• Title/Summary/Keyword: Exploratory laparotomy

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A Case of Scrotal Swelling Induced by Tunica Vaginalis Abscess (고환초막강의 농양에 의한 음낭 부종 1례)

  • Kim Jong-Hoon;Lee Dong-Keun;Lim In-Seok
    • Childhood Kidney Diseases
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    • v.7 no.1
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    • pp.103-105
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    • 2003
  • Scrotal swelling may be acute or chronic, painful or painless. Common causes of scrotal swelling in newborns are hydrocele, inguinal hernia, testicular torsion, testicular tumor, scrotal hematoma, meconium peritonitis and epididymitis. Abrupt onset of a painful scrotal swelling necessitates prompt evaluation. Testicular torsion and incarcerated inguinal hernia require urgent surgical management. We report a case of scrotal swelling caused by a tunica vaginalis abscess in a 20-days-old boy. He was admitted to the hospital due to fever, irritability and left scrotal swelling with local heat, tenderness and redness. Exploratory laparotomy was performed to rule out testicular torsion. On the operative field, congestive erythematous inflammation on the left tunica vaginalis was noted and it was filled with a pus like discharge. The cultured organism was Streptococcus agalactiae(group B). He recovered quickly after debridement and administration of empirical antibiotics.

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Non-occlusive Mesenteric Ischemia (NOMI) Secondary to Traumatic Hemorrhagic Shock: Case Report (외상성 출혈성 쇼크 환자에서 발생한 비 폐쇄성 장간막 허혈)

  • Lim, Kyoung Hoon;Jung, Hee Kyung;Cho, Jayun;Lee, Sang Cjeol;Park, Jinyoung
    • Journal of Trauma and Injury
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    • v.27 no.4
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    • pp.204-207
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    • 2014
  • Non-occlusive mesenteric ischemia (NOMI) encompasses all forms of mesenteric ischemia with patent mesenteric arteries. NOMI is commonly caused by decreased cardiac output resulting in hypoperfusion of peripheral mesenteric arteries. We report a case of NOMI secondary to hemorrhagic shock and rhabdomyolysis due to trauma. A 42-year-old man presented to our trauma center following a pedestrian trauma. On arrival, he was drowsy and in a state of hemorrhagic shock. He was found to have multiple fractures, both lung contusion and urethral rupture. An initial physical examination and abdominal computed tomography (CT) scan revealed no evidence of intra-abdominal injury. High doses of catecholamine were administered for initial 3 days due to unstable vital sign. On day 25 of hospitalization, follow-up abdominal CT scan demonstrated that short segment of small bowel loop was dilated and bowel wall was not enhanced. During exploratory laparotomy, necrosis of the terminal ileum with intact mesentery was detected and ileocecectomy was performed. His postoperative course was uneventful and is under rehabilitation.

Delayed Clinical Symptoms of Gallbladder Rupture by Gallbladder Mucocele in a Dog (담낭 점액낭종에 의한 담낭 파열의 만성 경과 증례)

  • Noh, Daji;Kwon, Youngsam;Choi, Hojung;Lee, Youngwon;Lee, Kija
    • Journal of Veterinary Clinics
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    • v.33 no.1
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    • pp.58-61
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    • 2016
  • An 11-year-old, intact male Cocker Spaniel dog was presented with history of abdominal distension, dyspnea for 10 days and lethargy for 1 day. Abdominal radiographs showed decreased serosal detail with abdominal distension. Abdominal ultrasounds revealed gallbladder mucocele with generalized peritonitis showing stellate-like sludge in the gallbladder with echogenic fat degeneration of cranial abdomen and abdominal free fluid containing echogenic materials. Loss of gallbladder wall integrity was shown clearly on computed tomography but ambiguously on ultrasound. Ultrasound-guided abdominocentesis was performed and showed amount of yellowish-bloody peritoneal fluid with vegetable matter and mucoid substance. On peritoneal fluid analysis, bilirubin level was elevated over three times than those of the serum. On exploratory laparotomy, gallbladder rupture and generalized bile peritonitis with intestinal adhesions were confirmed and cholecystectomy with peritoneal lavage was performed. One day after operation, patient died. This report describes delayed clinical symptoms of gallbladder rupture by gallbladder mucocele. In addition, this is the first case report using computed tomography made a diagnosis gallbladder rupture in a dog. Computed tomography might be helpful to diagnose gallbladder rupture.

