• Title/Summary/Keyword: 장천공

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Colon Perforation during Air Enema Reduction of Intussusception (소아 장중첩증에서 공기 주입 정복술 시행 도중 발생한 장천공)

  • Kim, Yong Kuk;Im, Hae Ra;Lee, Gwang Hoon;Han, Soo Jin;Sun, Yong Han;Ryoo, Eell;Cho, Kang Ho;Tchah, Hann;Lee, Hak Soo
    • Clinical and Experimental Pediatrics
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    • v.46 no.1
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    • pp.37-41
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    • 2003
  • Purpose : Although air enema reduction has been known as a good method of diagnosis and treatment of intussusception, it could develop colon perforation. However, there have been few studies about this complication. So we analyzed the risk factors of colon perforation during air enema reduction in patients with intussusception. Methods : We reviewed the charts of 12 colon perforation patients during air enema reduction of intussusception, who were admitted to Gil Medical Center from Jan. 1990 to Dec. 2001. Their age, sex, major symptoms, length of time till hospital visit, types of intussusception, operative findings and pathologic reports were reviewed. Results : Among 657 cases, 596 patients(90.7%) were successfully treated, but 12 patients(1.83%) failed in air enema reduction and had colon perforation. In patients with colon perforation the male to female ratio was 11 : 1, and average age was 5.3 months. The most common symptom at the time of hospital visit was vomiting(91.7%). Cyclic irritability(75.0%), bloody stool(75.0%) and abdominal mass(41.7%) were also noted. The average length of time between symptom onset and hospital visit was 44.7 hours. Types of intussusception were predominantly ileocolic, ileocecal, and ileoileocolic. The site of perforation was most commonly found at the proximal part of intussusception including ascending colon(50%) and transverse colon(50%). Most cases were uncomplicated, and had a single perforation. Pathologic reports showed hemorrhagic necrosis and mesenteric laceration at the site of colon perforation. Complications of colon perforation were tension pneumoperitonium(58.3%), requiring immediate decompression. Conclusion : The chance of colon perforation during air enema reduction increases in cases with small bowel obstruction on simple abdominal x-ray of a patient younger than 6 months, delay in time till hospital visit and higher air pressure during reduction. Therefore more careful investigation is needed in these cases.

Clinical experience of therapeutic effect of peritoneal drainage on intestinal perforation in preterm infants (미숙아의 장천공에서 복막 배액술의 치료효과에 관한 임상적 경험)

  • Lee, Jun Seok;Koo, Kyo Yeon;Lee, Soon Min;Park, Min Soo;Park, Kook In;Namgung, Ran;Lee, Chul;Choi, Seung Hoon
    • Clinical and Experimental Pediatrics
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    • v.52 no.11
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    • pp.1216-1220
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    • 2009
  • Purpose:To analyze and compare various cases in which peritoneal drainage was used as the primary treatment method in preterm infants with intestinal perforation. Methods:Among the preterm infants of less than 28 weeks of gestation who were admitted to the neonatal intensive care unit (NICU) at the Gangnam Severance Hospital from April 2006 to April 2009, 7 who had developed intestinal perforation were studied retrospectively. We investigated the clinical characteristics, secondary operation performances, morbidities, complications, and mortalities. Results:Among the 7 infants, 5 survived. Of the 5 cases, 3 received laparotomy, of which 2 were confirmed as having necrotizing enterocolitis. Of the 2 infants who died, 1 had received laparotomy before 48 h of peritoneal drainage, while the other had not received any subsequent treatment. Of the 7 children, 4 had patent ductus arteriosus (PDA), of which 3 had received indomethacin injection. Five infants had begun enteral feeding before they developed intestinal perforation. Of the 5 infants who survived, 4 were diagnosed with cholestasis. Of the 7 infants, 4 developed periventricular leukomalacia (PVL) and 3 developed rickets. Conclusion:Although the use of peritoneal drainage as the primary management of intestinal perforation in preterm infants is controversial, we suggest that it can be used for treating extreme premature neonates. Further randomized controlled study will be required to determine the feasibility of using this method.

