• Title/Summary/Keyword: Abdominal surgery

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Intralobar Pulmonary Sequestration Receiving Its Blood Supply from the Celiac Artery (복강 동맥에서 혈액 공급을 받는 엽내 폐 분리증 1예)

  • Jung, Ki-Hwan;Lee, Seung-Hwa;Lee, Ju-Han;Jo, Won-Min;Shin, Chol;Kim, Je-Hyeong
    • Tuberculosis and Respiratory Diseases
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    • v.68 no.6
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    • pp.358-362
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    • 2010
  • Intralobar pulmonary sequestration is a rare congenital lung anomaly. It is defined as a portion of nonfunctioning lung parenchyma that receives its blood supply from an anomalous systemic artery. Patients often present with chronic or recurrent pneumonia. A chest radiograph may show a cystic lesion with air-fluid levels in the lung base. A high index of suspicion is needed for a diagnosis. Surgical removal of a symptomatic intralobar pulmonary sequestration is generally the treatment of choice. Identifying the aberrant artery is a difficult problem when resecting a pulmonary sequestration. The thoracic and abdominal aortas are the most common origins for the abnormal blood supply. However, arterial supply from the celiac artery is quite rare. We present a case of intralobar pulmonary sequestration with the blood supply originating from the celiac artery.

A Case of Norepinephrine Secreting Pheochromocytoma in a Dog (개에서 Norepinephrine 분비 갈색세포종 증례1)

  • Choi, Ul-Soo;Kim, Dong-Hoon;Kim, Hyun-Wook;Choi, Ji-Hye;Jang, Jae-Young
    • Journal of Veterinary Clinics
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    • v.26 no.3
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    • pp.268-272
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    • 2009
  • An-11-year-old male Shih-tzu was admitted to emergency care unit of Haemaru Referral Animal Hospital with signs of dyspnea, anuria and depression. There were abnormalities on complete blood count and serum chemistry included leukocytosis with mild left shift, mild azotemia, and increased ALT activity. Fluid therapy(0.9% saline, 40 ml/hr) and antibiotics were immediately initiated. The patient began to vomit after 5 hours' rest and pale mucous membrane, bradycardia, and hypertension were noted. Abdominal ultrasonography revealed enlarged left adrenal gland and thrombus in caudal vena cava(CVC). Result of ACTH stimulation test was normal. Cytology of ultrasound-guided FNA smears showed numerous naked nuclei, which was suggestive of adrenal medullar tumor. Concentrations of 24 hour urine metanephrine and normetanephrine was moderately increased compared to those of a control dog. Adrenal mass was surgically removed, and biopsy of the CVC mass was obtained. After surgery the patient began to recover but the dog acutely developed cardiopulmonary arrest and died. On histopathology the adrenal mass and biopsy of the CVC mass were consistent with pheochromocytoma. On electron microscopic view norepinephrine specific granules were found in the cytoplasm of tumor cells.

Recurrence of Choledocholith in the Common Bile Duct after Cholecystectomy in a Dog (개에서 담낭절제술 후 총담관에 재발한 총담관결석증)

  • Chang, Jin-Hwa;Yun, Seok-Ju;Kim, Ju-Hyung;Kang, Ji-Houn;Kim, Gon-Hyung;Na, Ki-Jeong;Chang, Dong-Woo
    • Journal of Veterinary Clinics
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    • v.27 no.5
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    • pp.605-609
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    • 2010
  • A 10-year-old spayed female Yorkshire terrier presented with vomiting, and anorexia. Obstructive choledocholith with concurrent pancreatitis and hepatorenal syndrome was diagnosed based on analyses of the blood profiles, abdominal radiographs, ultrasonography and CT. Choledoliths were removed from the common bile duct, yet the patient died suddenly 10 days after surgery. Recurrent choledolithiasis has not been reported in a cholecystectomized dog and this report focuses on the imaging features of ultrasonography and CT of recurrent choledoliths.

Effects of 37℃ Carbon Dioxide Pneumoperitoneum on Core Body Temperature, Systolic Blood Pressure, Heart Rate and Acid-Base Balance: A Randomized Double-blind Controlled Trial (복강경 수술에서 기복제 이산화탄소의 37℃ 가온이 수술 중 체온, 수축기압 및 심박동수와 산염기 균형에 미치는 영향)