Surgery of Advanced Esophageal Cancer after Chemotherapy (선행화학요법을 시행한 식도암 환자의 외과적 고찰)

  • 임수빈;이종목
    • Journal of Chest Surgery
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    • v.29 no.5
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    • pp.536-541
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    • 1996
  • Between June 1988 and June 1994, twenty five patients with locAlly advanced esophageal carcinoma received preoperative chemotherapy (Cisplatln, 5-Fluorouracil with or without Etoposide) and followed by resection. All patients had clinical evidence of airway involvement or distant Iymphnode involve- ment (M 1 Iymphnode) on bronchoscopy or computed tomographic scans. The major response rate to chemotherapy decided by the postoperative stage was 48% (12125). The resection rate was 92% (23/25) with overall complete resection rate of 72% (18125). Two patients had exploratory laparotomy (thorn- cotomy) only. Thirteen patients had esophagogastrostomy with a combined abdominl and Rt. thoracic approach (Ivor Lewis operation), slx pAtients had transhiatal esophagectomy, four patients had esophagogastrostomy with a combined Rt. thoracotonly & abdominal, cervical approach. There were three postoperative deaths (12%). Follow-up duration was between 3.3 months to 65 months. Median survival ime of resected patients except hospital death was 14.8 months. Actuarial survival at 12, 24 months was 72.9%, 26.2%. Signifi- cant better survival was associated with responder group (postoperative stage less than lIB) (P=0.029). These results demonstrate that 1) Preoperative Cisplatin based combined chemotherapy Produce high response rate, 2) High complete resection rate with acceptable mortality rate occur after preoperative chemotherapy, 3) Better surviL dl can be anticipated if complete resection performed after major re- sponse to preoperative chemotherapy.

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A Case of Intestinal Hemangioma Complicated with Thrombocytopenia (Kasabach-Merritt syndrome) in Premature Infant (미숙아에서 혈소판 감소증에 의해 발견된 장 혈관종(Kasabach-Meritt 증후군) 1례)

  • Lee, Young-Jin;Bae, Sul-Hee;Song, Eun-Song;Choi, Soo-Jin-Na;Kim, Yoon-Ha;Choi, Young-Youn
    • Neonatal Medicine
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    • v.17 no.1
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    • pp.116-122
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    • 2010
  • Kasabach-Merritt syndrome is a rare thrombocytopenic consumptive coagulopathy associated with a giant hemangioma. We experienced a case of unexplained ascites with thrombocytopenia in a 32 week premature infant. An exploratory laparotomy was performed to determine the cause of the refractory ascites and thrombocytopenia. An intestinal hemangioma was found, but, surgical removal was not performed due to the extensive involvement. Hemangioma was confirmed by SPECT (single-photon emission computed tomography) and the thrombocytopenia was treated with steroid therapy. It is recommended that hemangioma of the visceral organs should be suspected when unexplained thrombocytopenia and disseminated intravascular coagulopathy persist.

Grain Foreign Body Embedded in the Spleen and Immune-Mediated Hemolytic Anemia in a Maltese Dog

  • Song, Joong-Hyun;Jang, Hyo-Mi;Lee, Hee-Chun;Sur, Jung-Hyang;Kang, Byeong-Teck;Jung, Dong-In
    • Journal of Veterinary Clinics
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    • v.34 no.1
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    • pp.39-42
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    • 2017
  • An 8-month-old, intact male Maltese dog was referred to us because of anorexia, diarrhea, and jaundice. Hematologic examination revealed immune-mediated hemolytic anemia, and abdominal ultrasonography revealed heterogeneous changes in mesenteric fat and coarse echotexture in the splenic parenchyma. Septic peritonitis was diagnosed on the basis of a bacterial culture test of the peritoneal fluid. Exploratory laparotomy and subsequent omental biopsy and splenectomy were performed. On histopathological examination, the omental mass and splenic lesions were diagnosed as grain foreign body granulomas. This report describes a rare case in which a grain foreign body was embedded in the spleen of a dog.

Liver Lobe Torsion with Hemangiosarcoma in a Dog

  • Park, Jiyoung;Lee, Hae-Beom;Jeong, Seong Mok
    • Journal of Veterinary Clinics
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    • v.33 no.6
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    • pp.376-380
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    • 2016
  • A 12-year-old spayed, female Siberian Husky dog weighing 40 kg was referred for sudden collapse without a traumatic history. A splenic mass and hemoperitoneum were identified by ultrasonography and abdominocentesis at a local animal hospital. Emergency exploratory laparotomy was performed once the patient was stabilized. A splenic mass and engorged hepatic mass in the torsed left liver lobe were identified. Partial hepatic lobectomy of the left lateral lobe was performed using a laparoscopic linear self-cutting stapler and the spleen was also removed using an ultrasonic scalpel. Histopathologic examination revealed a diagnosis of splenic hemangiosarcoma with metastasis to the liver. Chemotherapy was not performed because the client did not give consent. The patient was checked regularly until death on POD 324. The metastatic nodules had spread to the lungs and other liver lobes and had gradually increased in size. Liver lobe torsion is a rare condition in dogs, especially accompanying neoplasia. This case supports a potential relationship between liver lobe torsion and neoplastic liver mass in dogs.

