• Title/Summary/Keyword: Abdominal Pain(AP)

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An Study on Abdominal Pain in Childhood according to Its Symptoms (소아(小兒) 복통(腹痛)에 관한 임상적(臨床的) 고찰(考察))

  • Kim Sung-Hee;Lee Seung-Yeon
    • The Journal of Pediatrics of Korean Medicine
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    • v.15 no.2
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    • pp.53-68
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    • 2001
  • Purpose : This Study was conducted to evaluate clinical manifestations of abdominal pain(AP) in childhood according to its symptoms and to find out characteristic of children with abdominal pain. Methods : Pacients who visited Dong-Eui Oriental Medical hospital from August to November 2001 due to abdominal pain were included. According to questionaire and history taking abdominal pain was classified by its six subtype in the Oriental Pediatic Text Book and Dong Eui Bo Gam(東醫寶鑑). Result : According to the Oriental Pediatic Text Book, among 41 children, 31.7% had symptoms of AP caused by cold in internal organs of deficiency(臟腑虛冷腹痛), 29.3% had symptoms of AP caused by diet(食積腹痛), 19.5% had symptoms of AP caused by cold(寒腹痛), 9.8% had symptoms of AP caused by both cold and diet, 7.3% had symptoms of AP caused by internal diet and external cold(內食外寒腹痛), 2.4% had symptoms of AP caused by stagnation of Ki and stasis of blood(氣滯血瘀腹痛). There is no AP caused by parasites(蟲腹痛). Otherwise, according to Dong Eui Bo Gam, 43.9% had symptoms of AP caused by cold, 26.8% had symptoms of AP caused by diet, 9.8% had symptoms of AP caused by both cold and diet, 7.3% had symptoms of AP caused by fire(熱腹痛), 7.3% had symptoms of AP caused by phlegm(痰飮腹痛), 4.9% had symptoms of AP caused by stagnated blood(瘀血腹痛). Also There is no AP caused by parasites. Conclusion : 1. The type of AP in Childhood is different from AP in adults. AP in Childhood is most occured by cold of deficiency and food, and there is few AP caused by fire. Six subtype in Dong Eui Bo Gam prefer adults to children and It is more studied that what kind of subtype is proper for AP caused by stress or drugs. So the study on subclassification and clinical Manifestations of AP in Childhood is more performed.

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A Study on Clinical Classification and Characteristic of Children with Recurrent Abdominal Pain (만성(慢性) 반복성(反復性) 복통(腹痛)을 주증(主症)으로 하는 환아(患兒)의 임상적(臨床的) 특징(特徵)에 관한 연구(硏究) -기능성 복통을 중심으로-)

  • Kim, Sung-Hee;Park, Sang-Wook;Lee, Seung-Yeon
    • The Journal of Pediatrics of Korean Medicine
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    • v.16 no.2
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    • pp.1-22
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    • 2002
  • Purpose : This Study was conducted to evaluate clinical characteristic of children with recurrent abdominal pain (RAP) and to be classified by its six subtype in the Oriental Pediatric Text Book and to find out relationship of western classification. Methods : Patients who visited Dong-Eui Oriental Medical hospital from August, 2001 to October, 2002 due to RAP were included. According to questionnaire and history taking, RAP was classified by its six subtype based on Oriental medical theory. Results : 1. Patients with RAP were more internalized, have a close relation with their parents, and have strong desires of success, but social intercourse is low. 2. 76% of Patients have a less desire to eat and 67% of Patients have a diarrhea or constipation. 3. According to questionnaire, first abdominal pain was their $3{\sim}5$ ages most, cause of occurrence was more 'eating cold foods' most, time of AP (abdominal pain) was $1{\sim}2$ hours after eating and no characteristic most, site of AP was the umbilicus most, shape of AP was impotent pain most, cause of reduce pain was abdominal massage and defection most. 4. frequency of RAP's type, AP caused by diet(食積腹痛) is 45.5%, AP caused by cold(寒腹痛) is 29.1%, AP caused by cold in internal organs of deficiency(臟腑虛冷腹痛) is 12.7%, stagnation of qi and stasis of blood(氣滯血瘀腹痛) is 10.9%, AP caused by internal diet and external cold(內食外寒腹痛) is 1.8%. There is no AP caused by parasites(蟲腹痛). 5. During clinical classifications of RAP, cause of occurrence was most important cause of reduce pian, defection practice was helpful for diagnosis, but shape of AP, site of AP was not helpful. 6. With relationship of Oriental classification and western classification, AP caused by diet is similar to dysmotilitylike dyspepsia and irriTable bowel syndrome. AP caused by cold is similar to irriTable bowel syndrome. AP caused by cold in internal organs of deficiency is similar to unspecified dyspepsia. stagnation of qi and stasis of blood and AP caused by internal diet and external cold is not like to western classification. Conclusion : RAP in Childhood is most occurred by food and cold. there is few AP caused by stagnation of qi and stasis of blood and internal diet and external cold. So the study on subclassification and clinical Manifestations of RAP in Childhood is more performed.

