• Title/Summary/Keyword: Strangulation

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A Case Report of Oriental Medical Treatment for a Patient with Acute Paralytic Ileus (급성 마비성 장폐색 환자의 한방치험 증례보고)

  • Song, Chang-Hun;Cho, Hyun-Seok;Kim, Jung-Chul;Lee, Jae-Eun;Ha, Jang;Baik, Tae-Hyun;Park, Jung-Han
    • The Journal of Internal Korean Medicine
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    • v.26 no.4
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    • pp.946-953
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    • 2005
  • Ileus is blockage of the intestine that prevents the contents of the intestine from passing to the lower bowel. In western medical treatment, surgery is mandatory for severe cases such as strangulation ileus. However more generally, conservative management is used for treatment. Examples of conservative management are decompression with tube, fluid treatment, enema and fasting cure. Until now, many oriental medical studies have been conducted on chronic ileus, but almost none on acute ileus. The results for the case in this report suggest that oriental medical treatment such as acupuncture, moxibustion, herbal medicine is effective in treating acute ileus. We think that further studies should be conducted on a combination therapy with other oriental medical treatment such as retention enema.

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Congenital Internal Hernia Presented with Life Threatening Extensive Small Bowel Strangulation

  • Lee, Narae;Kim, Su-Gon;Lee, Yeoun Joo;Park, Jae-Hong;Son, Seung-Kook;Kim, Soo-Hong;Hwang, Jae-Yeon
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.16 no.3
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    • pp.190-194
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    • 2013
  • Internal hernia (IH) is a rare cause of small bowel obstruction occurs when there is protrusion of an internal organ into a retroperitoneal fossa or a foramen in the abdominal cavity. IH can be presented with acute or chronic abdominal symptom and discovered by accident in operation field. However, various kinds of imaging modalities often do not provide the assistance to diagnose IH preoperatively, but computed tomography (CT) scan has a high diagnostic accuracy. We report a case of congenital IH in a 6-year-old boy who experienced life threatening shock. CT scan showed large amount of ascites, bowel wall thickening with poor or absent enhancement of the strangulated bowel segment. Surgical exploration was performed immediately and had to undergo over two meters excision of strangulated small bowel. To prevent the delay in the diagnosis of IH, we should early use of the CT scan and take urgent operation.

Repair of Morgagni Hernia through the Abdominal Approach - A case report - (복부접근법을 이용한 Morgagni Hernia의 교정 - 1예 보고 -)

  • Hwang, Jung-Joo;Kim, Do-Hyung;Lee, Yang-Deok;Kim, Kil-Dong
    • Journal of Chest Surgery
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    • v.40 no.10
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    • pp.722-725
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    • 2007
  • Morgagni's hernia constitutes about 3% of all the congenital diaphragm hernias. It is usually asymptomatic and it is frequently found coincidentally during routine diagnostic testing in adulthood. It is usually diagnosed by simple chest X-ray, but when this condition is without intestinal herniation, then chest CT or other modalities are necessary. Operative repair is desirable when there is the risk of strangulation of the intestine. The trans-thoracic or trans-abdominal approaches are possible to treat this malady. We report here on one case for which we successfully used a laparoscopic approach to treat this problem.

Fixation of Epidural Catheters using blood Set -Report of 120 cases- (지속성 경막외카테터의 거치 방법 -수혈선을 이용하여-)

  • Chang, Bo-Yul;Kim, Soon-Jae;Kim, Hyun-Soo;Kim, Kwang-Min;Choi, Byung-Jo
    • The Korean Journal of Pain
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    • v.1 no.2
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    • pp.199-202
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    • 1988
  • Secure fixation is essential for continous epidural catheterization on a long-term-basis. Adhesive tape or surgical knots were commonly used for those patients, but the surgical knot method has a tendency to cause strangulation of catheter. Another invasive technique, subcutaneous tissue tunnelling is more safe than other methods but requires sophisticated technique and time. We employed a simple device using a blood transfusion set for patients who have epidural catheters placed safely un their backs. In 120 patients treated for postoperative and chronic pain by means of this technique, the results were as follows: 1) Five of 120 patients (4.2%) developed backache and pruritus, but there were no instances of respiratory depression, local infection and headache. 2) Nine of 120 patients (7.5%) failed booster-injections, but two cases were due to be non-technical errors. 3) The duration of fixation was 1~3 days in most cases (85%), the longest being for 21 days.

