• Title/Summary/Keyword: Abdominal approach

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Three Cases of Transdiscal Superior Hypogastric Plexus Block (경추간판적 상하복 신경총 차단 3예)

  • Lee, Sang-Hun;Lee, Keun-Sang;Woo, Nam-Sik;Lee, Ye-Chul;Kim, Chul-Ho;Kim, Ju-Woan
    • The Korean Journal of Pain
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    • v.9 no.1
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    • pp.219-222
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    • 1996
  • Superior hypogastric plexus block is extensively recognized as a unique nerve block method for the treatment of low abdominal pain originating from organs of the pelvic area. This block is difficult to perform on older patients, especially those with osteophyte, as they will experience a high degree of pain with this technique. Therefore we reported trans-discal superior hypogastric plexus by method of approach needle through disc. This method is less painful to the patient as compared to bilateral approach; and easier to place the needle tip at precise and proper location.

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Clinical Evaluation of Traumatic Diaphragmatic Injuries (외상성 횡격막 손상에 대한 임상적 고찰)

  • Seo, Seong-Gu;Gwon, O-Chun;Lee, Gil-No
    • Journal of Chest Surgery
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    • v.27 no.12
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    • pp.1023-1026
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    • 1994
  • We reviewed 10 cases of traumatic diaphragmatic injuries at Soonchunhyang University Gumi Hospital from January 1990 through April 1993. seven patients were male and three patients were female. The age distribution was ranged from 25 to 79 years, predominant 4th decades occurred in male. The traumatic diaphragmatic injuries were due to blunt trauma in 9 cases (traffic accident 7 and crash injury 2) and penetrating wound in 1 case (stab wound). The common symptom were dyspnea (60%), chest pain and abdominal pain in order frequency. In the blunt trauma and crash injury, te rupture site was all located in the left(9 cases). In the penetrating wound, the rupture site was located in the right(1 case). The surgical repair of 10 cases were performed with transthoracic approach in 9 cases and thoracoabodominal approach in 1 case. The postoperative mortality was 10% (1/10). The cause of death was multiple organ failure with pulmonary edema.

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Surgical Corretion of Ebstein's Anomaly -Report of One Case- (Ebstein 심기형의 외과적 치료 -1례 보고-)

  • 권은수
    • Journal of Chest Surgery
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    • v.27 no.12
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    • pp.1027-1030
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    • 1994
  • We reviewed 10 cases of traumatic diaphragmatic injuries at Soonchunhyang University Gumi Hospital from January 1990 through April 1993. Seven patients were male and three patients were female. The age distribution was ranged from 25 to 79 years, predominant 4th decades occurred in male. The traumatic diaphragmatic injuries were due to blunt trauma in 9 cases[traffic accident 7 and crash injury 2] and penetrating wound in 1 case[stab wound]. The common symptoms were dyspnea[60%], chest pain and abdominal pain in order frequency. In the blunt trauma and crash injury, the rupture site was all located in the left[ 9 cases ]. In the penetrating wound, the rupture site was located in the right[1 case]. The surgical repair of 10 cases were performed with transthoracic approach in 9 cases and thoracoabdominal approach in 1 case. The postoperative mortality was 10%[1/10]. The cause of death was multiple organ failure with pulmonary edema.

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An Automated Way to Detect Tumor in Liver

  • Meenu Sharma. Rafat Parveen
    • International Journal of Computer Science & Network Security
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    • v.23 no.10
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    • pp.209-213
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    • 2023
  • In recent years, the image processing mechanisms are used widely in several medical areas for improving earlier detection and treatment stages, in which the time factor is very important to discover the disease in the patient as possible as fast, especially in various cancer tumors such as the liver cancer. Liver cancer has been attracting the attention of medical and sciatic communities in the latest years because of its high prevalence allied with the difficult treatment. Statistics indicate that liver cancer, throughout world, is the one that attacks the greatest number of people. Over the time, study of MR images related to cancer detection in the liver or abdominal area has been difficult. Early detection of liver cancer is very important for successful treatment. There are few methods available to detect cancerous cells. In this paper, an automatic approach that integrates the intensity-based segmentation and k-means clustering approach for detection of cancer region in MRI scan images of liver.

