• Title/Summary/Keyword: Pediatric Abdominal CT

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Group B Streptococcal Renal Abscess in a 17-Year-Old Girl with Type 1 Diabetes Mellitus

  • Oh, Kyeong Eun;Yim, Hyung Eun;Yoo, Kee Hwan
    • Childhood Kidney Diseases
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    • v.24 no.1
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    • pp.53-57
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    • 2020
  • Streptococcus agalactiae or group B streptococcus (GBS) is associated with infections in neonates and pregnant women. Herein, we describe a rare case of GBS renal abscess with peritonitis and pleural effusion in a 17-year-old girl with type 1 diabetes mellitus. The girl was admitted due to fever and right flank pain. Laboratory findings included leukocytosis and increased C-reactive protein level and erythrocyte sedimentation rate. Her serum glucose level was 484 mg/dL. Urinalysis showed no pyuria. Renal sonography revealed parenchymal swelling in the right kidney. The patient was administered intravenous cefotaxime. Urine and blood cultures were negative. Fever seemed to improve, but the following day, she complained of abdominal pain and fever. Antibiotic was switched to imipenem, and abdominal and pelvic CT revealed a ruptured right renal abscess, peritonitis, and bilateral pleural effusion with atelectasis. Pigtail catheter drainage of the abscess was performed. Culture from the abscess was positive for GBS, and fever subsided 2 days after the drainage. She was discharged with oral cefixime. The clinical course of urinary tract infections (UTIs) can be atypical in patients with diabetes, and GBS can be a cause of UTIs. Prompt diagnosis and management are necessary to prevent complications in patients showing atypical courses.

A Case Report on Korean Medical Treatment for Induced Remission of Pediatric Crohn's Disease (한방치료로 관해가 유도된 소아 크론병 환자의 증례 보고)

  • Lee, Hyun-Jin;Lee, Hanul;Jeong, Hae In;Cho, Yun-jae;Keum, Chang-Yul;Han, Aram;Ha, Na-yeon;Kim, Jinsung
    • The Journal of Internal Korean Medicine
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    • v.42 no.5
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    • pp.853-862
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    • 2021
  • Objectives: This case study examined the effectiveness of Korean medical treatment for pediatric Crohn's disease. Methods: A 15-year-old female Korean patient with Crohn's disease received acupuncture, electroacupuncture, herbal medicine, moxibustion, and aromatherapy treatment for 1 month in a hospital. Results: Decreases in the Pediatric Crohn's Disease Activity Index score (from 22.5 to 7.5) and the size of two abscesses (from 39.97 mm to 33.36 mm, and from 28.14 mm to 18.71 mm) according to an abdominal CT were observed following treatment. Nausea and vomiting disappeared, stool condition improved, and weight increased (from 30 kg to 33 kg) following treatment. Nausea and vomiting disappeared, stool condition improved, and weight increased (from 30 kg to 33 kg) following treatment. Conclusion: It would be worth examining the long-term effectiveness of Korean medical treatment for pediatric Crohn's disease.

A Case of Solid and Papillary Epithelial Neoplasm of the Pancreas (고형 및 유두상 췌장 종양 1례)

  • Kim, Jong-Keun;Lee, Hyung-Shin;Kim, Sang-Yong;Han, Ji-Whan;Lee, Kyung-Yil;Whang, Kyung-Tai
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.3 no.2
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    • pp.217-221
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    • 2000
  • Solid and papillary epithelial neoplasm of the pancreas is an uncommon low-grade malignant tumor found predominantly in young females. It is rare in childhood. The origin of the tumor is probably from a multipotential stem cell of the pancreas. Neoplasm usually behave like a very low grade malignancy, so that complete removal is the treatment of choice for the tumor arising anywhere in the pancreas. We report a case of solid and papillary epithelial neoplasm of the pancreas in a 14 year -old girl who presented with intermittent abdominal pain and abdominal mass. CT scan shows a large, about $7{\times}6\;cm$ sized, well-marginated hypodense round mass in the head of the pancreas with some ill defined enhancing solid internal portion. She had taken complete excision of the pancereatic mass and Roux-en-Y pancreaticojejunostomy and histologically comfirmed solid and papillary epithelial neoplasm of the pancreas. A brief review of literature was made.

