• Title/Summary/Keyword: 소아 CT

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Motor delay : cerebral palsy (운동발달 장애)

  • Park, Ho Jin
    • Clinical and Experimental Pediatrics
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    • v.49 no.10
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    • pp.1019-1025
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    • 2006
  • Motor delay, when present, is usually the first concern brought by the parents of children with developmental delay. Cerebral palsy that is the most common motor delay, is a nonspecific, descriptive term pertaining to disordered motor function that is evident in early infancy and is characterized by changes in muscle tone, muscle weakness, involuntary movements, ataxia, or a combination of these abnormalities. A wide range of causative disorders and risk factors have been identified for cerebral palsy, and broadly classified into 5 groups; perinatal brain injury, brain injury related to prematurity, developmental abnormalities, prenatal risk factors, and postnatal brain injury. Delay in attaining developmental milestones is the most distinctive presenting complaint in children with cerebral palsy. A detailed history and thorough physical and neurologic examinations are crucial in the diagnostic process. The clinician should be cautious about diagnostic pronouncement unless the findings are unequivocal. Several serial examinations and history review are necessary. All children with cerebral palsy should undergo a neuroimaging study, preferably MRI, because an abnormality is documented on head MRI(89%) and CT(77%). The high incidence rates for mental retardation, epilepsy, ophthalmologic defects, speech and language disorders and hearing impairment make it imperative that all children with cerebral palsy be screened for mental retardation, ophthalmologic and hearing impairments, and speech and language disorders; nutrition, growth, and swallowing also should be closely monitored.

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.

A Case of Infantile Lobar Emphysema (유아 대엽성 폐기종 1례)

  • Lee, Seock-Yeol;Lee, Seung-Jin;Lee, Cheol-Sae;Lee, Kihl-Rho;Oh, Mee-Hye
    • Advances in pediatric surgery
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    • v.13 no.1
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    • pp.87-92
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    • 2007
  • An 1-month old female newborn was admitted to our hospital because of jaundice which occurred at 2 days after birth. Plain chest X-ray and chest CT revealed a collapsed right middle lobe and lobar emphysema was suspected. Right upper lobectomy of the lung was done and pathologic findings showed an infantile lobar emphysema. After the operation, the newborn was discharged without complication and was followed up through the out patient clinic. Infantile lobar emphysema is rare and male dominant. Left upper lobe of the lung is the most prevalent site. Patients with infantile lobar emphysema complain of respiratory symptoms. We report one case of infantile lobar emphysema on right upper lobe of lung, in a female with no respiratory symptoms.

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Percutaneous Fixation with Cannulated Screws and Ilizarov External Fixator in Triplane Fracture of the Distal Tibial Epiphysis in Children (소아 경골 원위 골단부 삼면 골절의 경피적 나사못 고정술과 Ilizarov 외고정 장치를 이용한 치료)

  • Hyun, Yun-Seok;Kim, Gab-Lae;Lee, Kwang-Nam;Lee, Eun-Su
    • Journal of Korean Foot and Ankle Society
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    • v.12 no.2
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    • pp.180-184
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    • 2008
  • Purpose: To evaluate the result of percutaneous fixation with cannulated screws and Ilizarov external fixator in triplane fracture of the distal tibial epiphysis in children. Materials and Methods: Between May 2004 and December 2007, 14 cases with triplane fractures were treated by percutaneous fixation with cannulated screws and Ilizarov external fixator after underwent CT imaging to assess the fracture pattern, articular disruption and to plan further management. Mean age and follow-up period were 14.1 years old and 15 months respectively. Results: There were satisfactory results in all 14 cases that had excellent reduction and stable fixation. All cases regained full range of movement within 6 weeks. Conclusion: We obtained satisfactory result after percutaneous fixation with cannulated screws and Ilizarov external fixator in triplane fractures of the distal tibial epiphysis in children.

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Ganglioneuroblastoma Associated with Malignant Hypertension and Cardiac Failure (심한 고혈압과 심부전을 동반한 신경절신경모세포종 1예)

  • Moon, Suk-Bae;Kim, Hae-Eun;Lee, Suk-Koo;Seo, Jeong-Meen
    • Advances in pediatric surgery
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    • v.15 no.1
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    • pp.68-72
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    • 2009
  • Neuroblastoma is the most common extracranial solid tumor in children, and accompanies various clinical symptoms including hypertension. Hypertension is associated with catecholamines secreted from the tumor, and is usually not severe. We report one case of malignant hypertension with cardiac failure in a patient with adrenal neuroblastoma, successfully treated with adrenalectomy. A 3 year-old boy complained of protrusion of the chest wall. Physical examination revealed severe hypertension with cardiac failure. The levels of metabolites of catecholamine were increased in blood (norepinephrine >2000 pg/mL) and urine (norepinephrine 1350.5 ug/day). Abdominal CT showed a 7 cm-sized solid mass arising from the right adrenal gland. After stabilizing the hemodynamics with oral phenoxybenzamine, right adrenalectomy was performed. Pathological diagnosis was a ganglioneuroblastoma. The hypertension and cardiac failure were resolved after tumor removal.

