• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권4호
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• pp.400-406
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• 2019

We report a 12-month-old female infant who had a history of neonatal sepsis with liver micro-abscesses that resolved with intravenous antibiotics during neonatal period. During her neonatal admission period, no umbilical vein catheter was inserted. Also, she did not undergo any abdominal surgeries or had a postnatal history of necrotizing enterocolitis. However, the child developed upper gastrointestinal bleeding in form of hematemesis and melena secondary to esophageal varices at the age of 12 months with an extra-hepatic portal vein obstruction with cavernous transformation and portal hypertension subsequently. The child underwent a successful endoscopic injection sclerotherapy. She is now 20-month-old and has portal hypertension but otherwise asymptomatic. We are proposing the possibility of a delayed-onset portal hypertension as a complication of liver abscess and neonatal sepsis.

• Journal of Trauma and Injury
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• 제24권2호
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• pp.111-117
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• 2011

Purposes: Pancreatic injury is rare in abdominal trauma patients (3%~12%). but it could result in significant morbidity and even mortality. Early and adequate decision making are very important in the management of patients with traumatic pancreatic injury. The purpose of this study was to assess the kinds of management and outcome through the review of our experience of pancreatic injury with multiple trauma. Methods: We reviewed 17 patients with traumatic pancreas injury via electronic medical records from Jan. 2002 and April. 2011. We collected demographic findings; the type, location and grade of pancreas injury, the treatment modality, and patient's outcomes, such as complications, length of hospital stay (LOS), and mortality. Results: Total 17 patients were reviewed, and man was 13 (88%). Traffic accident was the most common cause of injury. Pancreas neck was the most common injured site, and occured in 5 patients. Ductal injury was detected in 7 cases. Eleven patients were treated by surgical procedure, and in this group, 3 patients underwent the endoscopic retrograde pancreas drainage procedure coincidently. ERPD was tried in 8 patients, and failed in 2 patients. The major complications were post-traumatic fluid collection and abscess which accounted for 70 % of all patients. The hospital stay was 35.9 days, and it was longer in patient with ductal injury ($38.0{\pm}18.56$ vs. $34.5{\pm}33.68$ days). Only one patient was died due to septic shock associated with an uncontrolled retroperitoneal abscess. Conclusion: Early diagnosis is the most important factor to apply the adequate treatment option and to manage the traumatic pancreas injury. Aggressive treatment should be considered in patients with a post-operative abscess.

• Asian Pacific Journal of Cancer Prevention
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• 제16권5호
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• pp.2027-2029
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• 2015

Background: Laparoscope-assisted gastrectomy in treating patients with gastric cancers developed with a background of highly invasive traditional surgery and is being increasingly performed in the Asian Pacific area. This study systemically investigated the technique and clinical results for comparison with traditional radical subtotal gastrectomy for gastric cancers. Methods: Clinical studies evaluating the effectiveness and side effects of laparoscope-assisted gastrectomy in treating patients with gastric cancers were identified using a predefined search strategy. Summary rates of effectiveness and side effects of laparoscope-assisted gastrectomy were calculated. Results: Thirteen clinical studies which including 1,412 patients with gastric cancer treated by laparoscope-assisted gastrectomy were considered eligible for inclusion. Systemic analysis showed that, for all patients, the pooled resection rate was 100%. Major adverse effects were anastomotic stenosis, abdominal abscess, abdominal bleeding, postoperative ileus. Treatment related death occurred in 0. 71% (10/1412). Conclusion: This systemic analysis suggests that laparoscope-assisted gastrectomy in treating patients with gastric cancers is associated with good curative rate and acceptable complications.

• Journal of Yeungnam Medical Science
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• 제31권1호
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• pp.56-60
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• 2014

Hepatic portal venous gas (HPVG) is a rare radiographic finding associated with severe intra-abdominal disease and fatal outcome. Most cases of HPVG are historically related to mesenteric ischemia accompanied by bowel necrosis. The current spread of computed tomography scan promotes not only the early detection of related severe diseases but also the identification of other causes of HPVG. It has been reported in many non-fatal conditions, such as inflammatory bowel disease, intra-abdominal abscess, bowel obstruction, paralytic ileus, endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy, and gastric dilatation. Among these, paralytic ileus is a very rare condition, with no case yet reported in South Korea. Reported herein is a case of HPVG in paralytic ileus, which was treated well internally and was promptly resolved.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권1호
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• pp.90-97
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• 2019

Crohn disease has a wide spectrum of clinical presentations and rarely can present with complications such as a bowel stricture or fistula. In this case report, we describe a 17-year-old male who presented with a history of recurrent anterior abdominal wall abscesses and dysuria. He was diagnosed with Crohn disease and also found to have a fistulous communication between the terminal ileum and a patent urachus. An ileocecectomy with primary anastomosis and complete resection of the abscess cavity was performed. He is on azathioprine for maintenance therapy and currently in remission. Clinicians should have a high index of suspicion for this complication in Crohn disease patients presenting with symptoms suggestive of urachal anomalies such as suprapubic abdominal pain, dysuria, umbilical discharge, and periumbilical mass.

