\pm}$2.1, 3.0${\pm}$1.9, 3.4${\pm}$1.9, and 2.4${\pm}$2.3 days, respectively. The frequency of diarrhea and vomiting was 5.8${\pm}$2.2 and 4.0${\pm}$2.8 per day, respectively. Diagnosis was made by abdominal ultrasonography in 22 patients (59.5%), abdominal CT in 2 patients (5.4%), and both modalities in 13 patients (35.1%). Besides the radiologic finding of thickening of the bowel wall, mesenteric lymphadenitis (59.5%), ascites (5.4%), and both mesenteric lymphadenitis and ascites (16.2%) were revealed. The mean duration of illness was 7.5${\pm}$5.0 days. There were no specific laboratory findings, and culture studies with stool or blood were negative. All of the patients recovered completely without specific treatment. Conclusion: Infectious ileocecitis has acute appendicitis-mimicking symptoms, but is self-limited within a few days, thus unnecessary treatment and work-up is avoided. However, distinguishing infectious ileocecitis from appendicitis, inflammatory bowel disease, and mesenteric lymphadenitis is important.

• Journal of Chest Surgery
• /
• 제37권12호
• /
• pp.1029-1031
• /
• 2004

We had expierienced pulmonary lymphangioleiomyomatosis(LAM) with bilateral chylothorax and chylous ascites. A twenty-one-year-old lass with chief complaint of abdominal pain was admitted through the emergency room. She received emergent pelvicoscopic surgery for the rupture of the right corpus luteum. We aspirated 1000ml of the uncoagulated blood. The bleeding point was cautherized electrically. LAM was diagnosed with tissue from the retroperitoneum. Chylous ascites and bilateral chylothorax were occurred despite of various treatments. On thoracotomy, bullous changed lung and lymphatic leakage from visceral and parietal pleura were observed. She died of respiratory insufficiency and general weakness after 6 months from admission.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• 제7권2호
• /
• pp.239-242
• /
• 2004

Eosinophilic gastroenteritis is a rare condition of unknown etiology characterized by peripheral eosinophilia, eosinophilic infiltration of the gastrointestinal tract, and gastrointestinal symptoms. Eosinophilic gastroenteritis is generally classified according to the Klain classification: predominant mucosal, muscular, and subserosal disease. Mucosal involvement may result in abdominal pain, nausea, vomiting, diarrhea, weight loss, anemia, protein-losing enteropathy, and intestinal perforation. Patients with muscular layer disease generally have obstructive symptoms. Subserosal eosinophilic infiltration may result in development of eosinophilic ascites. Most commonly, the stomach, duodenum, and small bowel are involved. A 13-year-old girl came to our hospital presenting with chronic, intermittent abdominal pain. She showed peripheral eosinophilia and biopsy specimen of the duodenum revealed eosinophilic infiltration of the mucosal layer. We here report a case of eosinophilic gastroenteritis.

• Parasites, Hosts and Diseases
• /
• 제30권2호
• /
• pp.147-150
• /
• 1992

The second case of human infection with Mesccestoides Zineatus in Korea was reported. The patient, a farm worker, complained of abdominal pain and massive discharge of sesame-like proglottids in his stool for several months. Worms, recovered by chemotherapy with niclosamide, consisted of 32 strobilae. This may be the heaviest worm burden in human infection ever reported. The infected man habitually ate the raw viscera of chickens.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• 제11권sup2호
• /
• pp.67-71
• /
• 2008

The incidence of inflammatory bowel disease (IBD), especially Crohn disease, in children is remarkably increasing in Korea. Therefore, it is necessary for pediatrician to be aware of the initial presentation of Crohn disease and ulcerative colitis. Laboratory tests, radiologic studies, and endoscopic procedures are helpful in differentiating between them. At the time of presentation, most of children with IBD have abdominal pain, diarrhea, hematochezia and/or weight loss. However, atypical presentation of these diseases may contribute to a delay in diagnosis.

• 대한예방의학회:학술대회논문집
• /
• 대한예방의학회 1993년도 제45차 추계 학술대회 연제집
• /
• pp.29-30
• /
• 1993

• 대한상한금궤의학회지
• /
• 제11권1호
• /
• pp.27-34
• /
• 2019

Objective : The purpose of the present study was to report the improvement of functional abdominal pain in a patient treated with a herb medication based on a disease pattern identification diagnostic system under the provision of Shanghanlun (DPIDS). Methods : According to DPIDS, the patient was diagnosed with Taeyang-byung, no. 25 provision, and was administered with Gyejiyimahwangyil-tang herb medication for 60 days. The severity of the abdominal pain was assessed with the five-point Likert scale. Results : The abdominal pain in the patient disappeared following treatment with Gyejiyimahwangyil-tang, which is described in the 25th provision of Shanghanlun. Conclusions : The present case report suggests that '瘧', a word in the 25th provision of Shanghanlun may indicate severe abdominal pain at nighttime and not just malaria.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• 제10권2호
• /
• pp.197-201
• /
• 2007

The gastrointestinal (GI) tract is the extranodal location most frequently involved in MALT lymphomas, and although MALT lymphomas can be found in the small intestine, most MALT lymphomas of the GI tract occur in the stomach. In addition, MALT lymphoma occurs predominantly in adults; however, a ten-year old female that was admitted to our hospital due to Rt. lower quadrant abdominal pain 1 month ago,was diagnosed with intussusception secondary to ileocecal MALT lymphoma. A biopsy specimen confirmed lymphocyte infiltration with lymphoepithelial lesions, suggesting a low grade MALT lymphoma. Therefore, we report a case of low-grade MALT lymphoma occurring in a ten-year-old female who presented with ileocecal intussusception.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• 제14권1호
• /
• pp.26-32
• /
• 2011

Chronic abdominal pain (CAP) is a common complaint encountered in pediatric clinics and a great concern for patients and their caretakers as well as health care professionals. A constant challenge is detecting individuals with organic diseases or psychosomatic disorders from the majority of patients who have a functional disorder including functional dyspepsia, irritable bowel syndrome, functional abdominal pain, and abdominal migraine. Beginning with a detailed history and physical examination, physicians must determine a differential diagnosis of CAP by applying the symptom-based Rome III criteria to positively identify a functional disorder. These findings should then be further analyzed based on diagnostic clues and red flags that indicate the presence of specific organic diseases and/or the need for further testing. Once a functional diagnosis has been made or an organic disease is suspected, physicians can initiate an empiric therapeutic trial. Since psychological distress accompanies both organic and non-organic abdominal pain in children, a cooperative diagnostic approach involving pediatricians and psychiatrists is recommended.