A Case of Ascarid Impaction and Intestinal Perforation in an Adult Zebra (Equus burchelli bohmi) (성숙한 얼룩말에서 Ascarid Impaction 및 장천공)

  • Yang, Jae-Hyuk;Lim, Yoon-Kyu
    • Journal of Veterinary Clinics
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    • v.28 no.4
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    • pp.442-445
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    • 2011
  • Macrocyclic lactone resistance has been reported in populations of Parascaris equorum from several countries. A Grant's zebra (Equus burchelli bohmi) was admitted to the Equine Hospital at Jeju Race Park with signs of chronic weight loss and severe depression. Clinical examination revealed tachycardia and dehydration. Over the course of a day, the zebra suffered from severe abdominal pain and subsequently died. Prior to admission, the zebra had received prophylactic anthelmintic treatment with ivermectin 3 times at 3-month intervals and was dewormed with ivermectin 30 days prior to the onset of depression. At necropsy, there were masses of ascarids in the stomach and small intestine, and intestinal perforation. There are many reports of ivermectin-resistant P. equorum in horses. However, anthelmintic resistance has not been formally demonstrated in zebras. This report describes diagnosed case of gastrointestinal impaction and intestinal perforation by P. equorum in an adult zebra. We suspect that ivermectin-resistant P. equorum larvae were the cause.

Fluoroscopic Stent Placement as a Bridge to Surgery for Malignant Colorectal Obstruction: Short- and Long-Term Outcomes (악성대장협착의 근치적 절제술을 위한 수술 전 투시장치 하 스텐트 설치술: 단기 및 장기 결과)

  • Jong Hyouk Yun;Gyoo-Sik Jung
    • Journal of the Korean Society of Radiology
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    • v.84 no.3
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    • pp.615-626
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    • 2023
  • Purpose To assess the outcomes of single-stage surgery following fluoroscopic stent placement for malignant colorectal obstruction. Materials and Methods This retrospective study included 46 patients (28 male and 18 female; mean age, 67.2 years) who had undergone fluoroscopic stent placement followed by laparoscopic resection (n = 31) or open surgery (n = 15) for malignant colorectal obstruction. The surgical outcomes were analyzed and compared. After a mean follow-up of 38.9 months, the recurrence-free and overall survival were estimated, and prognostic factors were evaluated. Results The mean interval between stent placement and surgery was 10.2 days. Primary anastomosis was possible in all patients. The mean postoperative length of hospitalization was 11.0 days. Bowel perforation was detected in six patients (13.0%). During the follow-up, ten patients (21.7%) developed recurrence; these included five of the six patients with bowel perforation. Bowel perforation had a significant effect on recurrence-free survival (p = 0.010). Conclusion Single-stage surgery following fluoroscopic stent placement may be effective for treating malignant colorectal obstruction. Stent-related bowel perforation is a significant predictive factor for tumor recurrence.

A case report of gastrointestinal perforation in patient after biliary stent insertion and the overview of gastrointestinal perforation (담도 스텐트 시술 후 장천공 증례보고 및 장천공에 대한 고찰)

  • Ga-Young Lee;Chan-Ran Park;Jung-hyo Cho;Chang-gue Son;Nam-hun Lee
    • The Journal of Korean Medicine
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    • v.43 no.3
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    • pp.195-203
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    • 2022
  • Objectives: This study aimed to emphasize the importance of accurate and timely diagnosis of acute abdominal pain with simple radiography by reporting a case of gastrointestinal perforation. Methods: We closely observed the diagnosis and progress of acute abdominal pain after biliary stent and reviewed the outline of gastrointestinal perforation. Results: Patient diagnosed with urethral cancer metastasis to lung and peritoneum was treated with complex Korean medicinal treatments to deal with anorexia, abdominal pain, jaundice and oliguria. During hospitalization, the patient's acute abdominal pain after biliary stent was diagnosed with gastrointestinal perforation by using plain chest and abdominal radiography. Conclusion: Using simple radiography to find out the emergency diseases such as perforation in acute abdominal pain is important clinically.

A Case of Churg-Strauss Syndrome with Interstinal Perforation (장천공이 동반된 Churg-Strauss 증후군 1예)

  • Park, Jung Hoon;Jung, Yun Seok;Kim, Yang Ki;Lee, Young Mok;Hwang, Jung Hwa;Kim, Ki-Up;Kim, Dong Won;Uh, Soo-Taek;Kim, Jae Jun
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.5
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    • pp.374-379
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    • 2009
  • Churg-Strauss syndrome (CSS) or allergic granulomatous angiitis is a rare syndrome that is characterized by hypereosinophilic systemic necrotizing vasculitis affecting small- to medium-sized arteries and veins. In general, it occurs in individuals with pre-existing allergic asthma. When CSS appears in patients, it has the following characteristics: eosinophilia of more than 10% in peripheral blood, paranasal sinusitis, pulmonary infiltrates, histological proof of vasculitis with extravascular eosinophils, and mononeuritis multiplex or polyneuropathy. Therapeutic trials dedicated to Churg-Strauss syndrome have been limited due to the rarity of this disorder and the difficulty in making a histological diagnosis. Proper treatment of patients with CSS is not widely known. In this case study, we report on our experience with an unusual patient case, characterized by purpura and a perforation of the small intestine after inadequate steroid therapy.