The Value of Preoperative Multidetector Computed Tomography for Deep Inferior Epigastric Artery Perforator Free Flap (심하복벽동맥 천공지 유리피판에서 술전 MDCT의 유용성)

  • Heo, Chan Yeong;Hong, Ki Yong;Yoon, Chang Jin;Eun, Seok Chan;Baek, Rong Min;Minn, Kyung Won
    • Archives of Plastic Surgery
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    • v.36 no.2
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    • pp.140-146
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    • 2009
  • Purpose: Autologous breast reconstruction with abdominal tissue is one of the best options after mastectomy. In a free transverse rectus abdominis myocutaneous(TRAM) or deep inferior epigastric artery perforator(DIEP) flap, a preoperative evaluation of the precise location of perforating vessels and vascular run - off systems is required. The objective of this report is to demonstrate the usefulness of multidetector computed tomography(MDCT) in the preoperative planning of patients undergoing breast reconstruction with abdominal flap. Methods: From June 2006 to January 2008, 28 patients underwent MDCT evaluation before breast reconstruction. All subjects were females with an age range of 30 to 55 years. The CT scan was performed using a 64 - slice MDCT scanner(Brilliance 64; Philips Medical Systems, Best, Netherlands). Results: One perforator or two major perforators were marked on image in good relation with a hand - held Doppler examination and intraoperative findings. All vascular run - off systems were cleared before operation. Conclusion: Preoperative evaluation of perforator arteries with MDCT angiography is beneficial in patients undergoing breast reconstruction. This technique provides a noninvasive approach of the vascular anatomy of the entire anterior abdominal wall.

Congenital Bochdalek hernia: report of 4 cases (선천성 Bochdalek hernia4례 보고)

  • Jin, Jae-Gwon;Park, Ju-Cheol;Yu, Se-Yeong
    • Journal of Chest Surgery
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    • v.15 no.4
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    • pp.432-439
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    • 1982
  • Congenital posterolateral diaphragmatic hernia [Bochdalek hernia] is the result of a congenital diaphragmatic defect in the posterior costal part of the diaphragm in the region of the tenth and eleventh ribs. There is usually free communication between the thoracic and abdominal cavities. The defect is most commonly found on the left [90%], but may occurs on the right, where the liver often prevents detection. The male to female ratio is 2:1. Owing to the negative intrathoracic pressure, herniation of abdominal contents through the defects occurs, with resultant collapse of the lung. Shifting of mediastinum to the opposite side and compression of the opposite lung occurs. Most often these hernias are manifestated by acute respiratory distress in the newborn. A second, but less well recognized, group of patient with Bochdalek hernia survive beyond the neonatal period, usually present at a later time with "failure of thrive, intermittent vomiting, or progressive respiratory difficulty. " The diagnosis can often be made on clinical ground from the presence of respiratory distress, absence of breath sounds on the chest presence of bowel sounds over the chest . Roentgenogram of the chest confirm the diagnosis. Obstruction and strangulation have been reported but are rare. Treatment consists of early reliable identification of these congenital diaphragmatic hernia with high risk and surgical repairment. and postoperative pharmacological management with extracorporeal membranous oxygenation [=ECMO] support in the period of intensive care. On the surgical approach, for defects on left side, an abdominal incision is preferred, because of the high incidence of malrotation and obstructing duodenal bands. In the neonate, the operative mortality may be appreciable, but, later repair almost always is successful. During the period from 1972 to 1982, 4 cases of congenital Bochdalek hernia were experienced at the Kyung-Hee University Hospital.

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The oriental-western literal study of Crohn's disease (크론씨병(극한성(局限性) 장염(腸炎))에 관(關)한 한의학적(韓醫學的) 고찰(考察))

  • Choi, Chang-Woo;Son, Chang-Gyu;Cho, Chong-kwan
    • Journal of Haehwa Medicine
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    • v.9 no.2
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    • pp.251-268
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    • 2001
  • We arrived at the following conclusion after we have studied crohn's disease through the literatures of western and oriental medicine. 1. Crohn's disease has a characteristic of granulomatous necrosis and cicatricial inflammation which is called by segmental enteritis, granulomatous enteritis. This falls under the category of "Diarrhea", "Dysentery" and is similar to "small intestinal diarrhea", "acute temesmus", "splenic diarrhea" in oriental medicine. 2. In western medicine, the cause of crohn's disease indefinites, but it is presumed immunological unbalance of alimentary canal. In oriental medicine, it is summarized as the abnormal ascending and descending circulation of stomach and splenic energies, the hepatic stagnation, being the lower part of cleaning qi by exogenous disease, dyspeptic convulsion. 3. The presenting symptoms of crohn's disease are intermittent chronic diarrhea, fever, weight loss, abdominal spastic pain or abdominal discomfort. When anyone has a abdominal mass, a rectal abcess, and a rectal constriction by physical examination, we can doubt crohn's disease. 4. The methods of western medical treatment are a suppression of intestinal toxic contents and inflammatory mediator, a supply of nutritive substanceus to intestinal epithelial cell. Oriental medical treatments of these are "inducing diuresis", "warming kidney to reinforce yang", "nourishing qi to invigorate spleen", "eliminatin dampness by cooling" according to syndrome differentiations. As mentioned above, we can confirm possibility of oriental medical treatment that induces recovery of immunologic control function and we need advanced experiment, study, and clinical approach.

