• Advances in pediatric surgery
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• v.10 no.2
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• pp.123-126
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• 2004

Intestinal obstruction secondary to intraabdominal adhesion is a well-known postoperative complication occurring after appendectomy. The aim of this study was to measure the incidence and clinical manifestations of mechanical intestinal obstruction after appendectomy for perforated appendicitis. We reviewed all of the children (age <16 years) who had been treated for appendicitis at Asan Medical Center between January 1996 and December 2001. Inclusion criterion included either gross or microscopic evidence of appendiceal perforation. Exclusion criteria were interval appendectomy, and patients immune compromised by chemotherapy. Associations of intestinal obstruction with age, sex, operation time, and use of peritoneal drains were analyzed. Four hundred and sixty two open appendectomies for appendicitis were performed at our department. One hundred and seventeen children were treated for perforated appendicitis (78 boys, 39 girls). The mean age was 8.9 years (range 1.5 to 14.8 years). There were no deaths. Eight patients were readmitted due to intestinal obstruction, but there was no readmission due to intestinal obstruction in patients with non-perforated appendicitis. The interval between appendectomy and intestinal obstruction varied from 12 days to 2 year 7 months. Four patients needed laparotomies. In three of four, only adhesiolysis was performed. One child needed small bowel resection combined with adhesiolysis. There was no significant association between age or sex and the development of intestinal obstruction. This was no association with operative time or use of peritoneal drain. Patients who required appendectomy for perforated appendicitis have a higher incidence of postoperative intestinal obstruction than those with nonperforated appendicitis. For the patients with perforated appendicitis, careful operative procedures as well as pre and postoperative managements are required to reduce adhesions and subsequent bowel obstruction.

• Advances in pediatric surgery
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• v.8 no.2
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• pp.138-142
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• 2002

Mesenteric and omental cysts are rare intra-abdominal lesions in childhood, and may present various clinical features such as an asymptomatic mass or an acute abdomen. Therefore, these entities are frequently misdiagnosed preoperatively or are found only incidentally at operation for other conditions. We analyzed our experiences of 19 cases in a 19 year period from 1981 to 1999, at College of Medicine, Catholic University of Korea. There were 12 boys and 7 girls with a mean age of 4.8 years (range, 3 days to 15 years). Common presenting symptoms were abdominal pain (47%), abdominal distension (31%), abdominal mass (24%), vomiting (15%) and fever (10%). Ultrasonography was the most preferred method of diagnosis. Other diagnostic modalities include CT, MRI, and abdominal ascites tapping in selected patients. Location of the mesenteric cysts was small bowel mesentery in nine, the right mesocolon and retroperitoneum in one, the left mesocolon in one, and the jejunum, sigmoid-colon mesentery in one. Most of the patients underwent cyst excision, but six patients required concomitant bowel resection for complete removal of the lesions, and two patients underwent unroofing and simple aspiration respectively. There was one mortality case due to sepsis.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.7 no.2
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• pp.278-283
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• 2004

Meckel's diverticulum is found in about 3% of the population, often incidentally during laparotomy or at autopsy. Over 50% of patients who develop symptoms from this anomaly are younger than 2 years of age. The most common symptom of this lesion is intestinal obstruction. Rarely Meckel's diverticulum is complicated by a mesodiverticular band, which is believed to be a remnant of a vitelline artery. We report a 11-year-old girl with small bowel obstruction because of an intestinal hernia beneath the mesodiverticular band. The causative factor was a stenotic area in the terminal ileum caused by a ringlike lipovascular mesenteric band encroaching externally on the lumen. Although the incidence of mesodiverticular bands complicating Meckel's diverticulum is quite low, the rapid clinical course and the associated high mortality rate make this an important disease.

• Journal of Veterinary Clinics
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• v.33 no.3
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• pp.176-178
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• 2016

Here we report a case of a 7-month-old Jindo puppy with a double intussusception. On survey radiography, a soft tissue opacity mass was identified in the mid-abdomen. Abdominal ultrasonography revealed a triple-circle sign. Double intussusception was diagnosed based on these findings. Exploratory laparotomy confirmed it to be a double intussusception in the small intestine. Small intestine involving the double intussusception was surgically resected followed by anastomosis. The dog had good prognosis without any complication. To the best of our knowledge, double intussusception is an extremely rare form of intestinal disease in dogs. It may cause blood supply to that section to be greatly reduced, thus causing ischemia and necrosis of the bowel tissue. Timely diagnosis with ultrasonographic findings and immediate surgical intervention are important to improve the prognosis of such cases.

• Archives of Pharmacal Research
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• v.21 no.2
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• pp.174-178
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• 1998

As a new colon-specific prodrug of 5-aminosalicylic acid (5-ASA), 5-aminosalicyl-glycine (5-ASA-Gly) was prepared by a simple synthetic route in good yield. Apparent partition coefficients of 5-ASA-Gly were lower than those of 5-ASA, which determined in$ CHCl_{3}$/pH 6.8 buffer or n-octanol/pH 6.8 buffer system. Stability of 5-ASA-Gly by peptidases was investigated by incubation of 5-ASA-Gly with the homogenates of tissue and contents of stomach, proximal small intestine or distal small intestine of rats at $37^{\circ}C$. 5-ASA was not detected, indicating that the prodrug was stable in the upper intestine. The amount of 5-ASA liberated from incubation of the prodrug in cecal or colonic contents of rats was about 65% or 27% in 8 hrs, respectively, which indicated that the prodrug activation took place more readily in the rat cecum whose bacterial counts are high like human colon. Results from in vitro experiments suggested 5-ASA-Gly as a promising candidate of a colon-specific prodrug of 5-ASA.

