• Title/Summary/Keyword: Strangulation

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Incarcerated umbilical hernia with small bowel obstruction in a continuous ambulatory peritoneal dialysis patient

  • Jeong, Yo-Han;Do, Jun-Young;Hwang, Mun-Ju;Kim, Min-Jung;Gu, Min Geun;Park, Byung-Sam;Choi, Jung-Eun;Kim, Tae-Woo
    • Journal of Yeungnam Medical Science
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    • v.31 no.1
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    • pp.25-27
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    • 2014
  • Patients treated with peritoneal dialysis have increased intra-abdominal pressure and a high prevalence of abdominal wall complications. Hernias can lead to significant morbidity in patients on peritoneal dialysis. Hernias are clinically important because of the risk of incarceration, strangulation and subsequent bowel obstruction, rupture, and peritonitis. In this paper, a case of incarcerated umbilical hernia with small bowel obstruction in a continuous ambulatory peritoneal dialysis (CAPD) patient is reported. The small bowel obstruction improved after herniorrhaphy, and the peritoneal dialysis was resumed 2 weeks after the herniorrhaphy. The patient had been undergoing CAPD without technical failure until the 2 months follow-up after the herniorrhaphy. This case shows that early detection of incarcerated umbilical hernia and herniorrhaphy can prevent resection of a strangulated small bowel so that it can remain on CAPD without post-operative technical failure. Umbilical hernias should be carefully observed and intestinal obstruction should be considered when a CAPD patient with an umbilical hernia has abdominal pain.

Congenital Bochdalek hernia: report of 4 cases (선천성 Bochdalek hernia4례 보고)

  • Jin, Jae-Gwon;Park, Ju-Cheol;Yu, Se-Yeong
    • Journal of Chest Surgery
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    • v.15 no.4
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    • pp.432-439
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    • 1982
  • Congenital posterolateral diaphragmatic hernia [Bochdalek hernia] is the result of a congenital diaphragmatic defect in the posterior costal part of the diaphragm in the region of the tenth and eleventh ribs. There is usually free communication between the thoracic and abdominal cavities. The defect is most commonly found on the left [90%], but may occurs on the right, where the liver often prevents detection. The male to female ratio is 2:1. Owing to the negative intrathoracic pressure, herniation of abdominal contents through the defects occurs, with resultant collapse of the lung. Shifting of mediastinum to the opposite side and compression of the opposite lung occurs. Most often these hernias are manifestated by acute respiratory distress in the newborn. A second, but less well recognized, group of patient with Bochdalek hernia survive beyond the neonatal period, usually present at a later time with "failure of thrive, intermittent vomiting, or progressive respiratory difficulty. " The diagnosis can often be made on clinical ground from the presence of respiratory distress, absence of breath sounds on the chest presence of bowel sounds over the chest . Roentgenogram of the chest confirm the diagnosis. Obstruction and strangulation have been reported but are rare. Treatment consists of early reliable identification of these congenital diaphragmatic hernia with high risk and surgical repairment. and postoperative pharmacological management with extracorporeal membranous oxygenation [=ECMO] support in the period of intensive care. On the surgical approach, for defects on left side, an abdominal incision is preferred, because of the high incidence of malrotation and obstructing duodenal bands. In the neonate, the operative mortality may be appreciable, but, later repair almost always is successful. During the period from 1972 to 1982, 4 cases of congenital Bochdalek hernia were experienced at the Kyung-Hee University Hospital.

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Small Intestine Resection and Anastomosis for Epiploic Foramen Entrapment of a Horse (말의 그물막구멍포착 교정을 위한 소장 절제 및 문합 1례)

  • Hwang, Hye-shin;Park, Chull-gyu;Hwang, Jun-seok;Chun, Yong-woo;Han, Janet H.;Lee, Inhyung
    • Journal of Veterinary Clinics
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    • v.32 no.4
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    • pp.374-379
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    • 2015
  • A 10-year-old gelding Warmblood weighing 560 kg was referred to J&C Equine Hospital with the history of hyperpnea, depression, pawing, and rolling for 7 hours. According to the results of clinical and ultrasound examination, it was considered that intestines were distended with thickened wall. The horse had been treated with lactated Ringers' solution (14 L, IV), flunixin meglumine (1.1 mg/kg, IV), and mineral oil (1 L, PO), but he did not show any responses to those treatments. Exploratory laparotomy was performed and identified incarcerated small intestine through the epiploic foramen. The horse received resection and anastomosis of the entrapped small intestine. After surgery, the horse was treated with intensive postoperative care of fluid therapy (5 L with 20 mEq/L KCl, every 2 hours), flunixin meglumine (1.1 mg/kg, IV, sid), antibiotics (penicillin 22,000 IU/kg, IV, qid and gentamicin 6.6 mg/kg, IV, sid), lidocaine constant rate infusion (bolus 1.3 mg/kg over 15 minutes then 0.05 mg/kg/minute), common nutritional supplements, nasogastric intubation every 2 hours and trunk bandage. Postoperative feeding program had started with small amount of hay every 4 hours and gradually increased to normal amount till 5 days. At 77 days after surgery, he showed sudden outbreak of colic and was euthanized. The causes of colic were small intestinal strangulation by passing through the mesenteric rents and postoperative adhesion between small intestines. According to the results, it is recommended to perform perioperative intensive care of horse with colic and to use several methods to prevent adhesions during abdominal surgery of horses.