  • Park, Jin il;Yoon, Haesang
    • Journal of Korean Biological Nursing Science
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    • v.19 no.2
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    • pp.76-85
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    • 2017
  • Purpose: The purpose of this study was to compare the effects of $21^{\circ}C\;CO_2$ and $37^{\circ}C\;CO_2$ pneumoperitoneum on body temperature, blood pressure, heart rate, and acid-base balance. Methods: Data were collected at a 1300-bed university hospital in Incheon, from February through September 2012. A total of 74 patients who underwent laparoscopic colectomy under general anesthesia with desflurane were randomly allocated to either a control group or an experimental group. The control group received $21^{\circ}C\;CO_2$ pneumoperitoneum; the experimental group received $37^{\circ}C\;CO_2$ pneumoperitoneum. The pneumoperitoneum of the two groups was under abdominal pressure 15 mmHg. Body temperature, systolic blood pressure, heart rate and acid-base balance were assessed at 30 minutes and 90 minutes after pneumoperitoneum, and again at 30 minutes after arriving at the Post Anesthesia Care Unit. Results: Body temperature in the $37^{\circ}C\;CO_2$ pneumoperitoneum group was significantly higher (F= 9.43, p< .001) compared to the $21^{\circ}C\;CO_2$ group. However, there were no statistically significant differences in systolic blood pressure (p= .895), heart rate (p= .340), pH (p= .231), PaCO2 (p= .490) and HCO3- (p= .768) between the two groups. Conclusion: Pneumoperitoneum of $37^{\circ}C\;CO_2$ is effective for the increase of body temperature compared to pneumoperitonium of $21^{\circ}C\;CO_2$, and it does not result in a decrease of blood pressure, heart rate or acid-base imbalance.

A Case of Primary Malignant Melanoma in the Mediastinum (종격동 종양이 주병소인 악성 흑색종 1예)

  • Koo, Bon-Sam;Jung, Yong-Seuk;Park, Hee-Bag;Ok, Cheol-Ho;Jang, Tae-Won;Jung, Man-Hong;Lee, Jae-Sung;Chun, Bong-Kwon
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.3
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    • pp.409-413
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    • 1999
  • Malignant melanoma develops from the melanocyte and the most common primary site is skin, followed by mucosa and retina. Even though any other tissue where melanocytes reside could be the primary site of the malignant melanoma, the one developed in the mediastinum is rarely reported. We experienced a patients of 54 years old woman whose initial symptom was progressive dyspnea for one month, and proved to have the anterior mediastinal mass with pleural effusion and the small mass in the abdominal soft tissue. The needle aspiration biopsy from the mediastinal mass showed the consistent findings with malignant melanoma. We concluded the mediastinum was the primary site of the malignant melanoma of this patient because we couldn't find any other evidence of primary tumor in skin, oral and gastrointestinal mucosa, and retina. She has been treated with combined chemotherapy with dacarbazine, cisplatin and vinblastine. Her symptom was improved after chemotherapy and follow up chest CT after three cycles of chemotherapy showed the decreased tumor size in the mediastinum.

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A Case with Mixed Infection of Actinomyces and Aspergillus in the Lung (폐를 침범한 방선균과 아스페르질루스의 혼합 감염 1예)

  • Lee, Suk-Sue;Yang, Sei-Hoon;Kim, Dong-Kwan;Jang, Jae-Jeong;Kim, Dong-Soon
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.4
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    • pp.870-875
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    • 1998
  • Actinomycosis is a bacterial infection that can affect virtually any site in the body. There are three major forms of actinomycosis: cervicofacial, abdominal, and thoracic. Aspergillus spp. are ubiquitous in the environment in most countries of the world. Pulmonary aspergillosis is clinically classified by aspergilloma, allergic bronchopulmonary aspergillosis and invasive aspergillosis. Actinomyces and Aspergillus, each of them was often reported in case, but mixed infection of both organisms have not been reported. We experienced a case of mixed infection of Actinomyces and Aspergillus involving the same area of the lung in a 62 year-old housewife presented with hemoptysis and solitary pulmonary nodule. Percutaneous needle aspiration and later surgical resection revealed sulfur granule mixed with Aspergillus hyphae in the same lesion. We report this case with a review of the literature.

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MR Imaging of Primary Retroperitoneal Mucinous Cystadenocarcinoma in Pregnant Woman (임산부에서 발생한 원발성 후복막 점액낭샘암종의 자기공명영상 소견: 1예 보고)

  • Lee, Jisun;Cho, Bum Sang;Kim, Yook;Yi, Kyung Sik;Kang, Min Ho;Lee, Seung Young;Kim, Sung Jin;Park, Kil Sun
    • Investigative Magnetic Resonance Imaging
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    • v.17 no.3
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    • pp.243-248
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    • 2013
  • Primary retroperitoneal mucinous cystadenocarcinoma is a very rare malignancy. To date, 51 cases have been reported, including 3 in pregnant women. Herein, we report magnetic resonance findings of a 31-year-old Korean woman (15 weeks and 3 days pregnant) with primary retroperitoneal mucinous cystadenocarcinoma. On abdominal magnetic resonance imaging (MRI), a mass was identified in the retroperitoneal area with a nodular lesion showing heterogeneous signal intensity and focal wall thickening on T1- and T2-weighted images. Exploratory laparotomy and tumor excision were performed. Histological examination revealed primary retroperitoneal mucinous cystadenocarcinoma. The patient subsequently underwent total hysterectomy, bilateral salpingo-oophorectomy, and omentectomy for metastatic mucinous cystadenocarcinoma of both ovaries 15 months after her initial surgery.