• Tuberculosis and Respiratory Diseases
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• 제66권6호
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• pp.457-462
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• 2009

역설적 반응은 감수성 있는 항결핵제를 복용중인 결핵 환자에서 치료시작 당시의 병변이 악화되거나 새로운 병변이 생기는 현상이고 이는 치료실패와 감별을 요한다. 일반적으로 역설적 반응은 기존 항결핵 치료로 좋은 결과를 보이므로, 이러한 임상 경과를 잘 이해함으로써 불필요한 검사나 치료약제 변경 등을 하지 않고 적절히 치료할 수 있게 될 것이다. 저자들은 적절한 항결핵제 치료 중에도 역설적 반응으로 결핵성 뇌농양, 결핵성 복막염이 연속적으로 병발한 환자 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• 한국임상수의학회지
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• 제25권2호
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• pp.102-105
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• 2008

The most common abnormality of the umbilicus in the foal is the patent urachus. Patent urachus may be a congenital or acquired condition in foals in which the urachus fails to close spontaneously at or shortly after parturition. A 17-day-old male Thoroughbred foal was requested to the Veterinary Pathology Laboratory of Cheju National University. The foal showed clinical signs such as umbilical urination, anorexia, depression, lethargy, and abdominal pain for 10 days. Because of the umbilical urination, the surgery for patent urachus was performed, but he died next day. Grossly, many pale yellowish foci 10-20 mm in diameter were scattered on the throughout surface of lungs. Severe subcapsular hemorrhage was observed in left kidney. Large milky yellow mass 10X6-7 cm in size was found in the adjacent area of right kidney. Histopathologically, many abscesses with bacterial cocci were scattered in the blood vessels or adjacent pulmonary parenchyma of lungs. Severe numerous abscesses with intralesional bacterial cocci were mostly occupied in the abdominal mass from right kidney. Gram staining for tissue sections demonstrated numerous Gram positive cocci in pulmonary and abdominal abscesses. In bacterial culture, catalase-positive beta-hemolytic colonies were isolated and confirmed as Staphylococcus (S.) aureus by Vitek system. Based on the results, acquired patent urachus and then multiple abscesses may be originated from the umbilical cord infected with S. aureus in this foal.

• Journal of Trauma and Injury
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• 제26권4호
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• pp.300-303
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• 2013

Blunt abdominal trauma is commonly encountered in the emergency department. The lack of historical data and the presence of distracting injuries or altered mental status, from head injury or intoxication, can make these injuries difficult to diagnose and manage. We experienced a case of traumatic organized hematoma misdiagnosed as intra-peritoneal tumor with intestinal obstruction. A 52-year-old homeless male patient who have chronic alcoholism was admitted via emergency room with infra-umbilical abdominal pain. At admission, he was drunken status and so we could not be aware of blows to the abdomen. He had a unknown large operation scar on mid abdomen. A computed tomography (CT) scan showed the intestinal obstruction of the ileum level with 5.5cm sized mesenteric tumor. We performed adhesiolysis and widely segmental resection of small bowel including tumor with side-to-side anastomosis due to great discrepancy in size. He stated later that he was a victim of the violence before 3 weeks. A final pathologic report revealed well encapsulated, traumatic mesenteric hematoma with organizing thrombi, ischemia and abscess formation with multiple adhesion bands. Finally, the patient was discharged without complications on postoperative day 14.

• Tuberculosis and Respiratory Diseases
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• 제65권3호
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• pp.212-215
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• 2008

본 증례는 와파린을 복용하던 72세 여자가 기침을 심하게 하던 중 하복부 통증과 압통을 보이는 복부 팽만이 발생하여 복부 전산화단층촬영을 통해 복직근초 혈종을 진단한 경우이다. 복직근초 혈종은 매우 드물지만 항응고제를 복용하는 고령 환자나 분만을 했거나 복부 수술을 받은 경우 등에서 발생할 수 있고, 드물게 기침에 의해서도 발생할 수 있다. 따라서 이런 환자에서 심한 복통이나 복부 종물이 관찰되는 경우 그 가능성을 한 번쯤 생각해보아야 하겠다. 전산화단층촬영은 복직근초 혈종 진단의 특이성과 민감도가 높아 진단에 도움이 되며 대부분은 보존적인 치료만으로 회복되므로 본 질환의 위험인자와 진단방법에 대해 숙지하고 정확한 진단을 하는 것이 무엇보다도 중요하겠다.

• Journal of Chest Surgery
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• 제30권10호
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• pp.1048-1050
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• 1997

본 국립의료원 흉부외과에서는 식도재건술에 따르는 아주 보기 드문 합병증을 경험하였다. 환자는 1969년 양잿물 섭취에 의하여 일년 뒤 양성 식도협착으로 발전하였다. 1972년 회결장을 이용한 식도 재건술을 실시 하였으나 복부 창상감염으로 농이 배출되었다. 그후로 창상부위에 분열과 유합이 되풀이 되었다. 1996년 이식한 결장의 협착으로 절제술 및 단단문합술을 시행하였다. 술중감염으로 인하여 염증반응이 진행하여 이식물의 협착을 초래하게 되었다고 결론지었다.