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Chronic Gastric Volvulus with Laparoscopic Gastropexy after Endoscopic Reduction: A Case Report

  • Lee, Hye Yeon;Park, Jung Hyun;Kim, Sung Geun
    • Journal of Gastric Cancer
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    • v.15 no.2
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    • pp.147-150
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    • 2015
  • Gastric volvulus is an uncommon clinical entity. There are three types of gastric volvulus; organoaxial, mesenteroaxial and combined type. This condition can lead to a closed-loop obstruction or strangulation. Traditional surgical therapy for gastric volvulus is based on an open approach. Here we report a successful case of a patient with chronic gastric volvulus with a laparoscopic treatment. A 79-year-old woman came to the emergency department with epigastric pain accompanied by nausea for 2 weeks. Abdominal computed tomography revealed markedly distended stomach with transposition of gastroesophageal Junction and gastric antrum. Barium meal study revealed presence of the antrum was folded over 180 degrees that was located above gastroesophageal junction. We attempted an endoscopic reduction, but it was unsuccessful. The patient got laparoscopic anterior gastropexy. Based on our result, laparoscopic gastropexy can be considered as a good choice of the treatment for gastric volvulus.

Henoch-Sch$\ddot{o}$nlein Purpura in Pediatric Surgery (소아외과에서의 Henoch-Sch$\ddot{o}$nlein 자반증)

  • Kim, Dae-Yeon;Kim, Seong-Chul;Kim, In-Koo
    • Advances in pediatric surgery
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    • v.6 no.1
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    • pp.45-49
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    • 2000
  • Henoch-Sch$\ddot{o}$nlein purpura is a systemic vasculitis of unknown etiology that is probably related to an autoimmune phenomenon. Henoch-Sch$\ddot{o}$nlein purpura is characterized by a purpuric rash, arthralgia, nephritis, and gastrointestinal manifestations. We reviewed 169 children hospitalized with a diagnosis of Henoch-Sch$\ddot{o}$nlein purpura between 1989 and 1998. One-hundred thirty-nine (82.2 %) had gastrointestinal findings including abdominal pain, nausea, vomiting and gastrointestinal bleeding. Surgical consultations were obtained for ten children, and laparotomy was performed in five. Three children suspected of having appendicitis underwent appendectomy. None had appendicitis. One child thought to have been intestinal strangulation was found to have hemorrhagic edema of the proximal jejunum and of the distal ileum. Another child underwent resection for an hemorrhagic infarct of the distal ileum. A high index of suspicion of this disease entity in the differential diagnosis of abdominal pain in children can avoid unnecessary laparotomy in most cases. However, life-threatening gastrointestinal complications may occur in low percentage of cases. Prompt recognition and adequate radiologic evaluation of the abdominal manifestation of this entity is necessary for early surgical intervention.

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Rapidly Progressive Small Bowel Necrosis in a Previously Healthy Child without Proven Mechanical Obstruction

  • Kim, Hyun Hee;Kang, Hyungoo;Park, Chul Hee;Kwon, Yu Jin;Jung, Euna;Lim, Misun
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.22 no.3
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    • pp.291-297
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    • 2019
  • Bowel ischemia is a life-threatening surgical emergency. We report a case of rapidly progressive bowel necrosis in a previously healthy child without proven mechanical small bowel obstruction. The definite diagnosis was established at the time of an exploratory operation. Of note, imaging studies and even a laparotomy did not reveal any evidence of acute appendicitis or mechanical obstruction such as intussusception or Meckel's diverticulum. During hospitalization, since we could not rule out surgical abdomen after inconclusive image findings, we closely followed the patient and repeated physical examinations carefully. Eventually surgical exploration was performed based on changes in clinical condition, which proved to be the right decision for the patient. We propose that in children with suspected strangulation of small bowel obstruction, especially when imaging findings do not provide a conclusive diagnosis, the timely exploratory surgical approach ought to be chosen based on carefully observed clinical findings and other evaluations.

