• Journal of Gastric Cancer
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• v.13 no.1
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• pp.65-68
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• 2013

Gastric carcinoma rarely presents as a perforation, but when it does, is perceived as advanced disease. The majority of such perforations are Stage III/IV disease. A T1 gastric carcinoma has never been reported to perforate spontaneously in English literature. We present a 56 year-old Chinese male who presented with a perforated gastric ulcer. Intra-operatively, there was no suspicion of malignancy. At operation, an open omental patch repair was performed. Post-operative endoscopy revealed a macroscopic Type 0~III tumour and from the ulcer edge biopsy was reported as adenocarcinoma. Subsequently, the patient underwent open subtotal gastrectomy and formal D2 lymphadenectomy. The final histopathology report confirms T1b N0 disease. The occurrence of a perforated early gastric cancer reemphasises the need for vigilance, including intra-operative frozen section and/or biopsy, as well as routine post-operative endoscopy for all patients.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.12 no.1
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• pp.51-56
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• 2009

We report a rare case of gastric perforation in a 13-year-old boy with anorexia nervosa. He was admitted to our hospital with the chief complaint of body weight loss. He had lower abdominal pain after 2 days. An abdominal CT revealed diffuse peritonitis. At laparotomy, the stomach was dilated and perforated. Postoperatively, the patient suffered from malnutrition. We monitored electrolytes, minerals, and fluids closely before and during the initiation of feedings to prevent morbidity and mortality associated with refeeding syndrome. We present an extremely rare complication that relates to this phenomenon, describing an acute gastric dilatation that led to gastric necrosis and perforation through an unusual mechanism in an extremely anorectic teenager during hospitalization for refeeding.

• Clinical and Experimental Pediatrics
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• v.56 no.6
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• pp.260-264
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• 2013

Dapsone (4,4'-diaminodiphenylsulfone, DDS), a potent anti-inflammatory agent, is widely used in the treatment of leprosy and several chronic inflammatory skin diseases. Dapsone therapy rarely results in development of dapsone hypersensitivity syndrome, which is characterized by fever, hepatitis, generalized exfoliative dermatitis, and lymphadenopathy. Here, we describe the case of an 11-year-old Korean boy who initially presented with high fever, a morbilliform skin rash, generalized lymphadenopathy, hepatosplenomegaly, and leukopenia after 6 weeks of dapsone intake. Subsequently, he exhibited cholecystitis, gingivitis, colitis, sepsis, aseptic meningitis, disseminated intravascular coagulation, syndrome of inappropriate antidiuretic hormone secretion, pneumonia, pleural effusions, peritonitis, bronchiectatic changes, exfoliative dermatitis, and acute renal failure. After 2 months of supportive therapy, and prednisolone and antibiotic administration, most of the systemic symptoms resolved, with the exception of exfoliative dermatitis and erythema, which ameliorated over the following 4 months. Agranulocytosis, atypical lymphocytosis, aseptic meningitis, and bronchiectatic changes along with prolonged systemic symptoms with exfoliative dermatitis were the most peculiar features of the present case.

• Clinical and Experimental Pediatrics
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• v.56 no.4
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• pp.182-185
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• 2013

Children have a natural tendency to explore objects with their mouths; this can result in the swallowing of foreign objects. Most ingested foreign bodies pass uneventfully through the gastrointestinal tract. However, some foreign bodies cause obstruction or perforation of the gastrointestinal tract, requiring surgical intervention. Perforation of the gastrointestinal tract may be associated with considerable morbidity and mortality. The most common sites of intestinal foreign body perforation are the ileocecal and rectosigmoid regions. Foreign body perforation of the duodenum is relatively uncommon. We report the first Korean case of duodenal perforation by an ingested 8-cm lollipop stick. Lollipops are popular with the children and fairly accessible to them, as most parents are not aware of their potential harm. Pediatric clinicians should be aware of the risks associated with lollipop stick ingestion. Our report also describes the feasibility and safety of laparoscopic diagnosis and management of pediatric patients with peritonitis induced by the ingestion of foreign bodies.

• Journal of Veterinary Clinics
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• v.28 no.1
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• pp.94-100
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• 2011

This study was performed to describe the radiographic and ultrasonographic features of retained surgical gauze known as gossypiboma in 9 dogs. Female dogs (n = 8) were at higher risk and seven out of the eight cases had a history of ovariohysterectomy. Seven dogs were symptomatic and the most common clinical signs were vomiting, anorexia, and inertia. A palpable abdominal mass was detected in six dogs. Radiographic signs included a localized abdominal mass with soft tissue density (n = 7) or a mass containing speckled gas (n = 1). Ultrasonography showed a hypoechoic mass with a hyperechoic center (n = 4), or a homogeneous hypoechoic mass (n = 3). The remaining dogs (n = 2) showed an intestinal wall surrounding a hyperechoic center. Regardless of the characteristics of a mass, an acoustic shadowing was accompanied from the center of a mass in all dogs. Ultrasonography also revealed complications such as adhesion between a mass and adjacent organs, and peritonitis and intestinal obstruction around a mass. The gossypiboma can be considered when a hypoechoic mass accompanying a hyperechoic center with acoustic shadowing is observed on ultrasound examination.

