• Title/Summary/Keyword: Pediatric surgery

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Granular cell tumor of the esophagus in an adolescent

  • Lee, Ji Sun;Ko, Kyung Ok;Lim, Jae Woo;Cheon, Eun Jeong;Kim, Young Jin;Son, Jang Sin;Yoon, Jung Min
    • Clinical and Experimental Pediatrics
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    • v.59 no.sup1
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    • pp.88-91
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    • 2016
  • Esophageal granular cell tumor (GCT) is a rare neoplasm originating from the Schwann cells of the submucosal neuronal plexus. Histology is the gold standard for its diagnosis. Endoscopic resection or surgical excision should be considered, depending on the potential for malignancy. Here, we report a case of an esophageal GCT in an adolescent. A 12-year-old boy presented with a 1-year history of dysphagia and vomiting. Upper gastrointestinal endoscopic examination and esophagography showed narrowing of the midesophagus, and computed tomography angiography of the thoracic aorta revealed an esophageal or periesophageal mass posterior to the paratracheal segment of the esophagus. The tumor was surgically excised, and based on the pathological findings, esophageal GCT was diagnosed.

A Case of Renovascular Hypertension Controlled by Renal Artery Embolization (신동맥 색전술로 치료한 신혈관 고혈압증 1례)

  • Yew, Jung Hun;Kim, Young Deuk;Shin, Byung Seok;Gil, Hong Ryang
    • Clinical and Experimental Pediatrics
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    • v.48 no.2
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    • pp.212-215
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    • 2005
  • Renal artery stenosis is a major cause of renovascular hypertension and the most common cause of treatable secondary hypertension. There are several methods to treat renal artery stenosis, including surgery, percutaneous transluminal renal angioplasty(PTRA), and renal artery stenting(RAS). But, renal artery embolization can be tried in atherosclerotic stenosis, multiple stenosis, microaneurysm, and stenosis difficult to try PTRA or RAS. We report a case of renovascular hypertension in a 14-year-old female who had multiple segmental renal artery stenosis. Hypertension was controlled by renal ablation therapy with renal artery embolization.

A Case of Pulmonary Sequestration with Pleural Effusion (산전 진찰에서 발견된 흉막액을 동반한 폐격리증 1례)

  • Ku, Hye Jin;Park, Ji Ae;Park, Su Eun;Kim, Young Dae
    • Clinical and Experimental Pediatrics
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    • v.48 no.2
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    • pp.221-223
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    • 2005
  • Congenital pleural effusions are uncommon. The majority of cases are due to chylothorax, hydrops fetalis, and infection. Effusions of this nature are, for the most part, self-limited. We experienced a rare case of a congenital unilateral pleural effusion due to an extralobar sequestraion with pulmonary lymphangiectasia. Pleural effusion was found by antenatal ultrasonography and confirmed by CT scans and CT angiography of the chest in the neonatal period. The patient underwent an open thoracotomy where extralobar sequestraion located between the diaphragm and the left lower lobe was removed. His postoperative course was uncomplicated and there was complete resolution of the pleural effusion.

A Case of Intestinal Hemangioma Complicated with Thrombocytopenia (Kasabach-Merritt syndrome) in Premature Infant (미숙아에서 혈소판 감소증에 의해 발견된 장 혈관종(Kasabach-Meritt 증후군) 1례)

  • Lee, Young-Jin;Bae, Sul-Hee;Song, Eun-Song;Choi, Soo-Jin-Na;Kim, Yoon-Ha;Choi, Young-Youn
    • Neonatal Medicine
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    • v.17 no.1
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    • pp.116-122
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    • 2010
  • Kasabach-Merritt syndrome is a rare thrombocytopenic consumptive coagulopathy associated with a giant hemangioma. We experienced a case of unexplained ascites with thrombocytopenia in a 32 week premature infant. An exploratory laparotomy was performed to determine the cause of the refractory ascites and thrombocytopenia. An intestinal hemangioma was found, but, surgical removal was not performed due to the extensive involvement. Hemangioma was confirmed by SPECT (single-photon emission computed tomography) and the thrombocytopenia was treated with steroid therapy. It is recommended that hemangioma of the visceral organs should be suspected when unexplained thrombocytopenia and disseminated intravascular coagulopathy persist.