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Acute Pancreatitis in Children (소아 급성 췌장염의 임상적 고찰)

  • Cho, Jae-Ho;Lee, Tae-Seok;Ko, Young-Gwan;Oh, Soo-Myung
    • Advances in pediatric surgery
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    • v.2 no.1
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    • pp.17-25
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    • 1996
  • Acute pancreatitis(AP) in children is not common but can be associated with severe morbidity rates and its diagnosis is often delayed. Thus, reported mortality rates range from 0 to 78%. We have treated 26 patients with AP from 5 to 17 years of age over the past 17 years. We are intended to assess the relevance of the prognostic criteria used to assess severity of adult AP and to review the etiology, clilical presentation, diagnosis, and management of AP in children. The authors retrospectively reviewed 26 children with AP managed in Kyung Hee University Hospital from 1978 to 1995. Among 26 patients with AP, male were 12, and female were 14. And the mean age of patients was 11.8 years. In 9(34.6%), no definitive cause was identified. Common causes of AP were trauma(23.1%) and biliary tract disease(23.1%). Other etiologies were viral infection(15.4%) and post ERCP(3.8%). The presenting features were abdominal pain(92.3%), vomiting(61.5%), fever(19.2%), submandibular pain(11.5%), and abdominal mass(7.6%). Back pain was rare(3.8%). Abdominal ultrasonographic findings were abnormal in 10 of 16 patients(62.5%) and abdominal CT findings were abnormal for 9 of 9 patients(100%). Seventeen patients(65.3%) were managed conservatively, and nine patients(34.6%) required surgical treatment. There was no mortality. To evaluate the severity of disease, we used the Imrie prognostic criteria used to assess the severity in adult AP. The number of positive criteria was correlated to the duration of hospitalization(r2=0.91) but statistically insignificant(p>0.05). But, the number of positive criteria was correlated to the operative incidence(r2=0.93) and statistically significant(p<0.05). The common causes of AP in children were unknown origin(34.6%), trauma(23.1%), and biliary tract disease(23.1%). Ultrasonography and computed tomography were useful imaging tools of AP in children. The Imrie criteria used to evaluate the severity in adult AP were suspected to be valuable to assess the severity of AP in children.

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Usefulness of Ultrasonographic Examination by a Pediatrician in Children with Abdominal Pain (소아 복통에서 소아과 의사에 의한 초음파 검사의 유용성)

  • Park, Hyun-Seok;We, Ju-Hee;Park, Jae-Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.14 no.2
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    • pp.141-147
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    • 2011
  • Purpose: Ultrasonography (US) is widely used as a screening test in patients with abdominal pain (AP). We investigated the usefulness of US by a pediatrician in children with AP. Methods: We retrospectively analysed the medical records of children with AP who undertook US from December, 2008 to July, 2010. Results: A total of 628 patients (325 male, 303 female) were enrolled in this study. The mean age of patients was $8.08{\pm}4.61$ years. Duration of AP was acute in 427 and chronic in 201 patients. Localization of AP was diffuse (36.9%), periumbilical (24.4%), epigastric (21.0%), and right lower quadrant (8.1%). On the examination, there were no abnormal findings in 327 patients (52.1%). Abnormal ultrasonographic findings were mesenteric lymphadenitis (27.1%), intestinal mural thickening (10.0%), intussusception (3.0%), appendicitis (2.6%), choledochal cyst (1.6%), and pancreatitis (0.3%). We performed additional imaging studies such as computed tomography (CT) or magnetic resonance imaging (MRI) in 39 patients who showed obscure findings on the US. In 33 patients (84.6%), the same results were obtained from CT or MRI. Two cases of appendicitis, one case of pancreatitis and one case of Henoch-Sh$\ddot{o}$nlein purpura were diagnosed by the CT examination. However, there were two cases of appendicitis diagnosed by US thathad no evidence of appendicitis on the CT. Diagnostic accuracy of initial US in children with abdominal pain was 99.4%. Conclusion: US by a pediatrician as a screening test in children with AP provides a rapid and accurate diagnostic indication and has non-invasive and radiation-free advantages.

