• Title/Summary/Keyword: Exploratory laparotomy

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Clinical Features of Complicated Meckel's Diverticulum Requiring Operation in Children (소아에서 수술을 요한 멕켈게실의 임상상)

  • Lee, Seong-Cheol;Mok, Woo-Kyun;Seo, Jung-Min;Jung, Sung-Eun;Park, Kwi-Won;Kim, Woo-Ki
    • Advances in pediatric surgery
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    • v.1 no.1
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    • pp.33-39
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    • 1995
  • The incidence of Meckel's diverticulum(MD) in general population has been assessed as 2 percent. The major complications of MD are bleeding, perforation, and intestinal obstruction. In spite that the complication rate of Meckel's diverticulum is relatively high(about 4.2% during a lifetime), the preoperative diagnostic rate of complicated MD is very low. Authors investigated the clinical characteristics of complicated MD to improve the diagnostic rate. 16 patients with complicated Meckel's diverticulum who were operated upon at the Department of Pediatric Surgery, Seoul National University Children's Hospital from June 1985 to December 1993 were reviewed. Among the 16 patients with complicated MD, 12 patients(75%) were under 2 year-old and male were predominant(88%). The most common complication was bleeding patients with bleeding MD (8 cases) were diagnosed preoperatively as MD. 8 patients with other complications(perforation : 4 cases, obstruction : 4 cases) could not be suspected as complicated MD except one patient who had previous history of melena. These patients were diagnosed after exploratory laparotomy under the various impression other than MD. Among 12 patients with ulcer related complications such as bleeding and perforation, heterotopic gastric mucosa was found in 11 patients. In conclusion, in any children with unexplained acute abdomen, especially under 2 years old, complicated MD must be included in differential diagnosis. In children with obscure lower gastrointestinal bleeding, $^{99m}Tc$-pertechnetate scintigraphy is a useful diagnostic tool to rule out bleeding MD.

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A Case of Primary Mucinous Cystadenocarcinoma (원발성 후복막 점액낭샘암종 1예)

  • Ji, Jun-Ho;Lee, Hwa-Jung;Park, Seung-Chan;Park, Jung-Chul;Choi, Eun-Jung;Seo, Hye-Jin;Lee, Won-Sik;Lee, Jung-Lim;Bae, Byung-Jo;Shon, Kyung-Rak;Lee, Kyung-Hee
    • Journal of Yeungnam Medical Science
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    • v.25 no.2
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    • pp.134-138
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    • 2008
  • Primary retroperitoneal mucinous cystadenocarcinoma is a very rare malignancy, and little is known concerning its pathogenesis, optimal treatment, and prognosis. A 29-year-old pregnant woman (21 weeks) presented with abdominal discomfort. CA 19-9, CA 125, and CEA were normal. Abdominal CT scanning revealed a $19{\times}15{\times}13cm$ retroperitoneal tumor. Exploratory laparotomy and tumor excision were performed. Mucinous retroperitoneal implants were removed as completely as possible. Histologically, the tumor showed focal areas of capsular invasion, but free resection margins. The uterus and both ovaries were normal in appearance. No adjuvant therapy was pursued. Six months later, peritoneal and bilateral ovarian metastases were discovered. Hence, we report the details of this case of primary retroperitoneal mucinous cystadenocarcinoma and present a review of the literature.

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Ovarian Cancers in 2 Dogs (개에서의 난소종양 2예)

  • 정성목;이충호;김완희;양정환;김대용;최민철;윤정희;이주명;권오경
    • Journal of Veterinary Clinics
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    • v.18 no.4
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    • pp.438-441
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    • 2001
  • Two female Yorkshire terrier was referred to Veterinary Medical Teaching Hospital, Seoul National University. In case 1, clinical signs were vomiting, anorexia and weight loss. Cystic intraabdominal mass was identified in radiographic and ultrasonographic examination. In case 2, clinical sign was abdominal distension. In radiographic and ultrasonographic examination, cellular ascites and bilateral intraabdominal masses next to kidneys were observed. Many clusters of glandular epithelial cells with anisocytosis, anisokaryosis, high N:C ratio coarse chromatin and prominent nucleoli were shown in cytologic examination of sanguineous ascites. In all two cases exploratory laparotomy was performed and enlarged ovaries were observed (Rt: 6$\times$5$\times$5 cm and Lt: 3$\times$2$\times$1 cm in case 1 and 3$\times$2$\times$1 cm bilaterally in case 2). After ovariohysterectomy histopathologic examinations were performed. Histopathologically the masses were diagnosed as ovarian adenocarcinoma and ovarian cystadenocarcinoma in case 1 and case 2, respectively. In both dogs no further chemotherapy was carried out. These two dogs had no gross evidence of tumor recurrence at the time of 3 months after tumor resection, but long-term follow-up might be needed.