A Case of Embryonal Rhabdomyosarcoma at Left Parotid Gland in 8-Month-Old Infant (8개월 영아의 좌측 이하선 부위에서 발생한 배아형 횡문근육종 1예)

  • Cho, Minhyuk;Kim, Yeon Soo;Shin, YooSeob;Kim, Chul-Ho
    • Korean Journal of Head & Neck Oncology
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    • v.30 no.2
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    • pp.119-122
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    • 2014
  • Rhabdomyosarcoma is the most common sarcoma in children less than 15 years of age. Two major histological subtypes are embryonal and alveolar. Embryonal rhabdomyosarcoma is diagnosed by immunopathology and treatments require coordinated management plans that include surgery, chemotherapy, and usually radiotherapy. 8-month-old male infant visited with swelling in left parotid area. Computed tomography scan showed a heterogeneous mass in the left parotid area and the result of fine-needle aspiration cytology was suspicious malignancy. Left total parotidectomy was performed and CSF leakage was noted and repaired. Confirmed by positive reactions to desmin and myogenin, the diagnosis was embryonal rhabdomyosarcoma. On postoperative brain MRI, extension along the meninges was noted and for treatment, chemotherapy and gamma knife radiosurgery were done. Five years after initial surgical resection(3 years and 10 months after completion of chemotherapy and gamma knife radiosurgery), the child did not show any evidence of local recurrence or distant metastasis.

Preliminary Results of Topical Mitomycin Application in Laryngotracheal Stenosis (후두기관협착증에 있어서 mitomycin 국소 도포 : 예비결과)

  • 임상철;조형호
    • Korean Journal of Bronchoesophagology
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    • v.9 no.2
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    • pp.60-64
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    • 2003
  • Restenosis frequently develops with granulation and overgrowth of scar following surgical treatment for laryngotracheal stenosis. Various methods such as stenting or CO2 laser application have been used to prevent restenosis, but they were seldom unsatisfactory. Mitomycin is an antineoplastic antibiotics derived from Streptomyces caespitosus; it inhibits fibroblast proliferation and acts as an alkylating agent to inhibit DNA synthesis. This study was desinged to evaluate effectiveness and determine indications of usage of topical mitomycin for laryngotracheal stenosis as a nonsurgical means of reducing postoperative granulation and scar tissue formation. Patients and Method : A retrospective study was performed on eight cases of laryngotracheal stenosis with topical mitomycin application. The author analyzed clinical outcomes of operative treatment with topical mitomycin. Patients underwent laryngotracheal reconstruction, endoscopic granulation removal, or bronchoscopic bougienage followed by topical application of mitomycin (0.4 mg/$m{\ell}$, 4minuntes) on the lesion intraoperatively. Result : Overall success rate of decannulation was 38% ($\frac{3}{8}$). Successful decannulation was possible in 75% ($\frac{3}{4}$) of laryngeal stenosis patients, 75% ($\frac{3}{4}$) of children, 60% ($\frac{3}{5}$) of the patients without previous surgery, and 75% ($\frac{3}{4}$) of bronchoscopic bougienage. Conclusion : The topical application of mitomycin in laryngotracheal stenosis was effective in untreated pediatric laryngeal stenosis which underwent bronchoscopic bougienage. Our results show that the topical mitomycin application for laryngotracheal stenosis could be a effective adjuvant treatment.

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Neonatal Intracranial Ischemia and Hemorrhage : Role of Cranial Sonography and CT Scanning

