• Advances in pediatric surgery
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• 제2권2호
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• pp.115-118
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• 1996

Meconium peritonitis is a primarily aseptic, chemical peritonitis caused by the spill of meconium into the abdominal cavity through an intestinal perforation during the intrauterine or perinatal period. The perforation is known to be related to intrauterine vascular compromise. Recently, the authors experienced 4 cases of ileal atresia complicated by meconium peritonitis. The male to female sex ratio was 1 : 3, and age at operation was 1 day(2 cases), 3 days(2 cases). Three cases had generalized peritonitis, and one the cystic type of meconium peritonitis. The types of ileal atresia were IIIa(2 cases), IIIb(1 case), and II(1 case). The proximal blind ileal end was perforated in 3 cases, and distal end perforation was in 1 case of cystic type. Postoperative recovery was excellent in all cases.

• Advances in pediatric surgery
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• 제5권2호
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• pp.141-145
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• 1999

Idiopathic small bowel ulceration distal to the duodenum is rare. Less than 5 % of the reported cases were in children. In the majority of the patients, a single ulcer of unknown cause is found in the jejunum or ileum. The diagnosis is difficult and usually made at the time of surgical exploration for complications, such as perforation, hemorrhage or obstruction. We treated a pediatric patient with perforation of an idiopathic ileal ulceration. The child was an 11-year-old boy who sustained blunt abdominal trauma. The involved ileal segment was resected. Pathologic findings were compatible with idiopathic small bowel ulceration. The clinical and pathological aspects of idiopathic ulcerations are discussed, and the literature reviewed.

• Clinical and Experimental Pediatrics
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• 제45권3호
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• pp.406-412
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• 2002

저자들은 Henoch-$Sch{\ddot{o}}nlein$ 자반증에 의한 심한 복통으로 내원한 5년 9개월 남아에서 corticosteroid 투여 도중에 합병된 소장 천공 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Journal of Chest Surgery
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• 제6권2호
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• pp.237-242
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• 1973

Two cases of traumatic diaphragmatic hernia are reported, who were operated on in this department during the last 12 months` period. The first case, a 34 year old male, fell from 6 meters` height while he was working on electric pole. He sustained rib fractures, left 8th, 9th and 10th rib, left diaphragmatic rupture and ileal perforation. In the pleural cavity, there were stomach, omentum, left lobe of liver, transverse colon and ileum, which were reduced into the peritoneal cavity, and the diaphragmatic aperture was closed through anterolateral thoracotomy. After closure of the thoracic incision, median abdominal incision was made and closed the ileal perforation by primary suture. The second case was a 19 year old tyre repairman, who felt abrupt severe abdominal pain during lifting a heavy lyre. A barium study revealed a marked displacement of the stomach into the left pleural cavity. Immediately, thoracotomy was performed and closed the ruptured diaphragm after reduction of the herniated stomach, omentum, transverse colon, spleen and small intestine. The size of the diaphragmatic aperture were measured 17cm. in first case and 12cm. in the other respectively. Both cases discharged after uneventful recovery.

• Childhood Kidney Diseases
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• 제15권1호
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• pp.76-80
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• 2011

Cytomegalovirus (CMV)는 신 이식 후 발생하는 감염의 가장 흔한 원인으로, 예방요법과 새로운항 바이러스 제제의 도입에도 불구하고 심각한 결과를 초래하며, 거부반응을 촉진한다는 의견도 제시되고 있다. 저자들은 이식 전 CMV 양성이었던 환아에서 후기 CMV 질환이 발병한 증례를 보고하고자 한다. 이식 6개월 후 mycophenolate mofetil ((MMF)을 투여한 후로 설사와 복통을 호소하던 환아는 이식 후 8개월에 소장이 파열되었다. 환아는 6주간의 치료후에 호전되었다. CMV감염의 위험 인자로 MMF의 역할에 대해서는 더 논의가 필요하나, MMF 투여 시이식 후 바이러스 감염에 대한 주의와 주기적인 추적 관찰이 필요하다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제20권2호
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• pp.130-133
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• 2017

Noroviruses have been recognized as the leading cause of epidemic and sporadic gastroenteritis since the advent of molecular diagnostic technique. They have been documented in 5-31% of pediatric patients hospitalized with gastroenteritis. Although norovirus gastroenteritis is typically mild and self-limited, it causes severe, but sometimes fatal, conditions in the vulnerable population such as immunocompromised patients, young children, and the elderly. Bowel perforation due to norovirus infection is rare. We report a case of small bowel perforation with norovirus gastroenteritis in the infant with Down syndrome during the hospitalization with pneumonia. Severe dehydration may cause bowel ischemia and could have triggered bowel perforation in this case. Physicians should be alert to the potential surgical complications followed by severe acute diarrhea, especially in high risk groups.