Extrahepatic Biliary Obstruction Secondary to Traumatic Diaphragmatic Hernia in Dog (개에서의 횡격막 탈장에 의한 간외담도폐색)

  • Yoon, Young-Min;Jeong, Dong-In;Yeon, Seong-Chan;Lee, Hee-Chun
    • Journal of Veterinary Clinics
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    • v.31 no.6
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    • pp.531-534
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    • 2014
  • A 3-year-old intact mixed hunting dog was referred to Gyeongsang Animal Medical Center with the clinical signs of vomiting, dyspnea, anorexia. The dogs had traumatic history that wounded at abdominal wall during the wild boar hunting 2 week ago. The dogs was diagnosed as extrahepatic biliary tract obstruction (EHBO) secondary to traumatic hernia. Diagnosis was based on radiographic features of a diaphragmatic hernia on survey radiography, dilated bile duct in abdominal ultrasonography and complete recovery due to the return of displaced organs into the peritoneal cavity and repair of the diaphragmatic rent. Diagnostic imaging and surgical intervention may result in a favorable outcome in dog with post hepatic obstruction secondary to diaphragmatic hernia. This case emphasizes the strangulation of bile duct by diaphragmatic rupture could be the cause of EHBO.

Treatment of Corrosive Esophageal Stricture by Transhiatal Esophagectomy and Esophagogastrostomy (경열공 식도절제술을 이용한 부식성 식도협착증의 치료)

  • Kim, Jae-Bum;Park, Chang-Kwon
    • Korean Journal of Bronchoesophagology
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    • v.15 no.1
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    • pp.35-40
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    • 2009
  • Background: Surgical treatment of corrosive esophageal stricture with colon interposition was very widely used. The colon interposition advantage is low reflux esophagitis risk and preservation of gastric capacity and peristalsis. This procedure was introduced by Orsoni and much improved. But, if stomach injury was minimal, gastric interposition is useful due to simple technique and low complication. Material and Method: Esophageal reconstruction by the transhiatal esophagectomy and intracervical esophagogastrostomy was done in 7 patients of corrosive esophageal stricture at Dong-San medical center from January 1998 to December 2007. Result: There were six female and one male patients raBackground Surgical treatment of corrosive esophageal stricture with colon interposition was very widely used. The colon interposition advantage is low reflux esophagitis risk and preservation of gastric capacity and peristalsis. This procedure was introduced by Orsoni and much improved. But, if stomach injury was minimal, gastric interposition is useful due to simple technique and low complication. Material and Method: Esophageal reconstruction by the transhiatal esophagectomy and intracervical esophagogastrostomy was done in 7 patients of corrosive esophageal stricture at Dong-San medical center from January 1998 to December 2007. Result: There were six female and one male patients ranging from 29 to 69 years of age. The complication was two anastomosis site leakage, one gastric necrosis and one mortality due to bowel strangulation and sepsis. Conclusion: Transhiatal esophagectomy and intracervical esophagogastrostomy is safety and useful method at selection case even though corrosive esophageal resection is debated.

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A Statistical Analysis on Forensic Autopsies Performed in Korea in 2017 (2017년도 법의부검에 대한 통계적 고찰)

  • Park, Ji Hye;Na, Joo-Young;Lee, Bong Woo;Yang, Kyung-moo;Choi, Young Shik
    • The Korean Journal of Legal Medicine
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    • v.42 no.4
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    • pp.111-125
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    • 2018
  • Statistical analysis was performed on national forensic autopsy data collected in the Republic of Korea, with the exception of Ulsan, during 2017. A total of 8,777 cases were categorized based on the region; information was provided by the Police Agency and the Coast Guard regarding sex, age, manner of death, and cause of death. Analysis of the manner of death revealed that 3,971 cases (45.2%) were unnatural deaths, 3,679 cases (41.9%) were natural deaths, and 1,127 cases (12.8%) were unknown deaths. Among the unnatural deaths, the majority of the cases (1,740 cases, 43.8%) were accidents, 1,316 cases (33.1%) were suicide, 385 cases (9.7%) were homicide, and 530 cases (13.3%) were undetermined deaths. Among the unnatural deaths, the majority of the cases (1,575 cases, 39.7%) were trauma, followed by 793 cases (20.0%) of poisoning and 689 cases (17.4%) of asphyxia. Falling down was the major cause of death by trauma (737 cases, 46.8%). As a result of the classification of asphyxia based on previous study, strangulation was the major cause, with 538 cases (78.1%). Among the natural deaths, heart disease was the major cause (1,790 cases, 48.7%), followed by vascular disease (697 cases, 18.9%).