  • Khan, Imran Ahmad;Wahab, Shagufta;Khan, Rizwan Ahmad;Ullah, Kkram;Ali, Manazir
    • Journal of Korean Neurosurgical Society
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    • v.47 no.2
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    • pp.89-94
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    • 2010
  • Objective : To evaluate the role of cranial sonography and computed tomography in the diagnosis of neonatal intracranial hemorrhage and hypoxic-ischemic injury in an Indian set-up. Methods : The study included 100 neonates who underwent cranial sonography and computed tomography (CT) in the first month of life for suspected intracranial ischemia and hemorrhage. Two observers rated the images for possible intracranial lesions and a kappa statistic for interobserver agreement was calculated. Results : There was no significant difference in the kappa values of CT and ultrasonography (USG) for the diagnosis of germinal matrix hemorrhage/intraventricular hemorrhage (GMH/IVH) and periventricular leucomalacia (PVL) and both showed good interobserver agreement. USG, however detected more cases of GMH/IVH (24 cases) and PVL (19) cases than CT (22 cases and 16 cases of IVH and PVL, respectively). CT had significantly better interobserver agreement for the diagnosis of hypoxic ischemic injury (HII) in term infants and also detected more cases (33) as compared to USG (18). CT also detected 6 cases of extraaxial hemorrhages as compared to 1 detected by USG. Conclusion : USG is better modality for imaging preterm neonates with suspected IVH or PVL. However, USG is unreliable in the imaging of term newborns with suspected HII where CT or magnetic resonance image scan is a better modality.

Gastric neurofibroma in von Recklinghausen disease : a cause of upper gastrointestinal bleeding (Von Recklinghausen disease병 환아에서 상부위장관 출혈로 발현한 위의 신경섬유종 1례)

  • Kwon, Bo Sang;Shim, Jeong Ok;Seo, Jeong Kee;Yang, Hye Ran;Ko, Jae Sung;Jung, Seong Eun;Kim, Woo Sun;Kang, Gyeong Hoon
    • Clinical and Experimental Pediatrics
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    • v.49 no.2
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    • pp.203-207
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    • 2006
  • Neurofibromatosis type 1 (von Recklinghausen disease, NF1) involves the central and peripheral nervous systems as well as the skin, bone, endocrine, gastrointestinal and vascular systems. The gastrointestinal neurofibroma associated with NF1 has been infrequently reported. We report our experience with a 15-year-old boy who had a gastric plexiform neurofibroma with upper gastrointestinal bleeding and underwent a tumorectomy because of massive upper gastrointestinal bleeding. We conclude that gastrointestinal bleeding and anemia in the setting of NF1 mandates complete endoscopic examination of the digestive tract to rule out neurofibromas. Surgical resection is the standard treatment.

Diagnosis of Right Ventricular Vegetation on Late Gadolinium-Enhanced MR Imaging in a Pediatric Patient after Repair of a Ventricular Septal Defect

  • Jeong, Jewon;Kim, Hae Jin;Kim, Sung Mok;Huh, June;Yang, Ji-Hyuk;Choe, Yeon Hyeon
    • Investigative Magnetic Resonance Imaging
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    • v.20 no.2
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    • pp.114-119
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    • 2016
  • We report a case of vegetation in a 4-year-old female with infective endocarditis, diagnosed by late gadolinium-enhanced (LGE) cardiovascular magnetic resonance (CMR) imaging. The patient had a history of primary closure for ventricular septal defect and presented with mild febrile sensation. No remarkable clinical symptoms or laboratory findings were noted; however, transthoracic echocardiography demonstrated a 14 mm highly mobile homogeneous mass in the right ventricle. On LGE CMR imaging, the mass showed marginal rim enhancement, which suggested the diagnosis of vegetation rather than thrombus. The extracellular volume fraction (${\geq}42%$) of the lesion was higher than that of normal myocardium. Based on the patient's clinical history of congenital heart disease and pathologic confirmation of the lesion, a diagnosis of infective endocarditis with vegetation was made.

The treatment of an impacted canine related with a miniplate inserted for mandibular fracture (하악골 골절 치료를 위한 miniplate와 관련된 매복견치의 치험례)

  • Hwang, Sang-Hee;Park, Hyo-Sang;Kwon, Tae-Geon;Nam, Ki-Young;Kim, Jong-Bae
    • The korean journal of orthodontics
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    • v.35 no.2 s.109
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    • pp.148-152
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    • 2005
  • This case report describes the treatment of an impacted tooth in relation to pediatric mandibular fracture. A 10-rear-old girl presented with au impacted mandibular canine related with a miniplate in the left mandibular body area. An ordinary surgical traction ended in failure. Good occlusion was established by removal of the miniplate. It would be considered important to make an exact diagnosis of the cause and remove the mechanical obstruction instantly for successful orthodontic treatment of an impacted tooth.