• Title/Summary/Keyword: Abdominal approach

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Acute Abdominal Pain in Children (급성 복통)

  • Kang, Ki Soo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.11 no.sup2
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    • pp.11-18
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    • 2008
  • We often have difficulties in the diagnosis of acute abdominal pain in children because they are unable to adequately express the characteristics of their pain. With a good understanding of the etiologies of abdominal pain associated with ages, we should create a diagnostic approach based on the location of the pain. First, we must differentiate the surgical abdomen from the non-surgical acute abdomen. Then, we have to identify whether the pain originating from intestinal obstruction, ulcerative diseases, or hepatobiliary dysfunction. It is important to interview and examine the patient serially until the patient completely improves. These attitudes will reduce the patient's pain caused by delayed diagnosis and unavoidable misdiagnosis. Finally, the new insight for the appropriate use of analgesics against acute abdominal pain in children is now needed by the pediatrician.

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A Case of Patient with Recurrent Vomiting and Abdominal pain due to Intestinal Pseudoobstruction (반복적 구토 및 복통으로 가성 장 폐쇄로 진단받은 환자 1례)

  • Cho, Hyung-Jun;Lee, Jin-Yong;Kim, Deog-Gon;Kim, Ki-Hoon
    • The Journal of Pediatrics of Korean Medicine
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    • v.18 no.1
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    • pp.93-104
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    • 2004
  • Objectives: Transverse myelitis is a rare neurological disorder that is part of a spectrum of neuroimmunologic diseases of the central nervous system. A patient was hospitalized with intestinal pseudoobstruction(poor oral feeding, vomiting, abdominal pain, constipation) secondary to Transverse myelitis. We treated her with Oriental medical approach and obtained satisfactory result. Methods: The Herbal medicine(Bihwa-eum), Acupuncture, Moxibustion therapy were applied for improving the deficiency of energy of the spleen and stomach, regulate the flow of vital energy. Results: After treatments, Patient's vomiting frequency is decreased and abdominal pain is improved and oral feeding is available. She gains in weight continuously. Conclusion: The authors thought that Bihwa-eum is effective to vomiting and abdominal pain due to intestinal pseudoobstruction. The more study is needed.

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The Effects of Abdominal Relaxed Breathing Training on Stress response and Blood Pressure for Elderly Hypertensionve Patient (고혈압 노인에서 복식호흡 이완훈련이 혈압 및 스트레스 반응에 미치는 영향)

  • 유수정;송미순
    • Journal of Korean Academy of Nursing
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    • v.31 no.6
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    • pp.998-1011
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    • 2001
  • In order to improve self-management of elderly hypertensives in this study, the researcher examined the effect of blood pressure regulation by an abdominal relaxed breathing training which regulates physical response to stress and lessens the activity of the sympathetic nerve. Method: A quasi-experimental pre-test and post-test design was used. Thirty elderly hypertensive patient ; Sixteen in the abdominal breathing group and fourteen in the control group participated in this study. The abdominal relaxed breathing training consisted of eight sessions twice a week for four weeks. There was no intervention for the control group. Result: 1. There was a significant decrease in systolic and diastolic blood pressure between the experimental group and control group over three different times, and interaction by groups and over time. 2. There was no significant difference in the level of total stress response, physical stress response, behavioral-cognitive stress response between the experimental group and control group over three different times, and interaction by groups and over time. Conclusion: Findings indicate that this study will contribute to develop nursing strategies for the regulation of blood pressure for the elderly, which is easy for the elderly to learn as a nonpharmacologic approach.

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Diagnostic Approach of Hepatic Mass using Ultrasound Guided Fine Needle Aspiration in a Dog (개에서 초음파를 이용한 간 종괴의 세침흡인술 증례)

  • 최호정;이기창;최민철;윤정희
    • Journal of Veterinary Clinics
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    • v.21 no.2
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    • pp.181-183
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    • 2004
  • Hepatic mass was aspirated under the guidance with ultrasound in 9-year old female maltese with signs of anorexia, hematochezia, vomiting, depression, and abdominal distension. Radiographic and abdominal ultrasonographic examinations were performed, which revealed enlarged tubular shaped uterine mass and solitary, small round hyperechoic hepatic mass dorsal to gall bladder as an incidental finding. Ultrasound-guided fine needle aspiration was completed, but histologic confirmation should be made for definitive diagnosis by tissue core or wedge biopsy.