• Journal of Chest Surgery
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• v.2 no.1
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• pp.59-64
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• 1969

Three cases of traumatic diaphragmatic hernia were repaired in this department from June 1967 to Nov.1968. The first case, a 14 year old girl, was diagnosed as diaphragmatic hernia during the operation of the diffuse peritonitis from jejunaI perforation 3 days after the traffic accident at local clinic and she was transfered to this hospital after the closure of the perforated jejunum. Herniated stomach, transverse colon, spleen and left lobe of the liver were repositioned and the diaphragmatic rupture at the posterolateral portion of the left diaphragm was repaired with two layer sutures by transthoracic approach. The second case. a 26 year old man. was diagnosed immediately after the traffic accident at local clinic and transfered to this hospital 24 hours later. Herniated and distended stomach, transverse colon and jejunum were repositioned and the large diaphragmatic rupture, about 9 cm in length, from the posterolateral portion to the base of the pericardium was directly repaired with two layer sutures. The third case, a 26 year old man, who had a history of stab wound at left lower lateral chest two years ago,was admitted with the sudden onset of abdominal pain and vomiting. The diaphragmatic hernia was confirmed with barium enema. The herniated stomach and transverse colon through the defect, about 3.5 cm in diameter, at anterolateral portion of the left diaphragm, were repositioned and the defect was repaired with two layer sutures. All of the cases recovered uneventfully.

• Journal of Gastric Cancer
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• v.1 no.1
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• pp.64-67
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• 2001

An exceedingly rare case of perforated early gastric cancer is reported. A 68-year-old man developed peritonitis due to perforation of early gastric cancer. An emergency radical operation was performed and was followed by an uneventful recovery. Histologic examination of the surgical specimen showed type III early gastric cancer composed of a signet ring cell carcinoma. Five years after surgery, the patients was alive with no evidence of tumor recurrence. The rarity of this complication in early gastric cancer is discussed, and a review of the literature is presented.

• Clinical and Experimental Pediatrics
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• v.54 no.8
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• pp.322-328
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• 2011

Nephrotic syndrome (NS) is one of the most common glomerular diseases that affect children. Renal histology reveals the presence of minimal change nephrotic syndrome (MCNS) in more than 80% of these patients. Most patients with MCNS have favorable outcomes without complications. However, a few of these children have lesions of focal segmental glomerulosclerosis, suffer from severe and prolonged proteinuria, and are at high risk for complications. Complications of NS are divided into two categories: disease-associated and drug-related complications. Disease-associated complications include infections (e.g., peritonitis, sepsis, cellulitis, and chicken pox), thromboembolism (e.g., venous thromboembolism and pulmonary embolism), hypovolemic crisis (e.g., abdominal pain, tachycardia, and hypotension), cardiovascular problems (e.g., hyperlipidemia), acute renal failure, anemia, and others (e.g., hypothyroidism, hypocalcemia, bone disease, and intussusception). The main pathomechanism of disease-associated complications originates from the large loss of plasma proteins in the urine of nephrotic children. The majority of children with MCNS who respond to treatment with corticosteroids or cytotoxic agents have smaller and milder complications than those with steroid-resistant NS. Corticosteroids, alkylating agents, cyclosporin A, and mycophenolate mofetil have often been used to treat NS, and these drugs have treatment-related complications. Early detection and appropriate treatment of these complications will improve outcomes for patients with NS.

• Clinical and Experimental Pediatrics
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• v.59 no.sup1
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• pp.53-56
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• 2016

Familial Mediterranean fever (FMF) is the most common Mendelian autoinflammatory disease, characterized by uncontrolled activation of the innate immune system that manifests as recurrent brief fever and polyserositis (e.g., peritonitis, pleuritic, and arthritis). FMF is caused by autosomal recessive mutations of the Mediterranean fever gene, MEFV which encodes the pyrin protein. Although FMF predominantly affects people from Mediterranean and Middle Eastern ethnic origins, 3 cases of FMF have been reported in Korea since 2012. We report another case of FMF in Korea in which the patient presented with a month-long fever without serositis. After treatment with colchicine was initiated, the patient's symptoms quickly subsided. The response to colchicine was helpful for diagnosis. We compare the FMF genotypes in Korea with in other countries. Studying FMF cases in Korea will help establish the best MEFV exons to use for screening and diagnosis of Korean FMF.

• Korean Journal of Veterinary Service
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• v.29 no.1
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• pp.79-82
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• 2006

A 5 years old gelding (Thoroughbred, Equus caballus) had shown severe abdominal pain, colic, after overeating of hay in the feed storage. following through treatment, it subsequently died. Grossly, the large colon was impacted with firm mass of food and congestion of blood vessel in the intestinal wall. There were mild peritonitis and pleuropneumonia. This case demonstrates typical large colon impaction with hard consistence ingesta due to improper management of horse.