Computed Tomography Assessment of Severity of Acute Pancreatitis in Bangladeshi Children

  • Kaniz Fathema;Bazlul Karim;Salahuddin Al-Azad;Md. Rukunuzzaman;Mizu Ahmed;Tasfia Jannat Rifah;Dipanwita Saha;Md. Benzamin
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.27 no.3
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    • pp.176-185
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    • 2024
  • Purpose: Acute pancreatitis (AP) is common among children in Bangladesh. Its management depends mainly on risk stratification. This study aimed to assess the severity of pediatric AP using computed tomography (CT). Methods: This cross-sectional, descriptive study was conducted in pediatric patients with AP at the Department of Pediatric Gastroenterology and Nutrition, BSMMU, Dhaka, Bangladesh. Results: Altogether, 25 patients with AP were included, of whom 18 (mean age, 10.27±4.0 years) were diagnosed with mild AP, and 7 (mean age, 10.54±4.0 years) with severe AP. Abdominal pain was present in all the patients, and vomiting was present in 88% of the patients. Etiology was not determined. No significant differences in serum lipase, serum amylase, BUN, and CRP levels were observed between the mild and severe AP groups. Total and platelet counts as well as hemoglobin, hematocrit, serum creatinine, random blood sugar, and serum alanine aminotransferase levels (p>0.05) were significantly higher in the mild AP group than in the severe AP group (p=0.001). The sensitivity, specificity, positive predictive value, and negative predictive value of CT severity index (CTSI) were 71.4%, 72.2%, 50%, and 86.7%, respectively. In addition, significant differences in pancreatic appearance and necrosis were observed between the two groups on CT. Conclusion: CT can be used to assess the severity of AP. In the present study, the CTSI effectively assessed the severity of AP in pediatric patients.

Effects of Agrimoniae Herba 30% ethanol extract on LPS-induced inflammatory responses in RAW264.7 macrophage cells (선학초(仙鶴草)추출물의 대식세포에서의 LPS-유도 염증반응에 대한 효능 연구)

  • Hwang, Ji Hye;Nam, Joo Hyun;Kim, Woo Kyung;Bae, Hyo Sang
    • The Korea Journal of Herbology
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    • v.31 no.2
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    • pp.63-69
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    • 2016
  • Objectives : The aerial parts of Agrimonia pilosa Ledeb (Agrimoniae Herba; AH) has been traditionally used as a Korean medicine to treatment of abdominal pain, sore throat, headaches, bloody discharge, parasitic infections and eczema. In this study, we investigated the effect of AH ethanol extract on lipopolysaccharide (LPS)-induced inflammation in RAW264.7 macrophage cells.Methods : AH was extracted by 30% ethanol (AH-E). Raw264.7 cells were treated with AH-E extract at different concentrations for 30 min and then stimulated with LPS (1㎍/㎖) or without for indicated times. Cell viability was measured by MTT assay, and nitric oxide (NO) production was measured by Griess assay. The expression of inflammatory mediators, iNOS and COX-2 and inflammatory cytokines, TNF-α, IL-1β, and IL-6 was detected by RT-PCR, and the phosphorylation of ERK1/2, p38 and JNK MAP kinases (MAPKs) was analyzed by Western blot. Also, the expression of NF-κB in nuclear and cytosol was detected by Western blot.Results : AH-E extract significantly decreased LPS-induced NO production in RAW264.7 cells. AH-E extract inhibited the mRNA expression of iNOS, COX-2, TNF-α, IL-1β, and IL-6 in LPS-stimulated cells with a dose-dependent manner. In addition, the phosphorylation of ERK, p38 and JNK MAPKs was also inhibited by AH-E extract. AP-E extract inhibited the nuclear translocation of NF-κB in LPS-stimulated cells.Conclusions : Our results suggest that AH-E extract has an anti-inflammatory activity in macrophages-mediated inflammation.