• 제목/요약/키워드: Duodenal perforation

검색결과 27건 처리시간 0.02초

십이지장 궤양 천공 단순 봉합수술 후 완전 피막형 자가확장 금속 스텐트 삽입술로 치료된 봉합 부위 누출 (Covered Self-expandable Metallic Stent Insertion as a Rescue Procedure for Postoperative Leakage after Primary Repair of Perforated Duodenal Ulcer)

  • 유영진;이용강;이중호;이형순
    • 대한소화기학회지
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    • 제72권5호
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    • pp.262-266
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    • 2018
  • Surgery has been the standard treatment for perforated duodenal ulcers, with mostly good results. However, the resolution of postoperative leakage after primary repair of perforated duodenal ulcer remains challenging. There are several choices for re-operation required in persistent leakage from perforated duodenal ulcers. However, many of these choices are complicated surgical procedures requiring prolonged general anesthesia that may increase the chances of morbidity and mortality. Several recent reports have demonstrated postoperative leakage after primary repair of a perforated duodenal ulcer treated with endoscopic insertion using a covered self-expandable metallic stent, with good clinical results. We report a case with postoperative leakage after primary repair of a perforated duodenal ulcer treated using a covered self-expandable metallic stent.

재발하는 간농양에서 총담관-십이지장 누공의 내시경적 치료 1예 (A Case of Recurrent Liver Abscess Due to Choledochoduodenal Fistula)

  • 허준호;최선택;손민수;이지은;정인희;기성호
    • Journal of Yeungnam Medical Science
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    • 제30권1호
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    • pp.39-42
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    • 2013
  • Cholelithiasis, duodenal ulcer, duodenal perforation and tumor invasion may lead to choledochoduodenal fistula (CDF). CDF often has no specific symptoms and may be incidentally detected in an upper gastrointestinal radiographic study or endoscopy; but in some cases, it may be accompanied by recurrent cholangitis and liver abscess. In this paper, a case of recurrent liver abscess caused by CDF is reported. A 62-year-old female was admitted to the authors' hospital because of right upper quadrant pain and fever. The abdominal computed tomography showed a liver abscess in the right lobe. A duodenal fistulous orifice was detected with endoscopy, and a contrast was injected through the duodenal orifice using a catheter under fluoroscopy. The injection of the contrast revealed a fistulous track between the duodenal bulb and the common hepatic duct. In fistulas complicated by recurrent liver abscess, surgery or medical management may be needed. The CDF in this case study was treated via endoscopic clipping.

A Case of Midgut Volvulus with Gastric Perforation and Periveintricular Leukomalacia in a Term Infant

  • Park, Seul Gi;Hwang, Jong Hee
    • Neonatal Medicine
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    • 제28권1호
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    • pp.53-58
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    • 2021
  • Intestinal malrotation with midgut volvulus (MV) is a life-threatening surgical emergency. Most events of MV occur in the neonatal period with bilious vomiting, abdominal distension, feeding intolerance, and bloody stools. Neonatal gastric perforation (GP) is a rare and life-threatening condition associated with high mortality. It occurs either in an idiopathic form or in association with gastrointestinal anomalies such as duodenal atresia and MV. The pathogenesis of both MV and GP is related to ischemic change and inflammatory response. MV and GP can lead to morbidities such as sepsis, intestinal ischemia, and organ failure, but not neurologic problems. We herein report the case of a term infant at 5 days after birth, with MV accompanied by GP, who developed periventricular leukomalacia.

Gizzard impaction and duodenal perforation in a yellow-billed spoonbill (Platalea leucorodia)

  • Ho-Seong, Cho;Yeonsu, Oh
    • 한국동물위생학회지
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    • 제45권4호
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    • pp.331-335
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    • 2022
  • A yellow-billed spoonbill kept at the zoo was found dead. As a result of the necropsy, the stomach (gizzard and proventriculus) and duodenum were full of undigested fish bones, and the undigested sharp fish bones were lodged in the gastric mucosa and clumped together, blocking the lumen. Thereafter, the intestinal wall was perforated and peritonitis occurred causing death. The cause of the fish spines becoming lodged in the gastrointestinal tract is unknown. It can only be assumed that there was a lack of a mechanism for the yellow-billed spoonbill in a zoo to go around and pick up grit or small stones and assist in mechanical crushing in the gizzard.

내시경으로 절제한 십이지장 Brunner선 선종 1예 (A Case of Duodenal Brunner's Gland Adenoma Treated by Endoscopic Rescetion)

  • 김성준;구민근;박준석;김경옥;이시형;김태년;최준혁
    • Journal of Yeungnam Medical Science
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    • 제28권1호
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    • pp.84-89
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    • 2011
  • Brunneroma, also known as Brunner's gland adenoma or harmatoma, is a very rare benign tumor of the duodenum, which is usually asymptomatic, and is discovered incidentally during endoscopic exam. These lesions are most commonly located in the duodenal bulb and clinical manifestations are variable. We report on a case of a large Brunner's gland adenoma in a 54-year-old man, which was successfully removed by endoscopic resection without complications, such as bleeding or perforation. Microscopically, it was composed entirely of variable Brunner's gland.