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Anomalous systemic arterial supply to lung without sequestration in an infant who has congenital heart disease : a case report (선천성 심장질환을 가진 영아에서 발견된 폐 격리증을 동반하지 않은 폐의 이상 체 동맥 기시 1례)

  • Jang, Yeon Woo;Choi, Duck Young
    • Clinical and Experimental Pediatrics
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    • v.49 no.8
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    • pp.895-897
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    • 2006
  • Systemic arterial supply from the aorta to the lung is a rare congenital anomaly within the spectrum of bronchopulmonary sequestration according to Pryce's terminology. We describe our experience of this anomaly in an infant with congenital cardiac disease confirmed by multidetector CT scan. We found a systemic arterial supply from the aorta to the right lower lobe of lung without right lower lobar pulmonary artery and bronchopulmonary sequestration. This combination of congenital anomaly is most rare form.

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 Hepatosplenic Tuberculous Abscess (간과 비장에서 발생한 결핵성 농양 1례)

  • Han, Yu Seok;Chung, Ju Young;Kim, Sang Woo;Kim, Sung Hee
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.1
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    • pp.108-111
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    • 2004
  • Tuberculosis is not a common cause of liver abscess and it is rarely considered in the differential diagnosis of a patient with hepatic mass. We report a case of tuberculous abscess of liver and spleen in a 15-year-old boy who presented with abdominal pain, fever and weight loss. The ultrasonographic and computed tomographic scan of the abdomen revealed multiple cystic lesions in the liver and spleen. Mycobacterium tuberculosis was cultured from the ascitic fluid and biopsy specimen of lymph node. Follow up CT scan of the abdomen after anti-tuberculosis medication for eighteen months showed complete resolution of the cystic lesions with calcified nodules.

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Group B Streptococcal Renal Abscess in a 17-Year-Old Girl with Type 1 Diabetes Mellitus

  • Oh, Kyeong Eun;Yim, Hyung Eun;Yoo, Kee Hwan
    • Childhood Kidney Diseases
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    • v.24 no.1
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    • pp.53-57
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    • 2020
  • Streptococcus agalactiae or group B streptococcus (GBS) is associated with infections in neonates and pregnant women. Herein, we describe a rare case of GBS renal abscess with peritonitis and pleural effusion in a 17-year-old girl with type 1 diabetes mellitus. The girl was admitted due to fever and right flank pain. Laboratory findings included leukocytosis and increased C-reactive protein level and erythrocyte sedimentation rate. Her serum glucose level was 484 mg/dL. Urinalysis showed no pyuria. Renal sonography revealed parenchymal swelling in the right kidney. The patient was administered intravenous cefotaxime. Urine and blood cultures were negative. Fever seemed to improve, but the following day, she complained of abdominal pain and fever. Antibiotic was switched to imipenem, and abdominal and pelvic CT revealed a ruptured right renal abscess, peritonitis, and bilateral pleural effusion with atelectasis. Pigtail catheter drainage of the abscess was performed. Culture from the abscess was positive for GBS, and fever subsided 2 days after the drainage. She was discharged with oral cefixime. The clinical course of urinary tract infections (UTIs) can be atypical in patients with diabetes, and GBS can be a cause of UTIs. Prompt diagnosis and management are necessary to prevent complications in patients showing atypical courses.

A Case of Erythropoietic Protoporphyria with Severe Liver Dysfunction and Neurological Symptoms (신경 및 위장관 증세를 동반한 Erythropoietic Protoporphyria 환아 1예)

  • Kim, Bo Hyun;Park, Young Nyun;Chung, Ki Sup
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.8 no.2
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    • pp.263-268
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    • 2005
  • Erythropoietic protoporphyria is a genetic disorder due to a deficiency of ferrochelatase resulting in excessive accumulation and excretion of protoporphyrin. The predominant clinical feature is photosensitivity. Severe hepatic failure occurs in a small percentage of patients, and neurological symptoms are very rare. We report a case of erythropoietic protoporphyria associated with severe hepatic dysfunction and neurological symptoms. A 9-year-old girl presented with severe abdominal pain, nausea, weakness and pain of extremities, and urinary retention. Ultrasonogram and abdominal CT scanning revealed a diffuse infiltrated and enlarged liver. Liver biopsy showed deposition of dense dark brown pigment within the bile, hepatocytes and Kupffer cells. Plus, dense dark brown deposits gave a red birefringent under polarize light. Porphyrin studies demonstrated markedly elevated serum free erythrocyte protoporphyrin. This girl was diagnosed as erythropoietic protoporphyria with severe liver dysfunction and neurological symptoms.

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