• Title/Summary/Keyword: Pneumoperitoneum

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Treatment of Prolonged Air-leak after Bilobectomy by Artificial Pneumoperitoneum (폐엽절제 후 발생한 지속적 공기누출의 인공기복에 의한 치료)

  • 조성준;이성호
    • Journal of Chest Surgery
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    • v.35 no.12
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    • pp.902-905
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    • 2002
  • Pulmonary resection often leaves a pleural space problem that can cause prolonged air leaks. We describe a patient with lung cancer undergoing a right middle and lower lobectomy complicated by prolonged air leaks. He had a history of pulmonary tuberculosis and COPD. Artificial pneumoperitoneum was made by instillation of air via a small central vein catheter into the left lower quadrant on postoperative day(POD) 21. The air leak ceased on POD 23 and the chest tube was removed on POD 25.

Severe Complication of Percutaneous Dilatational Tracheostomy (경피적 확장 기관 절개술의 중대 합병증)

  • Cho, Young-Jin;Lim, Ji-Hyung;Lee, Yong-Joo;Nam, Inn-Chul
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.27 no.1
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    • pp.54-57
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    • 2016
  • Percutaneous dilatational tracheostomy (PDT) has become an increasingly popular method of establishing an airway for patients in need of chronic ventilator assistance. We report a rare case of a 42-year-old female who developed extensive subcutaneous emphysema, bilateral pneumothoraces, pneumomediastinum, and pneumoperitoneum after percutaneous dilatational tracheostomy. The patient suffered from amyotrophic lateral sclerosis, and underwent PDT after a period of mechanical ventilation. During PDT, tracheostomy tube was inserted into the paratracheal space. Follow-up chest radiography and computed tomography of chest and abdomen revealed extensive subcutaneous emphysema, bilateral pneumothoraces, pneumomediastinum, and pneumoperitoneum. The patient was treated successfully with insertion of the thoracostomy tube and conservative care.

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Development of Pneumoperitoneum after Endoscopic Retrieval of Gastric Foreign Body in a Dog (개에서 위내 이물의 내시경적 제거 후 발생한 기복증 증례)

  • Kim, Dong-In;Lee, Youngjae;Kang, Byeong-Teck;Kim, Gonhyung;Chang, Dongwoo;Na, Ki-Jeong;Yang, Mhan-Pyo;Kang, Ji-Houn
    • Journal of Veterinary Clinics
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    • v.31 no.4
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    • pp.333-336
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    • 2014
  • An 1-year-old, intact female Yorkshire Terrier weighing 1.83 kg was referred for vomiting and anorexia. Survey abdominal radiographs revealed marked gastric distention. Ultrasonography showed a hyperechoic material with acoustic shadowing near the pylorus. A foreign body and ulceration were identified during gastroscopic examination. After endoscopic retrieval of gastric foreign body, unexpectedly abdominal distention was developed. Abdominal radiographs revealed pneumoperitoneum, but no leakage of contrast media was observed in gastrointestinal contrast study. Three days after hospitalization with supportive care, no abnormal findings were detected, and then the dog was discharged. This case describes the development of peumoperitoneum during endoscopic retrieval of gastric foreign body.

Effects of Using Carbon Dioxide on Heart Rate and Arterial Blood Pressure during Laparoscopic Ovariohysterectomy in Dogs (개에서 복강경을 이용한 난소자궁절제술시 $CO_2$가스에 의한 기복증이 심박수와 동맥혈압에 미치는 영향)

