• Title/Summary/Keyword: Intra-abdominal

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Descending Thoracic Aorta to Bilateral Femoral Artery Bypass in a Hostile Abdomen

  • Lee, Hong-Kyu;Kim, Kun-Il;Lee, Won-Yong;Kim, Hyoung-Soo;Lee, Hee-Sung;Cho, Sung-Woo
    • Journal of Chest Surgery
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    • v.45 no.4
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    • pp.257-259
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    • 2012
  • Descending thoracic aorta to femoral artery bypass has been used as a remedial operation after aortic or axillofemoral graft failure or graft infection and other intra-abdominal pathologies not amenable to standard aortofemoral revascularization. It can avoid abdomen approach and has been known as a durable procedure with excellent long-term patency. We reported descending thoracic aorta to femoral artery bypass grafting for primary revascularization in a 55-year-old male with hostile abdominal conditions.

Accidental High Epidural Block -A case report- (우발성 고위경막외차단 경험 1예 -증례보고-)

  • Park, Jung-Goo;Cheun, Jae-Kyu
    • The Korean Journal of Pain
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    • v.8 no.1
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    • pp.159-163
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    • 1995
  • Accidental high epidural block is a rare but serious complication. It can result from many factors, which include the volume and concentration of drug, posture, puncture site, age, pregnancy or intra-abdominal mass, and patients' height and weight. We had a case of accidental high epidural block recently. This is a case report which was confirmed by an epiduragram. A healthy 50-year-old woman with a huge uterine myoma was scheduled for a total abdominal hysterectomy under continous epidural analgesia. Epidural catheterization was carried out smoothly. However, an unexpected hypotension was noticed after an epidural injection of 2% lidocaine 25 ml. Thereafter, the patient was intubated and her respiration was controlled during the operation. Using the 5mg of ephedrine, her blood pressure and pulse were well maintained. The scheduled operation was carried out for one hour uneventfully, but after the operation, she felt paresthesia on her hands in the recovery room. To differentiate between the high epidural and the subdural blocks. We injected 5 ml of a water soluble Niopam 300 through the catheter postoperatively. It was observed on the epiduragram that the catheter was placed in the epidural space. It was suggested that the high epidural block was induced from the widespread diffusion through the narrowed epidural space due to the engorgement of the epidural venous plexus by the patient's huge uterine myoma.

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A Case of Henoch-Schönlein Purpura with Fulminant Complications and Its Long-term Outcome

  • Lee, Dong Hyun;LEE, Eun-So;Hong, Jeong;Park, Kwang-Hwa;Pai, Ki Soo
    • Childhood Kidney Diseases
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    • v.23 no.2
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    • pp.128-133
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    • 2019
  • Henoch-$Sch{\ddot{o}}nlein$ purpura (HSP) is a systemic vasculitis characterized by purpura, arthritis, abdominal pain, and nephritis. Gastrointestinal involvement can manifest as pain, intussusception, intestinal bleeding, and intestinal perforation. We report a case of fulminant HSP at an age of eight in 1994, with multiple complications of intra-thoracic bleeding, massive intestinal perforation, nephritis, and various skin rashes. The brisk bleeding findings of intestinal on Technetium-99m-labeled red blood cell scan ($^{99m}Tc$ RBC scan) were well matched to those of the emergency laparotomy and the resected intestine. The patient's abdominal conditions improved gradually but nodular skin eruptions developed newly apart from improving preexisting lower limb rashes and the urine findings continued abnormal, so skin and kidney biopsy were done for the diagnosis. After cyclosporine therapy, skin eruptions and urine findings returned to normal gradually. On a follow-up after 25 years in 2019, the patient is 33-year-old, healthy without any abnormality on blood chemistries and urine examination.

The application of electrochemotherapy in three dogs with inoperable cancers

  • Yeom, Seung Chul;Song, Kun Ho;Seo, Kyoung Won
    • Korean Journal of Veterinary Research
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    • v.61 no.1
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    • pp.9.1-9.6
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    • 2021
  • Factors such as location, volume, and the type of neoplasm complicate achieving tumor control. Electrochemotherapy (ECT) is a supplementary treatment for inoperable neoplasms in veterinary patients. Three dogs were diagnosed with a tumor. Two were squamous cell carcinoma (SCC), and the other was liposarcoma, each with a single tumor with the size range of 1 to 5 cm. The tumor locations were the cervical, oral, and abdominal cavity. ECT was selected as a treatment. Bleomycin was injected intratumorally at the dose of 0.5 to 1.0 mg/㎤. Five minutes after the injection, electric pulses applied in a sequence of eight pulses lasting 100 μsec each, were delivered in 1,000 V/cm. An evaluation was performed after 1 week, and the next session was administered 2 weeks later. In a patient with oral SCC, the tumor was in partial remission after two sessions of ECT. Another patient with SCC on her neck was showed complete remission after 2 weeks of ECT administration. A third patient showed stable disease for 8 weeks. Complications were mild and transient and included skin necrosis, edema, local pain, and gait disturbance. ECT is a valid adjuvant, especially for inoperable, cutaneous, or accessible intra-abdominal tumors.