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소아에서의 합병성 위십이지장 궤양 (A Clinical Analysis of Complicated Gastroduodenal Ulcer in Children)

  • 정광용;정연준;김찬영;양두현;김재천
    • Advances in pediatric surgery
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    • 제10권1호
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    • pp.22-30
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    • 2004
  • A total of 30 cases of the peptic ulcer in children, who underwent operations from January 1981 to December 1995 because of complications at Department of the Surgery, Chonbuk National University Medical School, is reviewed. Twenty-three were males (76.7%), 7 females (23.3%) and male was preponderant at 3.3:1. There were 25 cases (83.3%) age 10 to 15 years, 3(10.0%) between 2 and 9 years, and 2 (6.7%) below 2. The ulcer was located at duodenum in 27(90.0%), and at stomach in 3 cases (10.0%). Complications were perforation in 19 cases (63.3%), pyloric obstruction in 9 (30.0%) and bleeding in 2 (6.7%). For perforation, truncal vagotomy with pyloroplasty was done in 11 cases, truncal vagotomy with hemigastrectomy and gastrojejunostomy in 6, and simple closure in 2 cases. For obstruction, truncal vagotomy with hemigastrectomy and gastrojejunostomy was done in 5, and truncal vagotomy and pyloroplasty in 3 cases. For bleeding lesions, truncal vagotomy and pyloroplasty was performed in 2 cases. Ten postoperative complications developed in 9 patients: adhesive ileus in 5, recurrence in 2, pneumonia 2, and wound seroma 1 case. One patient developed a primary duodenal perforation and another a recurrent obstruction. Both of patients had symptoms for more than 3 years and were treated with truncal vagotomy and pyloroplasty for the primary operations. Hospital stay was 11.5 days for the patient with perforated ulcer, 11.0 days for the patient with pyloric obstruction, and 14.5 days for the child with bleeding. Average hospital period was 11.6 days. To reduce recurrences after operation, extensive procedure such as distal gastrectomy with vagotomy at the first operation should be considered in case with severe complication or with patients who have been symptomatic for long periods.

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들장관증후군의 대체 감압 치료로서 경담낭 십이지장 배액술: 두 건의 증례 보고 (Transcholecystic Duodenal Drainage as an Alternative Decompression Method for Afferent Loop Syndrome: Two Case Reports)

  • 홍지훈;김갑철;차중근;박종민;박병건;박서영;김상운
    • 대한영상의학회지
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    • 제85권3호
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    • pp.661-667
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    • 2024
  • 들장관증후군은 위장 재건술을 동반한 위절제술 후 발생하는 드문 합병증이다. 이 질환은 담관염, 췌장염, 복막염을 동반한 십이지장 천공과 같은 치명적인 상태에 이를 수 있어서, 즉각적인 감압 치료가 필요하다. 담관 확장이 없는 들장관증후군 환자를 위한 대체 감압 치료법으로 경담낭 십이지장 배액술을 시행한 두 건의 증례를 보고하고자 한다. Billroth II 문합술과 위원위절제술을 시행한 2명의 환자가 상복부 통증과 구토를 주소로 응급실에 내원하였다. 컴퓨터단층촬영에서 급성 췌장염을 동반한 들장관증후군으로 진단되었다. 담관 확장이 없어 담도를 통한 접근이 어려워, 경담낭 접근을 통해 담낭관을 통과한 후 들장관을 감압하기 위한 십이지장 배액 카테터를 설치하였다. 환자들은 배액술 시행 후 각각 2주와 1개월째에 추가적인 수술적 치료 없이 퇴원하였다.

자석 이물에 의한 위-십이지장 누공 1예 (A Case of Gastroduodenal Fistula Caused by Ingested Magnetic Foreign Bodies)

  • 이원희;민영돈;문경래
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제11권1호
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    • pp.84-88
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    • 2008
  • 여러 개의 자석을 삼킨 경우 자석들이 서로 잡아당겨 압력 괴사로 인한 장폐쇄, 장천공, 누공 형성 등의 합병증을 일으킬 수 있다. 따라서 영 유아나 정신과적인 문제가 있는 큰 아이의 경우 자석이나 자석이 포함된 장난감과 같은 물건들을 멀리하고, 자석을 삼킨 경우에는 즉시 확인해 보아야 한다. 저자들은 1년 전부터 주기성 구토를 호소했던 중등도 정신지체를 가진 12세 남아에서 삼킨 장난감 자석 4개로 인해 위-십이지장 누공을 형성하였고 수술 후 호전된 1예를 치험하였기에 보고하는 바이다.

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개에서 비만세포종과 관련된 기복증의 초음파학적 진단례 (Ultrasonographic Diagnosis of Pneumoperitoneum Associated with a Mast Cell Tumor in a Dog)

  • 왕지환;박기태;이경우;연성찬;이효종;이희천
    • 한국임상수의학회지
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    • 제27권4호
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    • pp.483-487
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    • 2010
  • A 7-year-old female maltese dog with anorexia and vomiting for a week, and left axillary and perineal mass was admitted to Gyeongsang National University Veterinary Teaching Hospital. CBC revealed mild leukocytosis and severe anemia. Abdominal radiography revealed multiple gas opacities in upper abdomen. On ultrasonography, large amount of echogenic free abdominal fluid were detected. In addition, There are enhanced peritoneal strip sign (EPSS) indicating peumoperitoneum in the upper abdomen. Fine needle aspiration of the mass was performed and the result was mast cell tumor. Duodenal perforation caused by mast cell tumor was identified on laparotomy.