Comparative Evaluations of Magnetic Resonance Image, Spiral Computed Tomography and Ultrasound in the Diasnosis of Experimental Diaphragmatic Rupture in the Rabbit (토끼의 횡격막 파열 진단에 있어서 자기공명영상, 나선형전산화단층촬영 및 초음파의 가치 비교)

  • 김학희;정승은;이배영;최병길;신경섭
    • Investigative Magnetic Resonance Imaging
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    • v.1 no.1
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    • pp.154-161
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    • 1997
  • Purpose: Traumatic rupture of the diaphragm is not easy to diagnose and often delayed. Delayed diagnosis of diaphragmatic rupture accompanied by higher chances of strangulation of herniated viscera which may result in higher morbility and mortality. The purpose of this study was to evaluate diagnostic accuracy of spiral CT, MRI and US for the diagnosis of diaphragmatic rupture in an animal model. Materials and Methods: Small, medium, and large sized transabdominal diaphragmatic ruptures were surgically made in experimental rabbits and then followed up with spiral CT, MR!, and US at 1 day, 3 day, and 1 week after operation. Results: US was superior to MR! or spiral CT in diagnosis of diaphragmatic rupture(P(0.05). The sensitivity and specificity were 94.4% and 92.9% for US, 54.0% and 85.7% for MRI, and 46.0% and 78.6% for spiral CT, respectively. The size of laceration was not related to diagnostic sensitivity in US. Sensitivity of MRI and spiral CT increased as the size of laceration were larger, but no statistical significance was present(P>0.05). All experimental animals developed pleural effusion or hemothorax one day after operation. In acute phase, US and MRI were more sensitive than spiral CT in detecting diaphragmatic rupture. Spiral CT was more sensitive than US and MRI in delayed phase but without statistical significance(P>0.05). In the experimental rabbits with accompanying visceral hernia through the diaphragmatic defect, diagnostic accuracy was found equally high among three image modalities(P>0.05). Conclusion: This study indicates that US is the most accurate diagnostic method in detecting injury to the diaphragm in a rabbit model. The findings obtained in this experimental study can be applied to the diaphragmatic rupture of human being.

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A Multi-Wavelength Study of Galaxy Transition in Different Environments (다파장 관측 자료를 이용한 다양한 환경에서의 은하 진화 연구)

  • Lee, Gwang-Ho
    • The Bulletin of The Korean Astronomical Society
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    • v.43 no.1
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    • pp.34.2-35
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    • 2018
  • Galaxy transition from star-forming to quiescent, accompanied with morphology transformation, is one of the key unresolved issues in extragalactic astronomy. Although several environmental mechanisms have been proposed, a deeper understanding of the impact of environment on galaxy transition still requires much exploration. My Ph.D. thesis focuses on which environmental mechanisms are primarily responsible for galaxy transition in different environments and looks at what happens during the transition phase using multi-wavelength photometric/spectroscopic data, from UV to mid-infrared (MIR), derived from several large surveys (GALEX, SDSS, and WISE) and our GMOS-North IFU observations. Our multi-wavelength approach provides new insights into the *late* stages of galaxy transition with a definition of the MIR green valley different from the optical green valley. I will present highlights from three areas in my thesis. First, through an in-depth study of environmental dependence of various properties of galaxies in a nearby supercluster A2199 (Lee et al. 2015), we found that the star formation of galaxies is quenched before the galaxies enter the MIR green valley, which is driven mainly by strangulation. Then, the morphological transformation from late- to early-type galaxies occurs in the MIR green valley. The main environmental mechanisms for the morphological transformation are galaxy-galaxy mergers and interactions that are likely to happen in high-density regions such as galaxy groups/clusters. After the transformation, early-type MIR green valley galaxies keep the memory of their last star formation for several Gyr until they move on to the next stage for completely quiescent galaxies. Second, compact groups (CGs) of galaxies are the most favorable environments for galaxy interactions. We studied MIR properties of galaxies in CGs and their environmental dependence (Lee et al. 2017), using a sample of 670 CGs identified using a friends-of-friends algorithms. We found that MIR [3.4]-[12] colors of CG galaxies are, on average, bluer than those of cluster galaxies. As CGs are located in denser regions, they tend to have larger early-type galaxy fractions and bluer MIR color galaxies. These trends can also be seen for neighboring galaxies around CGs. However, CG members always have larger early-type fractions and bluer MIR colors than their neighboring galaxies. These results suggest that galaxy evolution is faster in CGs than in other environments and that CGs are likely to be the best place for pre-processing. Third, post-starburst galaxies (PSBs) are an ideal laboratory to investigate the details of the transition phase. Their spectra reveal a phase of vigorous star formation activity, which is abruptly ended within the last 1 Gyr. Numerical simulations predict that the starburst, and thus the current A-type stellar population, should be localized within the galaxy's center (< kpc). Yet our GMOS IFU observations show otherwise; all five PSBs in our sample have Hdelta absorption line profiles that extend well beyond the central kpc. Most interestingly, we found a negative correlation between the Hdelta gradient slopes and the fractions of the stellar mass produced during the starburst, suggesting that stronger starbursts are more centrally-concentrated. I will discuss the results in relation with the origin of PSBs.

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