Laparoscopic management of early primary peritoneal pregnancy: a case report

  • Koo, Hwa-Seon;Bae, Ju-Youn;Kang, Inn-Soo;Koong, Mi-Kyoung;Kim, Hye-Ok;Cha, Sun-Hwa;Choi, Min-Hye;Kim, Ji-Young;Yang, Kwang-Moon
    • Clinical and Experimental Reproductive Medicine
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    • v.38 no.2
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    • pp.109-114
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    • 2011
  • Peritoneal pregnancy is an implantation in the peritoneal cavity exclusive of tubal, ovarian, or intra-ligamentary implantations. This is a rare obstetric complication with high maternal mortality and even higher perinatal mortality, and secondary type was most common. Risk factors for peritoneal pregnancy are previous history of extrauterine pregnancy or tubal surgery pelvic post-inflammatory status or presence of an intrauterine device. As it is a life-threatening condition, expectant management carries a risk of sudden life-threatening intra-abdominal bleeding and a generally poor fetal prognosis. So, when it is recognized, immediate termination of pregnancy is usually recommended. Early diagnosis of peritoneal pregnancy is difficult, but is important by their life threatening progress course to patients. Recently, we experienced primary peritoneal pregnancy which meets both the original and modified criteria. In this paper, we reported the case of early diagnosed and successfully treated peritoneal pregnancy despite of their diagnosis was incidentally.

A Case of Rectus Sheath Hematoma Complicated with Hypovolemic Shock in a Critically-Ill Patient (중환자에서 발생한 저혈량성 쇼크 동반 복직근초 혈종 1예)

  • Shin, Hong-Joon;Kim, Yoon-Hee;Chi, Su-Young;Ban, Hee-Jung;Kwon, Yong-Soo;Oh, In-Jae;Kim, Kyu-Sik;Lim, Sung-Chul;Kim, Young-Chul;Kim, Soo-Ok
    • Tuberculosis and Respiratory Diseases
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    • v.69 no.6
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    • pp.480-482
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    • 2010
  • Rectus sheath hematoma (RSH) is a rare condition caused by hemorrhage into the rectus sheath. It is usually associated with severe cough, abdominal surgery, coagulopathy, and anticoagulation treatment. RSH can be difficult to diagnose and can be misdiagnosed as acute appendicitis, as diverticulitis, or as an ovarian mass. Although RSH usually presents as a benign condition, it can be life threatening, especially in the critically-ill patient. Here, we report a case of fatal RSH due to hypovolemic shock in a critically-ill 73-year-old woman, who had received heparin treatment due to acute myocardial infarction in the intensive care unit and who had been successfully treated by conservative management.

A Comparison of Patient-Controlled Analgesia and Conventional Intramuscular Opioid Regimen in Relation to their Post-Operative Pain Control and Side Effects (수술후 통증 관리의 Patient-Controlled Analgesia와 마약류의 전통적인 근육내 주사와의 비교)

  • Lee, Sang-Hun;Lee, Jin-Kyung;Lee, Kyn-Chang;Woo, Nam-Sik;Lee, Ye-Chul
    • The Korean Journal of Pain
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    • v.6 no.1
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    • pp.55-59
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    • 1993
  • Using a visual analogue scale, we compare the effect of patient-controlled analgesia and conventional intramuscular opioid regimen in 68 patients undergoing lower abdominal or gynecological surgery. We also recorded the incidence of side effects. We checked visual analogue scale 4 hours interval for 30 cases managed by patient-controlled analgesia and 38 cases of conventional intramuscular opioid group managed by obstetrician. We maintained fentanyl $0.33{\mu}g/kg/hr$ and set self administrable bolus dose $5.0{\mu}g$(lockout interval: 15 min) in patient-controlled analgesia group. Conventional intramuscular bolus injection group were administered meperidine 50 mg for 4 hour interval. Mean visual analogue scale scores obtained by patient-controlled analgesia group and intramuscular bolus injection group were $2.49{\pm}0.67$ and $4.53{\pm}1.28$(p<0.05). Side effects such as; no significant incidence of respiratory depression, urinary retention, postural hypotension, nausea, vomiting and pruritus were developed by either group. These results suggest that patient-controlled analgesia was more effective method compared with conventional intraumuscular opioid injection regimen for post-operative pain management.

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