Splanchnic Nerve Block at T12 Level (제 12흉추부위에서 시행한 내장신경차단)

  • Park, Chung-Hyun;Yoon, Kuck-Mi;Oh, Hung-Kun
    • The Korean Journal of Pain
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    • v.5 no.1
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    • pp.17-22
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    • 1992
  • Splanchnic nerve block(SNP) is performed to relieve intractable upper abdominal cancer pain. Boas, in a technique using fluoroscopy, was the first to note the difference between transcrural celiac plexus block and retrocrural splanchnic nerve block(SNB). We have experienced 10 cases of SNB at the T12 level under control of fluoroscopy. Our results support this approach as an effective method for upper abdominal cancer pain control.

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A Clinical Analysis of Abdominal Stab Wounds (복부 자상의 치료 방법에의 접근)

  • Park, Ji-Yeon;Chung, Min;Lee, Yeong-Don;Lee, Jung-Nam;Lee, Woon-Ki;Park, Yeon-Ho;Baek, Jung-Heum;Park, Heung-Gyu;Kim, Keon-Kuk;Kang, Jin-Mo;Choi, Sang-Tae;Lee, Won-Suk;Park, Seung-Youn
    • Journal of Trauma and Injury
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    • v.23 no.2
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    • pp.134-141
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    • 2010
  • Purpose: A classic approach to abdominal stab wounds has been a routine laparotomy for the purpose of diagnosis or treatment. However, management protocols for abdominal stab wounds are still contentious in most trauma centers. We examined the relationship between the character of the stab wound and the injured intraabdominal organs by retrospectively analyzing the medical records of patients with abdominal stab wounds admitted to Gil hospital, and the findings for our patients are then confronted with a review of the literature. We aimed to propose proper management protocols to approach abdominal stab wounds. Methods: The medical records of all 80 patients sustaining abdominal stab wounds, admitted at the Department of Surgery, Gil Hospital, Gachon Medical School, from January 2004 to December 2008 were retrospectively reviewed. All the abdominal stab wounds were collated based on the site and the character of the injury, investigations performed on admission, results of investigations, operations performed and findings at the time of the operation. Results: The most prevalent age group was patients in their forties and the average age of the patients was 41 years for both genders. The stab wounds were most commonly located at the periumbilical area (16.9%), followed by the epigastric area (15.6%), and 18.2% of the patients had multiple wounds. The most commonly eviscerated organ was the omentum (9 out of 16 cases); 61.7% of non-eviscerated patients underwent a therapeutic laparotomy while 81.3% of eviscerated patients underwent a therapeutic laparotomy. The small bowel was the most commonly injured organ (22.7%, 17 out of 75 injuries). The review revealed a relatively common diaphragmatic injury in abdominal stab wound patients (8 cases, 10.5%). The average hospital stay was 11 days. Conclusion: This review revealed commonly eviscerated and injured intraabdominal organs in abdominal stab wound patients and their relationship with a therapeutic laparotomy. Although the management is still controversial, the authors suggest indications for an immediate laparotomy and a protocol for managing abdominal stab wounds. Hemodynamic instability and peritoneal irritation signs are definite indicators for an immediate laparotomy, but the review revealed intraabdominal organ evisceration alone not to be a statistically significant factor. In addition, the authors suggest that abnormal CT findings can be valuable for making a decision on management of hemodynamically stable stab wound patients. Further study may clarify a role for a more selective approach to operative intervention and for a more extensive use of selective observation.

A New Approach Method of Measuring Abdominal Pressure for Urodynamic Monitoring System (요역동학 측정시스템을 위한 새로운 복압측정 기법)

  • Seo, Jeong-Hwan;Kim, Keo-Sik;An, Yang-Su;Kim, Kyeong-Seop;Song, Chul-Gyu
    • The Transactions of The Korean Institute of Electrical Engineers
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    • v.56 no.6
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    • pp.1170-1176
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    • 2007
  • The conventional urodynamic monitoring is fulfilled by artificially filling a bladder with saline. Generally. it is difficult to evaluate the physiological functions of the storage and voiding of a bladder. With this aim, we constructed an ambulatory urodynamic monitoring (AUM) system and proposed a novel method estimating abdominal pressure by measuring bio-impedance variations. Our system was clinically evaluated for 10 patients. It turned out to be that as the intensity of the abdomen contraction increased, the amplitude of bio-impedance signal and the RMS value of EMG increased more as compared to those who observed during the rest mode. Also, we determined the optimum electrode pair for estimating the abdominal pressure using bio-impedance method and consequently compared with the conventional methods. Because impedance changes differ from a weight, a height, contractile force, volume of muscle and blood other or whatever of individuals, it was quantified in terms of impedance change, correlation coefficient and SNR Our results showed the optimum electrode pair (1,9) which could detect impedance changes due to the increase of the intensity in the abdominal pressure. The correlation coefficient and quadratic function between the RMS values of EMG and the impedance changes were 0.87 and $y=0.0014x^2+0.0620x+0.6958$, respectively. Thus, our system demonstrated that the abdominal pressure could be measured noninvasively and conveniently by simply estimating bio-impedance values. We propose that this optimum electrode configuration would be useful for the future studies involving the handy measurements of abdominal pressure with our suggested ambulatory urodynamics monitoring system.