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Primitive Neuroectodermal Tumor of the Liver in a 13-year-old Boy: A Case Report (염증성 거짓 종양으로 오인된 간 내 발생한 원시신경외배엽종양)

  • Lee, Sang-Goo;Kim, Ji-Eun;Lee, Ji-Hyuk;Lee, Hye-Jin;Lee, Jong-Seung;Lee, Jee-Hyun;Choe, Yon-Ho
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.11 no.2
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    • pp.214-218
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    • 2008
  • Primary primitive neuroectodermal tumor (PNET) of the liver is a rare disease with aggressive behavior and poor prognosis. We report a case of a PNET of the liver in a 13-year-old boy. The patient was admitted to the hospital with fever and abdominal pain. Abdominal CT and MRI revealed a 5.5 cm sized, septated, non-enhancing mass in the hepatic hilum. The patient was initially diagnosed with an inflammatory pseudotumor. Despite 9 days of antibiotic therapy, the patient's clinical symptoms did not improve. A liver biopsy was performed in the interest of formulating a differential diagnosis. This procedure revealed tumor cells positive for CD99 on immunohistochemistry. The patient was diagnosed with a PNET.

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A Case of Henoch-Sch$\"{o}$nlein Purpura with Acute Pancreatitis and Hypovolemic Acute Renal Failure (급성 췌장염과 저혈량성 급성 신부전이 동반된 Henoch-Sch$\"{o}$nlein 자반증 1예)

  • Oh, Ki-Won;Park, Sang-Kyu;Kim, Joon-Sung
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.12 no.2
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    • pp.226-229
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    • 2009
  • Gastrointestinal involvement in Henoch-Sch$\"{o}$nlein purpura (HSP) is common. However, both acute pancreatitis and acute renal failure appear to be very rare complications of HSP. We describe a case of HSP with acute pancreatitis and hypovolemic acute renal failure in a 7-year-old girl who presented with a vasculitic purpuric rash involving the lower extremities, abdominal pain, hematochezia, vomiting, and oliguria. Laboratory findings showed increased serum levels of amylase, lipase, and creatinine. An abdominal CT scan revealed diffuse enlargement of the head and body of the pancreas. The patient was successfully managed with conservative treatment, including corticosteroids, and then her pancreatic enzymes and renal function returned to normal. Acute pancreatitis should be differentiated from other causes of acute abdomen in HSP to avoid unnecessary surgery.

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Intussusception due to Diverticulum of Ileocecal Area -A case report- (회맹부 게실에 의한 장중첩증 1례 보고)

  • Kim, In-Cheol;Shin, Dae-Won;Choi, Yong-Jae;Bae, En-Joo;Lee, Kyeung-Ja;Ryu, Boung-Yoon;Cho, Ji-Woong;Choi, Kyung-Chan
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.4 no.1
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    • pp.104-107
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    • 2001
  • Intussusception is a frequent cause of bowel obstruction in the first five years of life and it is one of the most common surgical emergencies in infancy and early childhood. The age of five months child was administered in Department of Pediatrics of Chunchon Sacred Heart Hospital. His main symptoms were vomiting and high fever for three days. Abdominal sonography, air reduction and abdominal computerized tomography (CT) were performed and the conclusion of these study was intussusception due to cyst mass lesion; duplication cyst, mesenteric cyst or Meckel's diverticulum. He was transferred for operation. We had performed laparotomy for reduction of the intussusception. Operative findings revealed ileocolic type of intussusception due to cystic tumor on ileocecal valve that was invaginated into the cecum, and hyperplasia of the Peyer's patch were seen. But we failed manual reduction because of the tumor in the ileocecal area. So we had performed partial resection of the ileocecum. Diverticulum of the ileum was confirmed by pathologic examination. We experienced unusual cause of the intussusception. So we report this case with a review of the literatures.

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Visceral Leishmaniasis in a Child (소아에서 진단된 Visceral Leishmaniasis)

  • Kim, Hyun-Young;Jung, Seung-Eun;Park, Kwi-Won;Kim, Woo-Ki
    • Advances in pediatric surgery
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    • v.10 no.1
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    • pp.35-38
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    • 2004
  • Visceral leishmaniasis is a life-threatening systemic infection caused by a protozoa of the genus leishmania and transmitted by sandfly. We report the first case of visceral leishmanaisis in Korea. The patient was a one-year-old girl admitted with the symptoms of fever, abdominal distension. pancytopenia, and purpura. She traveled to Argentina 5 months ago, and has had symptoms such as fever and pale appearance. Laboratory findings were: WBC, 12.680/$mm^3$; Hg, 3.7g/dL; platelet, 100K; total bilirubin, 1.2mg/dL; AST/ALT, 48/10 U/L. CT scan and MRI showed hepato-splenomegaly. On laparotomy, excision of an accessory spleen and splenic hilar lymph nodes were performed. Many amastigotes were microscopically identified in histiocytes from the biopsy tissues. Sodium stibogluconate was administrated for 2 weeks, which did not relieve the symptoms. After administration of the additional Amphotericin B for 3 weeks, symptoms were improved.

