• Title/Summary/Keyword: Exploratory laparotomy

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Appendiceal Perforation in the Neonate (신생아에서 발생한 충수돌기 천공)

  • Park, Dong-Weon;Chang, Soo-Il
    • Advances in pediatric surgery
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    • v.3 no.2
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    • pp.168-171
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    • 1997
  • Appendiceal perforation is uncommon in the neonate. Diess reported the first case in 1908. Approximately 111 additional cases have been reported since that time. However, with exclusion of neonatal appendicitis associated with inguinal or umbilical hernias, necrotizing enterocolitis, meconium plug, and Hirschsprung's disease, there are only 36 cases of primary neonatal appendicitis. We treated a 12 days old boy with perforation of the appendix. The infant was 3000 g at birth and had a normal spontaneous vaginal delivary at 35 weeks of gestation. The mother was 31-year-old and had premature rupture of membrane. After normal feeding for the first 5 days of life, the infant had emesis of undigested milk, decreased activity and jaundice. The baby was admitted to the Pediatrics. Progressive abdominal distension, fever, decreased activity, and vomitting developed over the next six days. Erect abdominal radiography showed pneumoperitoneum. At exploratory laparotomy, a $0.8{\times}0.6$ cm sized perforation was noted at antime-senteric border of midportion of the appendix. Trasmural inflammation and the presence of ganglion cells were noticed on histology.

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Sertoli-Leydig Cell Tumor of the Ovary in a 4 year-old Girl - A Case Report - (4세 영아의 난소에서 발생한 Sertoli-Leydig 세포 종양 -1예 보고-)

  • Kim, Hye-Jin;Choe, Byung-Ho;Park, Jin-Young
    • Advances in pediatric surgery
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    • v.15 no.1
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    • pp.73-79
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    • 2009
  • Sertoli-Leydig cell tumor is a rare sex-cord stromal tumor of the ovary. They make up less than 0.5 % of all ovarian tumors. We experienced a case of an ovarian Sertoli-Leydig cell tumor in a 4 year-old girl who presented with nausea, vomiting, and lower abdominal pain of 2 days' duration. On physical examination, there was mild tenderness in the right lower quadrant of the abdomen. Abdominal ultrasonography and computed tomography (CT) scan revealed a pelvic mass measuring $5{\times}3cm$ that appeared to arise from the right ovary. At exploratory laparotomy, a $6{\times}5{\times}3cm$ solid right ovarian mass without torsion was found. A right salpingo-oophorectomy was performed. The postoperative course was uneventful. The child was discharged 5 days after surgery.

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A Case of Complicated Congenital Cardiac Anormaly Occurred in Shepherd Mongrel Dog (세퍼드 잡종견에 발생한 복합적 선천성 심장기형의 일예)

  • Kim Duck-Hwan;Kim Kyo-Joon;Kwon Oh-Deog;Jun Moo-Hyung;Park Chung-Hee;Lee Byung-Chul;Choi Hi-In;Park Kyung-Soo
    • Journal of Veterinary Clinics
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    • v.5 no.2
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    • pp.111-118
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    • 1988
  • One four-month-old female shepherd mongrel dog with chief complaints of abdominal distension and dysponea was referred. The authors performed physical examination, hematological examination, X-ray examination, exploratory laparotomy, electrocardiography and angiography as antemortem investigation in addition to postmortem examination. This patient revealed complicated congenital cardiac anormaly including patent ductus arteriosus, both atrial and ventricular hypertrophy, distension in the base of the pulmonary artery, pulmonary stenosis, aortic insufficiency, patent foramen ovate and coronary arteriovenous fistula.