New Technique of Intracorporeal Anastomosis and Transvaginal Specimen Extraction for Laparoscopic Sigmoid Colectomy

  • Wang, Zheng;Zhang, Xing-Mao;Zhou, Hai-Tao;Liang, Jian-Wei;Zhou, Zhi-Xiang
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.16
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    • pp.6733-6736
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    • 2014
  • Background: Despite the growing acceptance of laparoscopic colon surgery, an abdominal incision is needed to remove the specimen and perform an anastomosis. Recently, natural orifice specimen extraction (NOSE) and intracorporeal anastomosis have been proposed to minimize abdominal wall trauma and improve the quality of laparoscopic colon resections Objective: To evaluate the feasibility and safety of a new approach combining intracorporeal delta-shaped anastomosis and transvaginal specimen extraction for totally laparoscopic sigmoid colectomy. Materials and Methods: Mobilization of bowel and dissection of lymph nodes were performed laparoscopically. After both proximal and distal incisal edges about 10.0 cm distance from sigmoid neoplasm were transected with an Endoscopic Linear Cutter-Straight, a small incision about 1.0 cm was created on the each colon wall of the contralateral side of the mesentery. Then anvils of an Endoscopic Linear Cutter-Straight were inserted into each colon through the small incisions, and incision and anastomosis between the walls of each colon were performed with a linear stapler. A V-shaped anastomosis was made on the wall and the remnant openings was reclosed with the Endoscopic Linear Cutter-Straight. The culdotomy was enlarged with laparoscopic ultrasound dissector. Transvaginal extraction of specimens was accomplished through a wound protector. Results: Surgery was performed for 11 patients with sigmoid cancer. No intraoperative complications or conversions occurred. The mean operating time was 132 min. All the patients were treated laparoscopically without any postoperative complications. Conclusions: The procedures of intracorporeal delta-shaped anastomosis and transvaginal specimen extraction are safe and oncologically acceptable for selected colon cancer cases.

Retroperitoneal Spinal Extradural Arachnoid Cyst Combined with Congenital Hemivertebrae

  • Park, Se-Hwan;Kuh, Sung-Uk;Lim, Beom Jin
    • Journal of Korean Neurosurgical Society
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    • v.52 no.3
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    • pp.257-260
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    • 2012
  • Spinal extradural arachnoid cysts usually cause symptoms related to spinal cord or nerve root compression. Here, we report an atypical presentation of a spinal extradural arachnoid cyst combined with congenital hemivertebra which was presented as a retroperitoneal mass that exerted mass effects to the abdominal organs. On image studies, the communication between the cystic pedicle and the spinal arachnoid space was indistinct. Based on our experience and the literature of the pathogenesis, we planned anterior approach for removal of the arachnoid cyst in order to focus on mass removal rather than ligation of the fistulous channel. In our estimation this was feasible considering radiologic findings and also essential for the symptom relief. The cyst was totally removed with the clogged 'thecal sac-side' end of the cystic pedicle. The patient was free of abdominal discomfort by one month after the surgery.

Splanchnic Nerve Block with Transdiscal Approach -A case report- (경추간판 접근법에 의한 내장 신경 차단 -증례 보고-)

  • Na, Young-Du;Lee, Jung-Koo;Jang, Young-Ho;Chung, Jung-Kil
    • The Korean Journal of Pain
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    • v.10 no.1
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    • pp.89-92
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    • 1997
  • Neurolytic splanchnic nerve block is effective for treatment of intractable upper abdominal cancer pain. Conventional approach for splanchnic nerve block is conducted in the prone position to ensure proper orientation and to allow insertion of needles on each side of the vertebral body. However, the prone position has some technical disadvantages as this position is frequently poorly tolerated by a majority of patients with advanced cancer due to severe abdominal pain, ascites and so on. Male patient, 53-year old with transverse colon cancer, carcinomatosis peritonei and $L_1,\;L_2$ vertebral body metastasis, was admitted for treatment of severe right upper quadrant and right iliac crest pain. We performed neurolytic splanchnic nerve block with transdiscal technique in the lateral decubitus position under fluoroscopic guidance, and well noted the usefulness and the advantage of this technique. The benefits of this technique are safe, simple and effective because the lateral position is better tolerated by patients and makes bony landmarks more accessible during fluoroscopy.

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