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An Unusual Case of Acute Pyelonephritis Caused by Shigella dysenteri in a Child (소아에서 Shigella dysenteri에 의한 신우신염 1례)

  • Oh, Kyung-Il;Kim, Sung-Jin;Zhang, Joo-Hee;Oh, Yun-Jung;Kang, Sung-Kil;Hong, Young-Jin;Son, Byong-Kwan;Lee, Ji-Eun
    • Childhood Kidney Diseases
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    • v.10 no.2
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    • pp.244-248
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    • 2006
  • Shigella infection usually produces gastrointestinal symptoms but rarely causes urinary tract infection. A 7-year-old girl was admitted for fever, chills, right flank pain, and dysuria. She had no vomiting or diarrhea. There was mild tenderness in her right lower abdomen, and right CVA tenderness was also noted. Acute pyelonephritis was diagnosed by abdominal CT. She showed improvement with intravenous administration of antibiotics. The first urine culture grew $1{\times}10^5$ CFU/mL Shigella dysenteri. Although urinary tract infections due to Shigella species are extremely rare, Shigella species should be considered as a possible cause of pediatric urinary tract infection. We report the first case of urinary tract infection caused by S. dysenteri, which presented as acute pyelonephritis without gastrointestinal symptoms in a child.

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Ganglioneuroblastoma Associated with Malignant Hypertension and Cardiac Failure (심한 고혈압과 심부전을 동반한 신경절신경모세포종 1예)

  • Moon, Suk-Bae;Kim, Hae-Eun;Lee, Suk-Koo;Seo, Jeong-Meen
    • Advances in pediatric surgery
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    • v.15 no.1
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    • pp.68-72
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    • 2009
  • Neuroblastoma is the most common extracranial solid tumor in children, and accompanies various clinical symptoms including hypertension. Hypertension is associated with catecholamines secreted from the tumor, and is usually not severe. We report one case of malignant hypertension with cardiac failure in a patient with adrenal neuroblastoma, successfully treated with adrenalectomy. A 3 year-old boy complained of protrusion of the chest wall. Physical examination revealed severe hypertension with cardiac failure. The levels of metabolites of catecholamine were increased in blood (norepinephrine >2000 pg/mL) and urine (norepinephrine 1350.5 ug/day). Abdominal CT showed a 7 cm-sized solid mass arising from the right adrenal gland. After stabilizing the hemodynamics with oral phenoxybenzamine, right adrenalectomy was performed. Pathological diagnosis was a ganglioneuroblastoma. The hypertension and cardiac failure were resolved after tumor removal.

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A Case of Intestinal Tuberculosis Complicated with Pulmonary Tuberculosis in a Young Aldolescent with Cerebral Palsy (뇌성마비 소아에서 진단된 폐결핵에 병발된 결핵성 장염 1례)

  • Choi, Sung Yun;Kim, Young Min;Bae, Sun Hwan
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.1
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    • pp.102-107
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    • 2004
  • About 20% of intestinal tuberculosis have active pulmonary tuberculosis. Intestinal tuberculosis can develop by swallowing sputum which have active pulmonary tuberculosis and by ingestion of contagious milk. We report a case of intestinal tuberculosis complicated with pulmonary tuberculosis in a 15-year old aldelescent who could not cough out sputum because of known cerebral palsy. He was admitted because of 3 day history of fever and bloody stool. Chest PA showed both upper lobe consolidation. AFB stain and AFB PCR was positive for tuberculosis. Colon study showed abscence of haustral marking and lead pipe appearance due to stenosis of ascending colon and mucosal edema. Abdominal CT scan showed mild wall thickening in ascending colon. Despite the anti-tuberculosis therapy with first line drugs, fever accompanying pleural effusion developed. Second line drug with Isoniazid and Rifampin improved clinical manifestation. After the report on sensitivity, we readjusted the regimen, and clinical manifestations improved gradually.

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