• Journal of Veterinary Clinics
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• v.29 no.1
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• pp.93-97
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• 2012

Four dogs (case 1; 2-year-old spayed female Schnauzer, case 2; 3-year-old spayed female Cocker Spaniel, case 3; 9-year-old castrated male Yorkshire Terrier, and case 4; 9-year-old intact female Shih-tzu) were referred to us with gastrointestinal signs such as diarrhea, vomiting, and anorexia. Results of blood analysis revealed hypoproteinemia and hypoalbuminemia in all dogs. Case 4 showed large circular mass which is connected with small intestine on abdominal ultrasonography and other 3 cases showed no remarkable findings on abdominal radiography and ultrasonography. We performed enterectomy in case 4 and gastrointestinal endoscopic examination with biopsy in other 3 patients. Finally, 4 patients diagnosed to protein losing enteropathy with 4 different etiologies.

• Nuclear Medicine and Molecular Imaging
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• v.40 no.3
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• pp.188-189
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• 2006

A 53-year -old man underwent $^{18}F$-FDG whole body PET/CT because of the detected liver mass on abdominal CT. The PET/CT showed a huge liver mass ($9{\times}9cm$, SUV: 12.12 ) in the right lobe and a focally hypermetabolic lesion in the right lower quadrant of abdomen (SUV: 9.12). At first, we suspected that the focal hypermetabolic lesion in RLQ was the physiologic uptake of ureter or a metastatic lesion of small bowel. We repeated the abdominal PET/CT next day. The focally hypermetabolic lesion was identified as the appendiceal mass. He underwent right hemicolectomy and right lobectomy of the liver. It was confirmed that the lesion was appendiceal adenocarcinoma with liver metastasis. Cancer of the appendix is an uncommon disease that is rarely suspected before surgery. But, we suggest that PET/CT is useful to identify the small lesion like appendiceal malignant mass.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.20 no.4
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• pp.268-272
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• 2017

Mesenteric cysts are rare intra-abdominal lesions occurring during childhood, which were first described in 1507. Cases of mesenteric cysts have been continuously reported, but these cases were very small in number. They are often asymptomatic and incidentally found while patients are undergoing work-up or receiving treatment for other conditions such as appendicitis, small-bowel obstruction, or diverticulitis; however, patients may still have lower abdominal pain and symptoms that are frequently associated with other abdominal conditions. The symptoms are variable and non-specific, including pain (82%), nausea and vomiting (45%), constipation (27%), and diarrhea (6%). An abdominal mass may be palpable in up to 61% of patients. We are to report the clinical course and literature of a child with mesenteric cysts who complained of acute abdominal pain, distension, and vomiting and were surgically treated after being diagnosed with mesenteric cysts based on radiological examination.

• YAKHAK HOEJI
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• v.42 no.1
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• pp.31-38
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• 1998

Dextran-5-(4-ethoxycarbonylphenylazo)salicylic acid ester(Dextran-5-ESA) was synthesized as a potential colon-specific prodrug of 5-aminosalicylic acid (5-ASA). No free 5-(4-eth oxycarbonylphenylazo) salicylic acid (5-ESA) was detected when the chemical stability of dextran-5-ESA was tested at pH 1.2, or pH 6.8 bath solution, Effects of the degree of substitution (DS) and molecular weight of dextran on the depolymerization by dextranase was investigated. Depolymerization(%) decreased with increasing DS, and was not affected by M.W. of dextran. The extent of prodrug conversion after incubation in the contents of various G.I. Tract segments of rats was evaluated. 5-ASA was released in the cecal contents, but not in the contents of proximal small intestine (PSI) or distal small intestine (DSI). No significant prodrug conversion was observed in the cecal contents of rats pretreated with kanamycin sulfate, which indicated that microbial enzymes were responsible for the cleavage of the prodrug.

• The Korean Journal of Medicine
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• v.93 no.6
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• pp.556-559
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• 2018

Intestinal tuberculosis is an infection of the gastrointestinal tract by the Mycobacterium tuberculosis complex. To the best of our knowledge, solitary intestinal tuberculosis accompanied by intestinal obstruction, particularly in the middle of the small intestine, is extremely rare. We report a case of solitary jejunal tuberculosis in a 49-year-old man with no underlying disease. He was admitted a few days after the onset of diffuse abdominal discomfort. Upon evaluation, we initially considered a malignancy of the distal jejunum with ileus due to the presence of a mass. Therefore, he underwent laparoscopic resection of the small bowel. Unexpectedly, the histologic specimen showed a chronic caseating granulomatous lesion with acid-fast bacilli. Ultimately, he was diagnosed with solitary jejunal tuberculosis. He was successfully treated with anti-tuberculosis drugs without any complications.