• 제목/요약/키워드: Exploratory laparotomy

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개의 십이지장에서 발생한 골수 외 형질세포종양 (Duodenal Extramedullary Plasmacytoma in a Dog)

  • 유미현;배일홍;노미영;김용백;김대용
    • 한국임상수의학회지
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    • 제24권4호
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    • pp.644-646
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    • 2007
  • This report deals with a 9-year-old neutered male Yorkshire terrier that had been suffered from vomiting, bloody diarrhea, anorexia. On exploratory laparotomy, pale-pink $10{\times}6cm$ duodenal mass was found and submitted to the Department of Veterinary Pathology, College of Veterinary Medicine, Seoul National University. Histologically, the duodenal mass consisted of compact sheet of poorly demarcated, highly infiltrative neoplasm. The neoplastic cells were round to polygonal and contained scant to moderate amounts of granular basophilic cytoplasm and eccentrically located irregularly round nuclei with stippled chromatins. The neoplastic cells were positive to lamda light chain immunohistochemically but were uniformly negative for toluidine blue stain and giemsa stains. Based on these results, this case was diagnosed as primary extramedullary plasma cell tumor of duodenum.

A Case of Cecal Volvulus Presenting with Chronic Constipation in Lissencephaly

  • Lee, Eun-Kyung;Kim, Ji Eun;Lee, Yun-Young;Kim, Saeyoon;Choi, Kwang Hea
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제16권2호
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    • pp.131-134
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    • 2013
  • Cecal volvulus is uncommon in pediatric patients and there are few reports of cecal volvulus with cerebral palsy. Here, we report the case of a 19-year-old male patient who presented with abdominal distension, a history of cerebral palsy, refractory epilepsy due to lissencephaly, and chronic constipation. An abdominal x-ray and computed tomography without contrast enhancement showed fixed dilated bowel intensity in the right lower abdomen. Despite decompression with gastric and rectal tube insertion, symptoms did not improve. The patient underwent an exploratory laparotomy that revealed cecal volvulus. Cecal volvulus usually occurs following intestinal malrotation or previous surgery. In this patient, however, intestinal distension accompanying mental disability and chronic constipation resulted in the development of cecal volvulus. We suggest that cecal and proximal large bowel volvulus should be considered in patients presenting with progressive abdominal distension combined with a history of neuro-developmental delay and constipation.

Double Intussusception in a Jindo Puppy : Triple-circle Sign

  • Kim, Hyun-su;Jeon, Soo-hee;Hwang, Tae-sung;Yoon, Young-min;Yeon, Seong-chan;Lee, Hee-Chun
    • 한국임상수의학회지
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    • 제33권3호
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    • pp.176-178
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    • 2016
  • Here we report a case of a 7-month-old Jindo puppy with a double intussusception. On survey radiography, a soft tissue opacity mass was identified in the mid-abdomen. Abdominal ultrasonography revealed a triple-circle sign. Double intussusception was diagnosed based on these findings. Exploratory laparotomy confirmed it to be a double intussusception in the small intestine. Small intestine involving the double intussusception was surgically resected followed by anastomosis. The dog had good prognosis without any complication. To the best of our knowledge, double intussusception is an extremely rare form of intestinal disease in dogs. It may cause blood supply to that section to be greatly reduced, thus causing ischemia and necrosis of the bowel tissue. Timely diagnosis with ultrasonographic findings and immediate surgical intervention are important to improve the prognosis of such cases.

Miniature Schnauzer에서 발생한 장간막 염전 1증례 (Mesenteric torsion in a Miniature Schnauzer)

  • 최지혜;김현욱;김진경;장재영;김준영;윤정희
    • 대한수의학회지
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    • 제48권1호
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    • pp.125-130
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    • 2008
  • Mesenteric torsion was diagnosed in a 2-year-old, spayed female Miniature Schnauzer. The patient was presented with acute depression, vomiting, lethargy and hematochezia. On physical examination, severe dehydration, tachycardia, tachypnea, weak femoral pulse, delayed capillary refill time and pale mucous membrane were found and the dog was in shock. Radiography and ultrasonography revealed intestines distended with gas, ascites and the "C" shaped distended intestine. Medical treatments including fluid therapy, analgesics, antibiotics and lidocaine for reducing reperfusion injury were applied. And then, the mesenteric torsion was definitively diagnosed through exploratory laparotomy and intestinal resection and anastomosis were performed. The dog made an uneventful recovery and was free of clinical sign one week after surgery. Mesenteric torsion is an unusual and life-threatening disease in dogs. It has usually been described in the middle and large breed dogs, especially German Shepherds. However, the mesenteric torsion should be included in the differential diagnostic lists for acute abdomen even in small breed dog. The mortality rate of mesenteric torsion can be reduced through prompt diagnosis, proper preventive therapy for shock and reperfusion injury and emergency surgery.

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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Chronic Intestinal Pseudo-Obstruction Caused by Intestinal Adenocarcinoma in a Mixed-Breed Dog

  • Moon, Heesup;Hong, Subin;Kim, Sangyeoun;Park, Sungguon;Kim, Taehwan;Kim, Nahyun;Lee, Jae-Hoon
    • 한국임상수의학회지
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    • 제33권4호
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    • pp.210-213
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    • 2016
  • A 9-year-old, mixed-breed, castrated male dog presented with a one-week history of severe vomiting. Abdominal radiography showed a dilated small intestine loop. Abdominal ultrasonography showed small-intestine distension up to 5 cm in diameter without mechanical obstruction. During exploratory laparotomy, an aperistaltic ileal segment was resected. There was no narrowed cavity in the resected plane. Histopathologic and immunohistochemical findings confirmed visceral myopathy due to intestinal adenocarcinoma in the ileum and revealed partial destruction of the longitudinal and circular muscles with fibrosis. Chronic intestinal pseudo-obstruction caused by adenocarcinoma was diagnosed after considering the above investigative results.