  • Cho, Seong-Su;Kim, Young-Ki;Park, Se-Jin;Lee, Seung-Yong;Lee, Scott-S.;Lee, Hee-Chun;Lee, Hyo-Jong;Chang, Hong-Hee;Yeon, Seong-Chan
    • Journal of Veterinary Clinics
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    • v.28 no.1
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    • pp.40-45
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    • 2011
  • Cardiovascular changes caused by $CO_2$ pneumoperitoneum during laparoscopic ovariohysterectomy (LOVH) were measured in nine healthy mixed breed dogs ($16.7{\pm}4.6kg$). The dogs were premedicated with the combination of atropine, acepromazine, and butorphanol. General anesthesia was induced with propofol and maintained with isoflurane in oxygen. Controlled ventilation maintained partial pressure of end-tidal $CO_2$ between 35-45 mmHg. The $CO_2$ pneumoperitoneum was maintained at a constant pressure of 12 mmHg and the dog was placed in the $15^{\circ}$ Trendelenburg position as LOVH was performed. Dorsal pedal artery was catheterized for measurements of heart rate (HR) and invasive arterial blood pressure (IBP). Prior to the intraperitoneal insufflation, baseline measurements of HR and IBP were made every minute for a total of 10 min. Then, measurements of HR and IBP were made every 5 min following intraperitoneal insufflation and were also made every 5 min following desufflation for a total of 10 min. The $CO_2$ pneumoperitoneum during LOVH resulted in a significant (P < 0.05) increase in systolic arterial blood pressure at the time of the onset of insufflation. In addition, diastolic and mean arterial blood pressure increased significantly (P < 0.05) at the time of the onset of insufflation and 5 min following insufflation. The mean heart rate did not change significantly during LOVH. Although IBP showed sharp initial rise following the $CO_2$ pneumoperitoneum, the changes were within physiological acceptable limits in these healthy, ventilated dogs.

Studies on the Diagnosis and Prevention of Ruminal Adhesions to Abdominal Wall in Goats (염소의 제1위 복벽유착의 진단 및 예방에 관한 연구)

  • Cheong Jong-Tae;Kwoen Oh-Kyeong;Nam Tchi-Chou
    • Journal of Veterinary Clinics
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    • v.10 no.1
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    • pp.19-35
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    • 1993
  • These studies performed to establish the diagnostic methods for the luminal adhesions to abdominal wall with radiography, ultrasonography and electromyography, and to evalute sodium carboxymethylcellulose(SCMC) for prevention of the abdominal adhesions in goats. The adhesion sites were not detected by rediography and ultrasonography at non-pneumoperitoneum, but detected after pneumoperitoneum in goats with experimentally induced ruminal abhesions to abdominal wall. Electromyography revealed only the presence of intraabdominal adhesions. In fibriongen values and total leucocytes, there were no alterations between SCMC treated and non-treated group. The average gross scores of adhesions in SCMC treated and non-treated were 0.3 and 2.7, respectively. It was concluded that radigraphy, electromyography and ultrasonography could be available for the diagnosis of the ruminal adhesions to abdominal wall and the use of SCMC was useful to prevent the intraabdominal adhesions in ruminants.

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Prognostic Factors of Necrotizing Enterocolitis (신생아 괴사성 장염의 예후 인자에 관한 연구)

  • Kang, Dong-Won;Gwak, Geum-Hee;Yang, Keun-Ho;Bae, Byung-Noe;Kim, Ki-Hwan;Han, Se-Whan;Kim, Hong-Joo;Kim, Young-Duk;Choi, Myeung-Jae
    • Advances in pediatric surgery
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    • v.14 no.2
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    • pp.144-152
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    • 2008
  • Necrotizing enterocolitis (NEC) is the most common gastrointestinal emergency in the neonatal population. The aim of this study is to evaluate surgical indication and prognostic factors of NEC. Clinical data of seventy patients, diagnosed as NEC between January 2000 & January 2007, were reviewed retrospectively. Fifty-seven patients had medical treatment and 7 of them died. Thirteen patients who presented with pneumoperitoneum on plain abdominal film or were refractory to medical treatment received surgical treatment, and 5 of them died. All the expired 12 patients weighed less than 2500 g. Twenty out of seventy patients showed thrombocytopenia, and 11 patients of them died. The finding of pneumoperitoneum and thrombocytopenia could be the most important surgical indication. Prematurity, low birth weight and thrombocytopenia were related to a bad prognosis. NEC patients who presents with these findings must be considered for close observation and intensive care.