Unusual Ultrasonographic Features of Chronic Hypertrophic Pyloric Gastropathy in Two Dogs

  • Rhim, Haerin;Moon, Sohyeon;Lee, Gahyun;Park, Seungjo;Cho, Kyoung-Oh;Choi, Jihye
    • Journal of Veterinary Clinics
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    • v.35 no.6
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    • pp.302-307
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    • 2018
  • This report describes the unusual ultrasonography features of chronic hypertrophic pyloric gastropathy in two dogs - a 12-year-old neutered male Pekingese (case 1) and an 11-year-old spayed female Shih Tzu (case 2) - with chronic vomiting and weight loss. Chronic hypertrophic pyloric gastropathy can be observed as the focal thickening of the pyloric wall with normal layers on ultrasonography images. However, in case 1, gastric neoplasia could not be ruled out because of the presence of regional lymph node enlargement; in case 2, an intussusception was tentatively diagnosed because of a mass within the pylorus, which appeared to be connected to the descending duodenum on the longitudinal image. In both cases, focally thickened pyloric walls were demonstrated through exploratory laparotomy, and the histopathological diagnosis of chronic hypertrophic pyloric gastropathy was made. Ultrasonography is useful for imaging the gastrointestinal tract, and the typical ultrasonographic features of chronic hypertrophic pyloric gastropathy have been reported. However, the possibility, that chronic hypertrophic pyloric gastropathy can present unusual ultrasonographic findings similar to those of tumors or intussusception, should also be considered.

Intestinal Lymphoma in a Halla Horse

  • Jeong, Hyohoon;Lee, Seyoung;Park, Kyung-won;Lee, Eun-bee;Kim, Jae-Hoon;Jung, Ji-Youl;Seo, Jong-pil
    • Journal of Veterinary Clinics
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    • v.39 no.3
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    • pp.138-143
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    • 2022
  • A 21-year-old female Halla Horse weighing 248 kg was referred to the Jeju National University Equine Hospital with the chief complaint of anorexia accompanied by general weakness and depression for the previous three days suspected to be related to colic. Extensive diagnostic tests were performed for the following six days, including complete blood count (CBC), serum chemistry, gastroscopy, x-rays, and ultrasound imaging. The signalment, history, symptoms, and test results strongly suggested a chronic intestinal inflammatory disease with or without an alimentary tumor; hence, an exploratory laparotomy was performed. Almost the entire small intestine wall was severely thickened with diffuse ecchymosis on the serosa and protruded nodules on the mucosa. A presumptive diagnosis of an intestinal tumor was made, and the patient was euthanized, considering the patient's welfare with poor prognosis and low expectancy. A massive part of the small intestine was collected and submitted for macroscopic and microscopic pathology evaluations. The pathologic examination, including immunohistochemistry (IHC), indicated equine intestinal lymphoma showing strong positivity for T cell marker. This report describes the clinical signs, diagnosis and pathological features of intestinal lymphoma in a Halla Horse in detail.

Thoracoabdominal injury with evisceration from a chainsaw assault: a case report

  • Salami, Babatunde Abayomi;Ayoade, Babatunde Adeteru;Shomoye, El-Zaki Abdullahi;Nwokoro, Chigbundu Collins
    • Journal of Trauma and Injury
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    • v.35 no.2
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    • pp.118-122
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    • 2022
  • The usual cause of penetrating thoracoabdominal injuries with evisceration are stab wounds with knives and other sharp weapons used during fights and conflicts. Evisceration of the abdominal viscera as a result of trauma, with its attendant morbidity and mortality, requires early intervention. Gunshot wounds can also cause penetrating thoracoabdominal injuries. We report the case of a 52-year-old male patient, a worker at a timber-processing factory, who was assaulted with a chainsaw by his colleague following a disagreement. He was seen at the accident and emergency department of Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria with a thoracoabdominal injury about 1.5 hours after the attack. He had a left thoracoabdominal laceration with abdominal evisceration and an open left pneumothorax. He was managed operatively, made a full recovery, and was discharged 16 days after admission. He was readmitted 4 months after the initial surgery with acute intestinal obstruction secondary to adhesions. He underwent exploratory laparotomy and adhesiolysis. He made an uneventful recovery and was discharged on the 9th postoperative day for subsequent follow-up.