우상 전흉부 자상에서 흉막강 관통 없는 간손상 및 횡격막 손상에 의한 혈흉 치험 1례 (Hemothorax Without Injury of the Pleural Cavity due to Diaphragmatic and Liver Laceration Caused by a Right Upper Anterior Chest Stab Wound)

  • 조규석;윤효철;김중헌;이상목
    • Journal of Trauma and Injury
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    • 제23권1호
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    • pp.49-52
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    • 2010
  • A hemothorax usually occur, due to injuries to the intercostal and great vessels, pulmonary damage, and sometimes fractured ribs. We report a case in which the hemothorax that occurred, neither intrathoracic injury nor injury to internal thoracic vessels and organs, via lacerated diaphragmatic and liver laceration due to a right upper part of anterior chest stab injury caused by a sharp object. The patient's general conditions gradually worsened, so chest and abdominal computed tomogram were taken. The abdominal computed tomogram revealed diaphragmatic injuries and bleeding from the lacerated liver. We performed an exploratory laparotomy to control the bleeding from the lacerated liver with simple primary sutures. In addition exploration was performed in the right pleural space through the lacerated diaphragm with a thoracoscopic instrument. There were no bleeding foci in the right pleural space, the vessels, or the lung on the thoracoscopic video. Closure of the lacerated diaphragm was achieved with simple, primary sutures. The postoperative course of the patient was uneventful, and the patient was discharged.

지연 수술로 호전된 간문맥 내 가스와 장관 기종을 동반한 괴사성 장염 (Necrotizing enteritis with portal vein gas and pneumatosis cystoides intestinalis treated with delayed operation)

  • 유지연;유영욱;김지혜;유상훈;하소영
    • Journal of Yeungnam Medical Science
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    • 제32권1호
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    • pp.13-16
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    • 2015
  • Portal vein gas and pneumatosis cystoides intestinalis are uncommon conditions and have been associated with poor prognosis. They are most commonly caused by necrotizing enterocolitis but may have other causes, and they can be associated with necrotizing and ischemic colitis, intra-abdominal abscess, small bowel obstruction, diverticulitis, colon cancer, and acute pancreatitis. With the more frequent use of computed tomography (CT) scans, portal vein gas and pneumatosis cystoides intestinalis have been increasingly detected in recent years. Because of its high mortality rate, necrotizing enteritis with portal vein gas and pneumatosis cystoides intestinalis may be treated with emergent exploratory laparotomy. We report a case of necrotizing enteritis with portal vein gas and pneumatosis cystoides intestinalis in a 47-year-old man treated with intensive medical management and delayed operation due to unstable condition and surgical mortality. He had good clinical results without complications after the delayed operation.

Pelvic Hydatidosis Mimicking a Malignant Multicystic Ovarian Tumor

  • Singh, Prem;Mushtaq, Deeba;Verma, Neetu;Mahajan, N.C.
    • Parasites, Hosts and Diseases
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    • 제48권3호
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    • pp.263-265
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    • 2010
  • Echinococcosis is a multisystem disease and has propensity to involve any organ, an unusual anatomical site, and can mimic any disease process. Primary peritoneal echinococcosis is known to occur secondary to hepatic involvement but occasional cases of primary peritoneal hydatid disease including pelvic involvement have also been reported. We report here 1 such case of primary pelvic hydatidosis mimicking a malignant multicystic ovarian tumor where there was no evidence of involvement of the liver or spleen. Our patient, a 27-year-old female, was detected to have a large right cystic adnexal mass on per vaginal examination which was confirmed by ultrasonography. Her biochemical parameters were normal and CA-125 levels, though mildly raised, were below the cut off point. She underwent surgery and on exploratory laparotomy, another cystic mass was found attached to the mesentery of the small gut. The resected cysts were processed histopathologically. On cut sections both large cysts revealed numerous daughter cysts. Microscopic examination of fluid from the cysts revealed free scolices with hooklets and the cyst wall had a typical laminated membrane with inner germinal layer containing degenerated protoplasmic mass. The diagnosis of pelvic hydatid disease was confirmed and patient was managed accordingly. Hydatid disease must be considered while making the differential diagnosis of pelvic cystic masses, especially in endemic areas.

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

  • 김종훈;이동근;임인석
    • Childhood Kidney Diseases
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    • 제7권1호
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    • pp.103-105
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    • 2003
  • 저자들은 고환초막강내의 농양(감염성 음낭수종)에 의한 발열과 보챔, 음낭부종으로 내원한 신생아에서 조기진단 및 적절한 치료로 성공적으로 회복된 1례를 경험하였으며 감염성 음낭수종은 신생아에서 드물지만 조기에 정확하게 진단되어 질 때, 그리고 고환, 부고환에 영향을 끼치지 않았을 경우 단지 배액술과 항생제 치료만으로도 성공적으로 치료할 수 있음을 보고하는 바이다.

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