Behcet's Disease with the Left Carotid Artery Aneurysm and Colon Perforation (좌측 경동맥류와 대장천공을 동반한 베체트병)

  • 전준경;장원채;최용선;오봉석
    • Journal of Chest Surgery
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    • v.37 no.3
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    • pp.279-281
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    • 2004
  • Behest's disease is manifested as ulcers present in oral cavity, on external genital organ, orbital area, and skin. This disease could also cause other symptoms by invading the cardiovascular system, respiratory system, gastrointestinal system, central nervous system, and urogenital system. It is very rare for Behcet's disease to be accompanied by carotid artery aneurysm and intestinal perforation. We report a patient with Behcet's disease, who is diagnosed with symptoms and pathological findings as haying carotid artery aneurysm and intestinal perforation at the same time. The patient underwent operation for the aneurysm and the intestinal perforation.

Intravenous immunoglobulin for severe gastrointestinal manifestation of Henoch-Schönlein purpura refractory to corticosteroid therapy (스테로이드 치료에 반응하지 않는 심한 위장관 증세의 Henoch-Schönlein 자반증 환아에서 정맥 면역글로불린 치료)

  • Yang, Hye Ran;Choi, Won Jung;Ko, Jae Sung;Seo, Jeong Kee
    • Clinical and Experimental Pediatrics
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    • v.49 no.7
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    • pp.784-789
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    • 2006
  • Purpose : $Henoch-Sch{\ddot{o}}nlein$ purpura(HSP) is a systemic vasculitis involving small vessels of skin, gastrointestinal(GI) tract and kidney. Digestive involvement of HSP can be serious with massive GI bleeding, perforation, and intussusception. However, some patients do not respond to conventional corticosteroid therapy. In this study, we investigated the efficacy of intravenous immunoglobulin (IVIG) for serious digestive manifestations not responding to steroid. Methods : From April 1999 to January 2005, 22 children diagnosed as HSP with severe GI symptoms were included. Initially, all patients were treated with intravenous methylprednisolone. IVIG 2 g/kg of body weight was infused in children refractory to steroid therapy. Clinical data were reviewed retrospectively. Results : Among 22 children, 12 children underwent IVIG therapy. The mean duration of corticosteroid therapy was $5.61{\pm}4.9$ days before IVIG therapy, and 11 of 12 patients experienced disappearance of GI manifestations after the initiation of IVIG infusion. In one patient, IVIG was ineffective in relieving abdominal pain, but melena subsided. Comparison of the duration of hospitalization between IVIG group and corticosteroid group revealed no significant difference($12.8{\pm}7.6$ days vs. $13.2{\pm}7.8$ days, P=0.777). But, the total duration of abdominal pain decreased in IVIG group although the difference between two groups was not significant($8.8{\pm}8.1$ days vs. $14.8{\pm}16.9$ days, P=0.306). Among 10 children treated with steroid only, 2 children were operated for bowel perforation and intussusception. In contrast, there was no perforation in 12 children who underwent IVIG therapy. Conclusion : IVIG could be the alternative therapy to corticosteroids in children with severe digestive manifestations of HSP.

Study on frequency dependency of Q for Stochastic Strong Ground Motion Simulation (추계학적 강지진동 모사를 위한 Q의 주파수 의존 특성에 대한 연구)

  • 연관희;박동희;장천중
    • Proceedings of the Earthquake Engineering Society of Korea Conference
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    • 2003.03a
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    • pp.77-84
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    • 2003
  • For stochastic strong ground motion simulation, frequency-dependent Q model (= $Q_{o}$ $f^{η}$) were evaluated for major geographical blocks according to the epicentral distance ranges by using a lateral Q tomography technique. The inversed Q results were used to qualitatively identify seismic albedos of each Q blocks and were compared with the previous Q studies. In addition, a functional Q model calibrated to the low frequency spectra of local earthquakes were suggested especially for use in analysing large and distant regional earthquake events.s.

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