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Lung Lobe Torsion with Concurrent Intestinal Lymphangiectasia in a Maltese Dog (Maltese 개에서 림프관 확장증을 동반한 폐염전 발생 증례)

  • Yoon, Hun-Young;Jeong, Soon-Wuk
    • Journal of Veterinary Clinics
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    • v.28 no.2
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    • pp.262-266
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    • 2011
  • A 4-year-old intact male, Maltese dog weighing 2.2 kg was presented for evaluation of tachypnea and hyperthermia. On initial evaluation, the dog was dyspneic, but alert and responsive. Muffled heart sound was noted with auscultation of the right hemithorax. The radiographic findings were consolidation of the right middle lung lobe, pleural effusion, and abdominal fluid accumulation. Thoracic computed tomography confirmed a contrast-enhancing mass within the right middle lung lobe. Surgical exploration of the thoracic cavity was performed using a right fifth intercostal thoracotomy. Examination of the right lung lobe revealed $360^{\circ}C$ torsion of the right middle lung lobe at the level of the hilus, in a clockwise direction. Lung lobectomy was performed using a thoracoabdominal stapling device with 2.5-mm vascular staples. Full-thickness intestinal biopsy by exploratory laparotomy was taken from the jejunum for histological assessment. Histopathologic examination of the full-thickness intestinal biopsy revealed distended lacteal located within the submucosa of the jejunum. Intestinal lymphangiectasia was resolved with prednisone and low fat diets. Subsequent communication with the owner revealed that the patient was in good health 6 months post-discharge.

A Case of Pulmonary Carcinosarcoma which Metastasize to Pelvic Cavity After Left Pneumonectomy (골반강내로 전이되어 발견된 수술적 치료후 재발한 폐암육종 1예)

  • Jung, In-Su;Kim, Young-Jee;Kim, Chung-Hyeon;Kim, Si-Min;Lee, Sang-Moo;Ahn, Young-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.5
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    • pp.453-461
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    • 2001
  • Pulmonary carcinosarcoma(Sarcomatoid carcinoma of the lung) is a rare pulmonary malignancy, which is defined as having an admixture of both carcinomatous and sarcomatous components. Pulmonary carcinosarcoma occurs most frequently in males between 50 and 80 years of age. It predominantly affects the upper lobe and/or the principal bronchi, and is associated with a history of smoking. Here, we report a case of pulmonary carcinosarcoma with a left lobe atelectasis due to an endobronchial mass in a 56-year-old male. After a left pneumonectomy, the pathologic stage was IIb ($T_3N_0M_0$). Four months later, an abdominal mass was observed and exploratory laparotomy revealed metastases of the pulmonary carcinosarcoma to the pelvic cavity.

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A Case of Mesenteric Myxosarcoma in a Dog (개에서 발생한 장간막 점액육종의 한 증례)

  • Kim, Sang-Chan;Kim, Hyun-Wook;Choi, Ji-Hye;Jang, Jae-Young;Choi, Ul-Soo
    • Journal of Veterinary Clinics
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    • v.29 no.2
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    • pp.173-176
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    • 2012
  • A 6-year-old male Shih tzu dog was presented for evaluation of abdominal distention. Abdominal radiography and ultrasonography revealed a soft tissue density mass containing large amount of fluid. Ultrasonography-guided fine needle aspiration of the mass was performed and cytologic impression was granulation tissue with hematoma and fibroplasias. On exploratory laparotomy a mass was identified at the root of mesentery adhered to distal jejunum. Because the mass could not be separated from the attached jejuna loops, the mass and the adhered sites were surgically removed all together and enteroanastamosis was performed. Histologically a low grade myxosarcoma was diagnosed. Tumor cells were positive with alcian blue stain and Ki67 index by immunohistochemistry was 2.5. The dog recovered from surgery uneventfully, and has been in good condition without any signs of recurrence or metastasis for about 30 months after surgery.