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Acid/base alterations during major abdominal surgery: 6% hydroxyethyl starch infusion versus 5% albumin

  • Kwak, Hyun Jeong;Lim, Oh Kyung;Baik, Jae Myung;Jo, Youn Yi
    • Korean Journal of Anesthesiology
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    • v.71 no.6
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    • pp.459-466
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    • 2018
  • Background: To compare the effects of intraoperative infusions of balanced electrolyte solution (BES)-based hydroxyethyl starch (HES) and saline-based albumin on metabolic acidosis and acid/base changes during major abdominal surgery conducted using Stewart's approach. Methods: Forty patients, aged 20-65 years, undergoing major abdominal surgery, were randomly assigned to the HES group (n = 20; received 500 ml of BES-based 6% HES 130/0.4) or the albumin group (n = 20; received 500 ml of normal saline-based 5% albumin). Acid-base parameters were measured and calculated using results obtained from arterial blood samples taken after anesthesia induction (T1), 2 hours after surgery commencement (T2), immediately after surgery (T3), and 1 hour after arriving at a postanesthetic care unit (T4). Results: Arterial pH in the HES group was significantly higher than that in the albumin group at T3 ($7.40{\pm}0.04$ vs. $7.38{\pm}0.04$, P = 0.043), and pH values exhibited significant intergroup difference over time (P = 0.002). Arterial pH was significantly lower at T3 and T4 in the HES group and at T2, T3, and T4 in the albumin group than at T1. Apparent strong ion difference (SIDa) was significantly lower at T2, T3, and T4 than at T1 in both groups. Total plasma weak nonvolatile acid ($A_{TOT}$) was significantly lower in the HES group than in the albumin group at T2, T3 and T4 and exhibited a significant intergroup difference over time (P < 0.001). Conclusions: BES-based 6% HES infusion was associated with lower arterial pH values at the end of surgery than saline-based 5% albumin infusion, but neither colloid caused clinically significant metabolic acidosis (defined as an arterial pH < 7.35).

A Case of Thoracoscopic Splanchnicectomy for Relief of Intractable Pain in Pancreatic Cancer -A case report- (췌장암 환자에서 난치성 통증에 대한 흉강경을 통한 내장신경 절제술 -증례 보고-)

  • Kim, Do Hyung;Shim, Je Kwang;Moon, Jin Chun;Yoon, Kyung Bong;Kim, Won Oak;Yoon, Duck-Mi
    • The Korean Journal of Pain
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    • v.19 no.1
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    • pp.111-114
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    • 2006
  • Pancreatic cancer often elicits intractable abdominal pain which has significant negative impact on the quality of life in patients. Various therapeutic modalities including celiac plexus block are being used to alleviate the pain. The anatomic location of the pancreas often hinders the spread of anesthetic or neurolytic solutions by obliterating the retrocrural space, thus making the classic retrocrural approach unsuccessful. The following case describes a patient with intractable abdominal pain originating from advanced pancreatic cancer, which could be managed successfully with thoracoscopic splanchnicectomy after retrocrural celiac plexus block had failed.

Descending Thoracic Aorta to Bilateral Femoral Artery Bypass in a Hostile Abdomen

  • Lee, Hong-Kyu;Kim, Kun-Il;Lee, Won-Yong;Kim, Hyoung-Soo;Lee, Hee-Sung;Cho, Sung-Woo
    • Journal of Chest Surgery
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    • v.45 no.4
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    • pp.257-259
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    • 2012
  • Descending thoracic aorta to femoral artery bypass has been used as a remedial operation after aortic or axillofemoral graft failure or graft infection and other intra-abdominal pathologies not amenable to standard aortofemoral revascularization. It can avoid abdomen approach and has been known as a durable procedure with excellent long-term patency. We reported descending thoracic aorta to femoral artery bypass grafting for primary revascularization in a 55-year-old male with hostile abdominal conditions.