Non-B, Non-T Acute Lymphoblastic Leukemia in a Cat

  • Sumin Cha;Hyunwoo Kim;Hyeona Bae;Minjeong Kang;Rankyung Jung;Minji Kim;DoHyeon Yu
    • Journal of Veterinary Clinics
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    • v.40 no.4
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    • pp.298-302
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    • 2023
  • A 7-year-old neutered male, domestic shorthair cat presented anorexia and lethargy. The complete blood cell count revealed severe non-regenerative anemia, lymphocytic leukocytosis, neutropenia, and thrombocytopenia. On the peripheral blood smear examination, medium to large lymphoblastic cells with moderate amounts of basophilic cytoplasm were observed in up to 70% of peripheral leukocytes. Feline leukemia and immunodeficiency viruses were not detected using a commercial diagnostic kit. While splenomegaly and blunt margins of the caudoventral liver were observed in abdominal radiography, changes in the intra-abdominal lymph nodes were not remarkable. Ultimately, flow cytometric immunophenotyping from the peripheral blood revealed a negative for B-cell markers (CD21-/CD79a-) and T-cell markers (CD3-/CD4-/CD5-/CD8-). Based on the hematological examination and the immunophenotyping assay, the cat was diagnosed with non-B, non-T acute lymphoblastic leukemia. Here, we report a rare case of non-B, non-T acute lymphoblastic leukemia to raise awareness and provide information on clinical symptoms and laboratory test and immunophenotyping analysis results.

Primary Peritoneal Psammocarcinoma Misdiagnosed as an Heterotopic Ossification: A Case Report (이소골화로 오진된 복막의 일차성 모래종암종: 증례 보고)

  • Gayoung Jeon;Seo Young Park
    • Journal of the Korean Society of Radiology
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    • v.84 no.4
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    • pp.958-963
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    • 2023
  • Primary peritoneal psammocarcinoma is a rare type of serous carcinoma that is characterized by the massive formation of psammoma bodies and the invasion of adjacent organs. A 55-year-old female who previously underwent a hysterectomy presented to the emergency room with severe abdominal pain. Contrast-enhanced CT revealed an intra-abdominal calcific mass. Initially, it was thought to be a heterotopic ossification due to the previous pelvic surgery with intact ovaries. However, this was diagnosed as a primary peritoneal psammocarcinoma. Primary peritoneal psammocarcinoma is a very rare disease entity that should be considered a differential diagnosis in patients with normal ovaries, massive ossification in the pelvic cavity, and calcific peritoneal nodules.

Comparison of Paramedian and Flank Approaches for Abdominal Unilateral Cryptorchidectomy in Korean Native Calves (한우에서 복강 내 편측성 잠복고환 제거를 위한 부정중선 및 겸부 접근의 비교)

  • Jeong, Jae-Kwan;Baik, Young-Chul;Kang, Hyun-Gu;Kim, Ill-Hwa
    • Journal of Veterinary Clinics
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    • v.30 no.1
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    • pp.66-70
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    • 2013
  • This report compared paramedian and flank approaches for the effective removal of abdominal unilateral cryptorchidism in calves. Two Korean native calves of approximately 300 kg in body weight, which had undergone the removal of a testis from the scrotum, were diagnosed as having abdominal unilateral (left) cryptorchidism by rectal palpation. One calf was administered with xylazine (0.2 mg/kg, IV) and was restrained in the dorsal recumbency position on the ground of barn for the paramedian approach, while the other calf was sedated with xylazine (0.03 mg/kg, IV) and restrained in the standing position for a flank approach. For the two calves, 2% lidocaine was administered by local infiltration, along the proposed incision line. Following incisions of the skin, muscle and peritoneum, the testis, which was located between the left kidney and inguinal canal, was grasped, exteriorized out of the abdominal cavity and detached from the gubernaculum testis. Then spermatic cord was ligated and cut. Finally, the testis was removed. An assistant was required to restraint a calf in dorsal recumbency for paramedian approach, and cryptorchidectomy was carried out with operator in a rather uncomfortable squatting posture, while restraint was rather simple and cryptorchidectomy was proceeded with operator in a standing posture where the flank approach was taken. During surgery, the gubernaculum testis was more strained during pulling the testis in the flank approach than in the paramedian approach, as the distance between incision site and the gubernaculum testis was greater in the flank approach than that in the paramedian approach. On the other hand, intra-abdominal pressure was greater in the paramedian approach than in the flank approach during surgery. The elapsed time between restraint and the end of surgery was 10 min shorter where the flank approach (35 min) was taken, than where the paramedian approach (45 min) was taken. In conclusion, this case study demonstrated that the flank approach might be more convenient than the paramedian approach for abdominal unilateral cryptorchidectomy in calves.