A Case of Canine Uterine Adenocarcinoma with Negative Estrogen and Progesterone Receptor Expression (개의 에스트로겐과 프로케스테론 수용체 발현이 되지 않은 자궁 선암종 증례)

  • Cho, Hyang-Mi;Kim, Hyun-Wook;Kim, Hye-Jin;Choi, Ji-Hye;Jang, Jae-Young;Choi, Ul-Soo
    • Journal of Veterinary Clinics
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    • v.28 no.3
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    • pp.303-306
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    • 2011
  • A 12-year-old female mixed breed dog receiving a progesterone drug was referred for evaluation of an abdominal mass. Abdominal radiography and ultrasonography revealed a swollen uterus and an associated mass. Serum chemistry revealed hyperglobulinemia consistent with acute inflammation based on the results of serum protein electrophoresis. Fine needle aspiration of the mass guided by ultrasonography was performed for cytological evaluation. The cytological impression was consistent with adenocarcinoma. Exploratory laparotomy identified a uterine body mass, which was surgically removed for histopathology. Histology of the mass identified a uterine adenocarcinoma. Immunochemistry using anti-estrogen and progesterone receptor antibodies was performed and neoplastic cells were negative to both antibodies while some normal elements were reactive to both of them. Computer tomography demonstrated evidence of metastatic disease in the lung one week after the surgery and the dog died about 40 days after surgery.

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.

Mesenteric Fibromatosis Mimicking Recurrence after Distal Gastrectomy for Gastric Cancer

  • Kim, Dae-Hoon;Oh, Seung-Jong;Oh, Jeong-A;Bae, Young-Sik;Choi, Min-Gew;Noh, Jae-Hyung;Sohn, Tae-Sung;Kim, Kyoung-Mee;Kim, Sung;Bae, Jae-Moon
    • Journal of Gastric Cancer
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    • v.10 no.2
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    • pp.79-83
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    • 2010
  • Mesenteric fibromatosis is a monoclonal, fibroblastic proliferation arising from musculoaponeurotic structure, and it is distinctive lesions defined as a group of non-metastasizing fibroblastic tumors which has local invasion and has a high recurrence rate after the surgical excision. The main treatment modality is the surgical excision. Radiation therapy, chemotherapy, and hormone therapy are also known as useful treatments. We report our experience of a recent case of Mesenteric fibromatosis. A 62-year old female patient had undergone gastrectomy due to gastric cancer. 18 months after gastrectomy, we detected an abdominal mass. The preoperative radiologic findings were suggestive of recurrence. Exploratory laparotomy was performed and post-operative pathologic diagnosis was confirmed as fibromatosis. We report a patient with mesenteric fibromatosis that mimic recurrence after gastrectomy for gastric cancer.

Small Intestine Resection and Anastomosis for Epiploic Foramen Entrapment of a Horse (말의 그물막구멍포착 교정을 위한 소장 절제 및 문합 1례)

  • Hwang, Hye-shin;Park, Chull-gyu;Hwang, Jun-seok;Chun, Yong-woo;Han, Janet H.;Lee, Inhyung
    • Journal of Veterinary Clinics
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    • v.32 no.4
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    • pp.374-379
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    • 2015
  • A 10-year-old gelding Warmblood weighing 560 kg was referred to J&C Equine Hospital with the history of hyperpnea, depression, pawing, and rolling for 7 hours. According to the results of clinical and ultrasound examination, it was considered that intestines were distended with thickened wall. The horse had been treated with lactated Ringers' solution (14 L, IV), flunixin meglumine (1.1 mg/kg, IV), and mineral oil (1 L, PO), but he did not show any responses to those treatments. Exploratory laparotomy was performed and identified incarcerated small intestine through the epiploic foramen. The horse received resection and anastomosis of the entrapped small intestine. After surgery, the horse was treated with intensive postoperative care of fluid therapy (5 L with 20 mEq/L KCl, every 2 hours), flunixin meglumine (1.1 mg/kg, IV, sid), antibiotics (penicillin 22,000 IU/kg, IV, qid and gentamicin 6.6 mg/kg, IV, sid), lidocaine constant rate infusion (bolus 1.3 mg/kg over 15 minutes then 0.05 mg/kg/minute), common nutritional supplements, nasogastric intubation every 2 hours and trunk bandage. Postoperative feeding program had started with small amount of hay every 4 hours and gradually increased to normal amount till 5 days. At 77 days after surgery, he showed sudden outbreak of colic and was euthanized. The causes of colic were small intestinal strangulation by passing through the mesenteric rents and postoperative adhesion between small intestines. According to the results, it is recommended to perform perioperative intensive care of horse with colic and to use several methods to prevent adhesions during abdominal surgery of horses.