Exercise rehabilitation for recurrent extraocular muscle movement limitation after pediatric blowout fracture surgery: a case report

  • Jeong Do Park;Syeo Young Wee;Se Young Kim
    • Archives of Craniofacial Surgery
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    • v.24 no.3
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    • pp.133-138
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    • 2023
  • White-eyed blowout fractures with extraocular muscle (EOM) entrapment necessitate emergency surgical intervention. However, even after surgery, diplopia or EOM motion limitations may persist due to the incomplete reduction of soft tissue herniation caused by inadequate dissection or unresolved muscle strangulation. In this report, we present a case of postoperative EOM movement limitation in a 5-year-old girl who experienced recurrent restriction in the upward gaze of her right eye 14 days after surgery. Instead of revision surgery, the patient was treated with targeted EOM exercises focusing on the inferior rectus muscle and inferior oblique muscle. The patient was instructed to slowly move her pupils from the central point to the upper and outer sides, then in a straight line from the central point to the lower and inner sides before returning to the center point. On the 28th postoperative day, 2 weeks after initiating the exercises, the patient's EOM motion fully recovered. This case highlights the effectiveness of EOM exercises as a non-surgical treatment approach for improving recurrent EOM movement limitations in the absence of soft tissue herniation following surgical management of blowout fractures in children.

Pleural Incarceration of the Transverse Colon after Transthoracic Esophagectomy - A case report - (개흉적 식도절제술 후 횡행결장의 흉강 내 탈장 - 1예 보고 -)

  • Jang, Hee-Jin;Lee, Hyun-Sung;Zo, Jae Ill
    • Journal of Chest Surgery
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    • v.42 no.1
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    • pp.115-118
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    • 2009
  • A 65 year-old man, who underwent transthoracic esophagectomy for mid-thoracic esophageal squamous cell carcinoma, suffered from an incarcerated herniation of the transverse colon through a defect in the left mediastinal pleura. The patient had a gas collection in the left lower lung field and this then insidiously progressed; the final result was total collapse of the left lung and hemodynamic compromise. The life-threatening herniation of the transverse colon into the pleural cavity after pervious esophagectomy was corrected by emergency laparotomy. Postoperative pulmonary complications after esophagectomy can induce potentially lethal transhiatal herniation because of the danger of intestinal obstruction or strangulation. The optimal approach to transhiatal herniation after esophagectomy is prevention.

Surgical Repair of Agenesis of Prepuce in a Dog (개의 포피무형성의 수술적 교정 1례)

  • Kim, Kyungmok;Lee, Joo-Myoung;Park, Hyunjung;Kim, Junghun;Won, Sangcheol;Cheong, Jongtae
    • Journal of Veterinary Clinics
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    • v.31 no.1
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    • pp.51-53
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    • 2014
  • An 10-day-old, male Jindo puppy was presented with anuria. This puppy was diagnosed as agenesis of prepuce and preputial orifice. To treat anuria exploratory operation was performed and the penis was found in situ under the skin. The penis was protruded outside of the skin. Because of strangulation and dryness of the penis by growing up, the artificial prepuce was made by making the subcutaneous tunnel. After that this puppy showed normal urination and had no complication. In case of the agenesis of the prepuce with the penis in situ, artificial prepuce by subcutaneous tunnel would be an alternative choice for saving the puppy.