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A Case of Severe Asthma Complicated with Pneumoperitoneum and Pneumomediastinum During AMBU Ventilation (AMBU(Air Mask Bag Unit) 환기로 복강기종과 종격동기흉이 합병된 중증 천식 1예)

  • Cho, Hoon;Choi, Byoung-Moon;Jung, Ho-Kyoung;Park, Ja-Young;Jang, Byoung-II;SunWoo, Mi-Ok;Seo, Chan-Hee;Sung, Han-Dong;Sin, Mi-Jeong;Hwang, Soon-Chul
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.6
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    • pp.585-589
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    • 2001
  • Pneumoperitoneum, Pneumomediastinum, subcutaneous emphysema and a pneumothorax are some of the mechanical complications of bronchial asthma. The incidence of pneumoperitoneum during an attack of acute asthma is rare. The pathogenesis is free gas track from the overdistended alveoli, through the bronchovascular sheaths to the mediastinum. If the high pressure is maintained, air can escape retroperitoneally into the abdomen and burst into the peritoneal cavity. A 43-year-old woman was admitted due to a severe asthma attack. She was required endotracheal intubation and AMBU(air mask bag unit) ventilation. Immediately after these procedures, pneumoperitonewn, pnewnomediastinwn, and subcutaneous emphysema developed. She was treated with mechanical ventilation and medical therapy. The pneumoperitonewn was resolved after 27days. Here, we report this case with the review of the relevant literature.

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Massive pneumoperitoneum following cardiopulmonary resuscitation (심폐소생술 후 발생한 다량의 기복증)

  • Choi, Jeonjwoo;Shin, Sangyol;Hwang, Yong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.5
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    • pp.3303-3307
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    • 2015
  • The purpose of this study was attemped to investigate the clinical presentation and pathophysiology of 74-year-old female who developed pneumoperitoneum as complications of chest compression from sudden cardiac arrest. Such chest compression is the same one excercised to by-stander and paramedics. A healthy 74 year female had a sudden mental deterioration while working at a restaurant. She was transfered from 119 emergency medical system to the hospital. After the symptom developed, by-stander called 119 who carry out 6 minutes Cardiopulmonary resuscitation(CPR). Defibrillation and CPR was carried out by health provider after the arrival, and the patients spontaneous circulation returned. After Return of spontaneous circulation(ROSC), patients was transferred to the nearst hopspital, but suspicious of myocardial infarction, she was again transferred to a larger scale hospital. At the hospital she took X-rays and Abdominal CT, and the results of suspicious gastro-intestinal perforation near gastro-esophageal junction, surgical repair was recommended. But in operation room, while operation went on, cardiopulmonary arrest appeared again, and she expired. For this reason, prehospital CPR needs more accurate localization of cardiac massage and serious consideration of positive pressure ventilation. Moreover, treatment of pneumoperitoneum after CPR needs more cautious consideration of patients hemodynamic stability.

Spontaneous Perforation of Colon in Previously Healthy Infants and Children: Its Clinical Implication

  • Kim, Soo-Hong;Cho, Yong-Hoon;Kim, Hae-Young
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.19 no.3
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    • pp.193-198
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    • 2016
  • Purpose: Spontaneous colon perforations are usually encountered as necrotizing enterocolitis in the neonatal period, but occur rarely in infants and children without pathological conditions. This study was conducted to describe its clinical implication beyond the neonatal period. Methods: Cases of spontaneous colon perforation confirmed after the operation were reviewed retrospectively and the clinicopathological characteristics were analyzed. Clinical data were compared according to the presence of pneumoperitoneum as initial findings. Results: Eleven patients were included in the study period and showed a history of hospitalization before transfer due to management for fever, respiratory or gastrointestinal problems. Six patients showed a sudden onset of abdominal distention and only seven patients showed a pneumoperitoneum as initial radiologic findings, however there were no significant clinicopathological differences. Perforation was found evenly in all segments of the colon, most commonly at the sigmoid colon in four cases. There were no specific pathologic or serologic causes of perforation. Conclusion: When previously healthy infants and children manifest a sustained fever with a sudden onset of abdominal distention during management for fever associated with respiratory or gastrointestinal problems, there is a great likelihood of colon perforation with no pathological condition. Prompt surgical management as timely decision-making is necessary in order to achieve a good progress.