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Spontaneous Rupture of the Diaphragm in an 8 Years-old Girl with Nephrotic Syndrome (저절로 파열된 횡경막 이완증 1예)

  • Lee, Seong-Cheol;Kim, Ki-Hong
    • Advances in pediatric surgery
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    • v.6 no.1
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    • pp.60-63
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    • 2000
  • Spontaneous rupture of the eventrated diaphragm is not common. The authors report a case of spontaneous rupture of the congenital diaphragmatic eventration. An 8 year-old girl with right congenital diaphragmatic eventration and nephrotic syndrome was seen in emergency room because of severe abdominal pain and vomiting. She had intermittent abdominal pain for 1 year. Plain chest X-ray and ultrasonography showed entrapped bowels in the right thoracic area. Exploratory laparotomy revealed a ruptured right eventration. THE displaced abdominal viscera were repositioned into the abdominal cavity and the ruptured diaphragm was trimmed and plicated. The postoperative course was uneventful. Only one case of spontaneous rupture of eventrated diaphragmatic has been reported in the English literature.

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A case of anisakiasis causing intestinal obstruction (장폐색을 동반한 공장 아니사키스증)

  • 김이수;이연호
    • Parasites, Hosts and Diseases
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    • v.29 no.1
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    • pp.93-96
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    • 1991
  • A 31-year old salesman living in 요eoul developed sudden피y abdominal pain due to intestinal obstruction. Exploratory laparotomy exhibited segmental jejunal cellulitis caused by penetrating Anisakis larva. The patient had eaten raw fish. The typical history of intestinal anisakiasis was presented with a short review of Korean patients of anisakiasis.

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Atypical Bile Peritonitis Associated with White Bile in a Dog with Ruptured Gallbladder

  • Kang, Hyo-Min;Jang, Hye-Jin;Kang, Ji-Houn;Kim, Gonhyung;Chang, Dongwoo;Na, Ki-Jeong
    • Journal of Veterinary Clinics
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    • v.35 no.1
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    • pp.17-18
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    • 2018
  • A 12-year-old spayed female Cocker Spaniel was presented with vomiting, diarrhea, depression, and hyporexia of 3-day duration. Microscopic examination of the abdominal fluid from a dog showed basophilic, amorphous to fibrillar materials without bile pigments or crystals. Total bilirubin concentration of the fluid was 19 times higher than the serum bilirubin concentration and exploratory laparotomy revealed a ruptured gallbladder and mucoceles in the abdominal cavity. Rupture of gallbladder mucoceles may cause atypical bile peritonitis in which mucinous material is observed instead of bile pigment.

Partial Pancreatectomy Using Ultrasonic Scalpel for Exocrine Pancreatic Ductal Papillary Carcinoma in a Cat

  • Park, Jiyoung;Lee, Young Won;Lee, Hae-Beom;Jeong, Seong Mok
    • Journal of Veterinary Clinics
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    • v.35 no.6
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    • pp.294-298
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    • 2018
  • This report presents a rare case of feline exocrine pancreatic ductal carcinoma including treatment and prognosis. A 4.6-year-old castrated male American Shorthair cat, weighing 5 kg was presented with intermittent vomiting, diarrhea and loss of appetite. Through physical examination and radiography, a cranial abdominal mass was identified. Exploratory laparotomy was carried out. The largest mass was connected to the left lobe of the pancreas, and there were several small, nodular masses scattered along the abdominal lining. The pancreatic mass was removed using an ultrasonic scalpel, and the patient recovered favorably. Histopathologically, the resected lesion was diagnosed as an exocrine pancreatic ductal papillary carcinoma. The patient was maintained with conservative therapy and euthanized on post-operative day 262. Partial pancreatectomy using an ultrasonic scalpel was accomplished safely without evidence of pancreatic leakage.

Hybrid Approach for Treatment of Multiple Traumatic Injuries of the Heart, Aorta, and Abdominal Organs

  • Kim, Seon Hee;Song, Seunghwan;Cho, Ho Seong;Park, Chan Yong
    • Journal of Chest Surgery
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    • v.52 no.5
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    • pp.372-375
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    • 2019
  • A 55-year-old man was admitted to the trauma center after a car accident. Cardiac tamponade, traumatic aortic injury, and hemoperitoneum were diagnosed by ultrasonography. The trauma surgeon, cardiac surgeon, and interventional radiologist discussed the prioritization of interventions. Multi-detector computed tomography was carried out first to determine the severity and extent of the injuries, followed by exploratory sternotomy to repair a left auricle rupture. A damage control laparotomy was then performed to control mesenteric bleeding. Lastly, a descending thoracic aorta injury was treated by endovascular stenting. These procedures were performed in the hybrid-angio room. The patient was discharged on postoperative day 135, without complications.