• Advances in pediatric surgery
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• 제1권1호
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• pp.59-62
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• 1995

Meconium peritonitis is defined as an aseptic, chemical or foreign-body peritonitis caused by spill of meconium in the abdominal cavity related to the prenatal perforation of the intestine. Perforation is usually caused by obstruction from meconium ileus, intestinal atresia, stenosis, volvulus, internal hernia, congenital peritoneal bands, intussusception, or gastroschisis. Less commonly, no evidence of distal obstruction exists. Here, we present two cases of generalized meconium peritonitis of antenatal diagnosis. The first case, detected at 8 months of gestational age, had a perforation of the proximal blind pouch of jejunal atresia, associated with respiratory distress due to severe abdominal distension. This case was successfully treated with resection and anastomosis and brief period of postoperative ventilatory support. The second case had a distal ileal perforation with thick meconium in the terminal ileum. In this case, there was no dilatation of ileum proximal to the perforation site. Resection and anastomosis was performed and postoperative course was uneventful.

• Clinical and Experimental Pediatrics
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• 제46권4호
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• pp.393-396
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• 2003

복부 팽만과 장천공 및 패혈증성 쇼크로 수술 후 진단된 신생아의 회장 폐쇄증에서 비후성 유문 협착증이 동반된 증례로서 회장 폐쇄증의 산전 진단 및 치료 과정에 있어서 다른 부위의 폐쇄증과의 차이를 인지하고, 문합 수술 후 지속적인 구토 증상을 보이는 공회장 폐쇄증 환아에 있어서 수술과 관련된 합병증 이외에 다른 위장관계의 동반 기형의 유무도 확인해야 하며 그 감별 진단에 비후성 유문 협착증도 고려해야 할 것으로 생각된다.

• Journal of Trauma and Injury
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• 제24권2호
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• pp.82-88
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• 2011

Background: The incidence of abdominal trauma with intra-abdominal organ injury or bowel rupture is increasing. Articles on the diagnosis, symptoms and treatment of small bowel perforation due to blunt trauma have been reported, but reports on the relationship of mortality and morbidity to clinical factors for prognosis are minimal. The purposes of this study are to evaluate the morbidity and mortality of patients with small bowel perforation after blunt abdominal trauma on the basis of clinical examination and to analyze factors associated with the prognosis for blunt abdominal trauma with small bowel perforation. Methods: The clinical data on patients with small bowel perforation due to blunt trauma who underwent emergency surgery from January 1994 to December 2009 were retrospectively analyzed. The correlation of each prognostic factor to morbidity and mortality, and the relationship among prognostic factors were analyzed. Results: A total of 83 patients met the inclusion criteria: The male was 81.9%. The mean age was 45.6 years. The mean APACHE II score was 5.75. The mean time interval between injury and surgery was 395.9 minutes. The mean surgery time was 111.1 minutes. Forty seven patients had surgery for ileal perforations, and primary closure was done for 51patients. The mean admission period was 15.3 days, and the mean fasting time was 4.5 days. There were 6 deaths (7.2%), and 25 patients suffered from complications. Conclusion: The patient's age and the APACHE II score on admission were important prognostic factors that effected a patient's progress. Especially, this study shows that the APACHE II score had effect on the operation time, admission period, the treatment period, the fasting time, the mortality rate, and the complication rate.

• Advances in pediatric surgery
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• 제11권2호
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• pp.141-149
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• 2005

Ulcerative colitis, an inflammatory bowel disease, is primarily managed medically with a combination of 5-ASA and steroids. However, this chronic disease requires surgical management if symptoms persist or complications develop despite medical management. The clinical course, indications and outcome of surgical management of 21 patients under the age of 15 who were endoscopically diagnosed with ulcerative colitis at the Seoul National University Children's Hospital between January, 1988 and January, 2003 were reviewed. Mean follow up period was 3 years and 10 months. The mean age was 10.3 years old. All patients received medical management after diagnosis and 8 patients (38 %) eventually required surgical management. Of 13 patients who received medical management only, 7 patients (53 %) showed remission, 4 patients are still on medical management, and 2 patients expired due to congenital immune deficiency and hepatic failure as a result of sclerosing cholangitis. In 8 patients who received surgical management, the indications for operation were, 1 patient sigmoid colon perforation and 7 patients intractability despite medical management. The perforated case had a segmental colon resection and the other 7 patients underwent total colectomy with ileal pouch-anal anastomosis. One patient expired postoperatively due to pneumonia and sepsis. and 1 is still on medical management because of mild persistent hematochezia after surgery. Six other operated patients are doing well without medical therapy. Pediatric ulcerative colitis patients can be surgically managed if the patient is intractable to medical management or if complications such as perforation are present. Total colectomy & ileal pouch-anal anastomosis is thought to be the adequate surgical method.