Total Laparoscopic Hysterectomy Versus Total Abdominal Hysterectomy for Endometrial Cancer: A Meta-analysis

  • Wang, Hui-Ling;Ren, Yan-Fang;Yang, Jun;Qin, Rui-Ying;Zhai, Kai-Hua
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.4
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    • pp.2515-2519
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    • 2013
  • The standard surgery for early-stage endometrial cancer is total abdominal hysterectomy (TAH), while total laparoscopic hysterectomy (TLH) is less invasive and assumed to be associated with lower morbidity. This meta-analysis was performed to investigate the effects of TLH versus TAH in women with early-stage endometrial cancer. We searched the PubMed, EMBASE, CBM and Cochrane Review databases for randomized trials assessing the effects of TLH versus TAH in women with early-stage endometrial cancer. The relative risks (RR) with 95% confidence intervals (CIs) from each study were pooled using meta-analysis. In our study, 9 randomized trials with a total of 1,263 patients were included. Meta-analyses showed that TLH was associated with lower risks of major complications (RR = 0.53, 95%CI 0.29-0.98, P = 0.042), total complications (RR = 0.59, 95%CI 0.42-0.82, P = 0.002) and postoperative complications (RR = 0.57, 95%CI 0.40-0.83, P = 0.003). However, there were no obvious differences in risks of intra-operative complications (RR = 0.98, 95%CI 0.62-1.55, P = 0.919) and mortality (RR = 0.96, 95%CI 0.66-1.40, P = 0.835). In conclusion, our results provide new evidence of a benefit for TLH over TAH in terms of major complications, total complications and postoperative complications in endometrial cancer patients.

Long-term Survival after Repeated Local Therapy and Salvage Chemotherapy for Recurrent Metastases from Gastric Cancer: a Case Report and Literature Review

  • Kwon, Jihyun;Han, Hye Sook;Kim, Hee Kyung;Baek, Seung-Woo;Yang, Yaewon;Lee, Ki Hyeong;Son, Seung-Myoung;Kim, Won-Dong;Kim, Dae Hoon;Yun, Hyo Yung
    • Journal of Gastric Cancer
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    • v.18 no.3
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    • pp.305-312
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    • 2018
  • We report a rare case of long-term survival in a patient who received local therapy and salvage chemotherapy for recurrent metastases, along with a literature review. A 65-year-old male patient underwent subtotal gastrectomy for advanced gastric adenocarcinoma. Six months after gastrectomy, 2 metastatic intra-abdominal lymph node enlargements were detected, which were treated with radiotherapy. At 55 months after gastrectomy, an abdominal wall mass was detected, which was treated by surgical resection. The patient received 5-fluorouracil/leucovorin/irinotecan chemotherapy for 27 months before and after radiotherapy and docetaxel chemotherapy for 6 months after surgical resection of the abdominal wall metastasis. At the last visit, 7.8 years since the initial resection of the primary gastric cancer and 6.2 years since detection of the first metastases, the patient was disease-free and required no further chemotherapy. This case suggests that repeated local therapy offers potential for long-term survival in a carefully selected subset of patients with recurrent metastases.

Incarcerated umbilical hernia with small bowel obstruction in a continuous ambulatory peritoneal dialysis patient

  • Jeong, Yo-Han;Do, Jun-Young;Hwang, Mun-Ju;Kim, Min-Jung;Gu, Min Geun;Park, Byung-Sam;Choi, Jung-Eun;Kim, Tae-Woo
    • Journal of Yeungnam Medical Science
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    • v.31 no.1
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    • pp.25-27
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    • 2014
  • Patients treated with peritoneal dialysis have increased intra-abdominal pressure and a high prevalence of abdominal wall complications. Hernias can lead to significant morbidity in patients on peritoneal dialysis. Hernias are clinically important because of the risk of incarceration, strangulation and subsequent bowel obstruction, rupture, and peritonitis. In this paper, a case of incarcerated umbilical hernia with small bowel obstruction in a continuous ambulatory peritoneal dialysis (CAPD) patient is reported. The small bowel obstruction improved after herniorrhaphy, and the peritoneal dialysis was resumed 2 weeks after the herniorrhaphy. The patient had been undergoing CAPD without technical failure until the 2 months follow-up after the herniorrhaphy. This case shows that early detection of incarcerated umbilical hernia and herniorrhaphy can prevent resection of a strangulated small bowel so that it can remain on CAPD without post-operative technical failure. Umbilical hernias should be carefully observed and intestinal obstruction should be considered when a CAPD patient with an umbilical hernia has abdominal pain.