Risk for Malignant and Borderline Ovarian Neoplasms Following Basic Preoperative Evaluation by Ultrasonography, Ca125 Level and Age

  • Karadag, Burak;Kocak, M.;Kayikcioglu, F.;Ercan, F.;Dilbaz, B.;Kose, M.F.;Haberal, A.
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.19
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    • pp.8489-8493
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    • 2014
  • Objective: To verify the basic preoperative evaluation in the discrimination between benign and malignant adnexal masses in our clinical practice. Materials and Methods: Data were collected on the records of 636 women with adnexal masses who had undergone surgery either by open or endoscopic approaches. Those with obvious signs of malignancy, any history of cancer, emergency surgeries without basic evaluation were excluded. The preoperative features by age, ultrasound and serum Ca125 level were compared with final histopathological diagnosis at the four departments of the institution. These are the general gynecology (Group 1: exploratory laparotomy), the gynecologic endoscopy (Group 2: laparoscopy and adnexectomy), the gynecological oncology (Group 3: staging laparotomy) and the gynecologic endocrinology and infertility (Group 4: laparoscopy and cystectomy). Results: There were simple and complex cyst rates of 22.3% and 77.2%, respectively. There were 86.3% benign, 4.1% (n:20) borderline ovarian tumor (BOT) and 6.4% (n:48) malignant lesions. There were 3 BOT and 9 ovarian cancers in Group 1 and one BOT and two ovarian cancer in the Group 2. During the surgery, 15 BOT (75%) and 37 ovarian cancer (77%) were detected in the Group 3, only one BOT was encountered in the Group 4. The risk of rate of unsuspected borderline or focally invasive ovarian cancer significantly increased by age, size, complex morphology and Ca125 (95% CI, OR=2.72, OR=6.60, OR=6.66 and OR=4.69, respectively). Conclusions: Basic preoperative evaluation by comprehensive ultrasound imaging combined with age and Ca125 level has proved highly accurate for prediction of unexpected malignancies. Neither novel markers nor new imaging techniques provide better information that allow clinicians to assess the feasibility of the planned surgery; consequently, the risk of inadvertent cyst rupture during laparoscopy may be significantly decreased in selected cases.

The Role of Endoscopic Retrograde Cholangiopancreatography (ERCP) in the Treatment of Traumatic Pancreas Injury (외상성 췌장 손상에서 내시경적 담췌관 조영술의 역할)

  • Jeong, Min-Young;Kim, Young-Hwan;Kyoung, Kyu-Hyouck;Lee, Sung-Koo;Hong, Suk-Kyung
    • Journal of Trauma and Injury
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    • v.24 no.2
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    • pp.136-142
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    • 2011
  • Purpose: Blunt pancreatic injury has a high mortality rate, especially if adequate management is delayed. Although many guidelines exist for diagnosis and treatment, there is no consensus to date. Therefore, we analyzed the role of endoscopic retrograde cholangiopancreatography (ERCP) as a diagnostic and therapeutic tool for the treatment of traumatic pancreatic injury. Methods: We retrospectively reviewed the electronic medical records (EMR) database at Asan Medical Center (Seoul, South Korea) to identify all patients diagnosed with trauma to the pancreas between June 2003 and December 2010. Clinical and operative findings, CT (computed tomography) images, and ERCP findings were assessed. Results: A total of 40 patients were evaluated in this study. Of these, 14 patients underwent diagnostic ERCP, and 26 did not. Of the 14 patients who underwent diagnostic ERCP, 5 were found to have normal pancreatic ducts, thereby preventing a needless laparotomy in these patients. Of the patients diagnosed with ductal injury, four were treated with endoscopic intervention, and four underwent an exploratory laparotomy. The remaining patient was treated with radiologic intervention (percutaneous drainage) to manage pancreatic pseudocyst formation. Conclusion: Our findings suggest that ERCP is a beneficial diagnostic and therapeutic modality for the treatment of traumatic pancreatic injury.