• Journal of Chest Surgery
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• v.20 no.4
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• pp.839-846
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• 1987

The records of 10 patients with traumatic diaphragmatic hernia seen from November 1977 through July 1987 were reviewed. All the patients had a transdiaphragmatic evisceration of abdominal contents into the thorax. We treated 7 male and 3 female patients ranging in age from 3 to 62 years. In 8 patients, diaphragmatic hernia followed blunt trauma and in 2 patients, stab wounds to the chest. The herniation occurred on the right side in 3 patients and on the left side in 7. All the patients sustained additional injuries: rib fractures [7 patients], additional limb, pelvic and vertebral fractures [6], closed head injury [2], lung laceration [1], liver laceration [1], renal contusion [1], ureteral rupture [1], and splenic rupture [1]. Organs herniated through the diaphragmatic rent included the omentum [6 patients], stomach [4], liver [4], colon [3], small intestine [1], and spleen [1]. For right-sided injuries, the liver was herniated in all 3 patients and the colon, in 1. in the initial or latent phase, dyspnea, diminished breath sounds, bowel sounds in the chest were noted in 4 patients, and in the obstructive phase, nausea, vomiting, and abdominal pain were found in all 3 patients. Two patients had a diagnostic chest radiograph with findings of bowel gas patterns, and an additional 8 had abnormal but nondiagnostic studies. Hemothorax, pleural effusion or abnormal diaphragmatic contour were common abnormal findings. Three patients were operated on during the initial or acute phase [immediately after injury], 4 patients were operated on during the latent or intermediate phase [3 to 210 days], and 3 patients were operated on during the obstructive phase [10 to 290 days]. Six patients underwent thoracotomy, 2 required thoracoabdominal incision, and 2 had combined thoracotomy and laparotomy. Primary suture was used to repair the diaphragmatic hernia in 9 cases. One patient required plastic repair by a Teflon felt. Empyema was the main complication in 2 patients. In 1 patient, the empyema was treated by closed thoracostomy and in 1, by decortication and open drainage. There were no deaths.

• The Journal of Internal Korean Medicine
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• v.34 no.4
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• pp.466-477
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• 2013

Objectives : To report and demonstrate the effect of decreasing ascites volume by SB intraperitoneal injection to a refractory ascites patient with synchronous colorectal liver metastasis and metachronous peritoneal carcinomatosis. Methods : Two cycles of intraperitoneal and intravenous SB injection were conducted. Each injection cycle was made up of 4 days. Nine vials of SB were injected to the patient every day. To compare the volume of ascites between pret- and post-treatment, follow-up computed tomography was done on June 3, 2013. To observe other therapeutic effects of SB injection, laboratory tests were conducted periodically. Results : On the follow-up computed tomography images, the amount of ascites and pleural effusion had decreased compared to the April 30, 2013 computed tomography images. The levels of aspartate transaminase, alanine aminotransferase and lactate dehydrogenase decreased significantly from May 9, to May 30, 2013. The amount of oral intake increased constantly during hospitalization. The patient's symptoms such as abdominal distension, abdominal pain and dyspnea were improving until discharge. Conclusions : Even if thiese results cannot be applied to every synchronous colorectal cancer liver metastasis patient, we demonstrated that SB intraperitoneal injection has ascites-decreasing effect to refractory ascites patients with synchronous colorectal liver metastasis and metachronous peritoneal carcinomatosis.

• Journal of Veterinary Clinics
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• v.32 no.1
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• pp.101-104
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• 2015

A 4-years-old, intact male Golden retriever dog was presented with abdominal distension and dyspnea. Physical examination revealed arrhythmia and cardiac murmur. Generalized cardiomegaly, pleural effusion and ascites were shown on thoracic and abdominal radiographs. Two-dimensional echocardiography revealed abnormal mitral and tricuspid valve motion, mitral and tricuspid regurgitation, left ventricular eccentric hypertrophy and left atrial dilation. Color-flow Doppler imaging revealed turbulent flow extending into the left ventricle during diastole from the mitral valve orifice, and into the left atrium during systole. Spectral Doppler recordings revealed highly increased early diastolic mitral valve inflow and prolonged pressure half-time of mitral inflow. Based on the echocardiographic examination, the diagnosis was made as the mitral valve dysplasia concurrent with mitral valve stenosis and tricuspid valve dysplasia.

• Journal of Veterinary Clinics
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• v.24 no.1
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• pp.46-50
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• 2007

A 7-year-old female, Jindo dog was referred to the Veterinary Teaching Hospital with mild dyspnea and anorexia due to a gunshot trauma. The dog was wounded in the thoracic region 3 days ago. Plain radiographs showed the left 8th rib fracture, interstitial pattern in the left caudal lung field and pleural effusion. Abdominal radiographs showed the lead bullet. Computed tomographs(CT) showed the size of pulmonary contusion, laceration, lung parenchymal injuries, hemothorax and perforation of abdominal wall. The therapeutic plan was based on abnormalities seen on CT scans but not clearly seen in survey radiographs. Thoracic CT significantly provides even more informations compared with the corresponding radiographs in thoracic gunshot trauma. Although thoracic survey radiographs are useful as a screening tool, CT is highly sensitive in detecting thoracic injuries after thoracic trauma and is superior to routine thoracic survey radiographs in visualizing lung contusion, pneumothorax and hemothorax. Therefore, we recommend CT in the initial diagnostic work-up of patients with thoracic injuries and with suspected chest trauma because early and exact diagnosis of all thoracic injuries along with sufficient therapeutic consequences may reduce complications.

• Journal of Veterinary Clinics
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• v.30 no.2
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• pp.138-141
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• 2013

A 4-month-old, intact male mongrel dog was presented with trauma (hit by car), astasia, stupor and abdominal pain. Radiographic findings were peritoneal effusion, intestinal dilation, right iliac fracture, and microcardia. Abdominal ultrasonography revealed severely, dilated small intestine containing anechoic fluid in lumen and intramural gas within the wall. The sonographic finding suggested pnematosis intestinalis (PI), and vascular compromise of bowel loop by trauma was strongly suspected. After the dog was dead, postmortem examination revealed discolored and necrotized small intestine strangulated by sublumbar muscle. The detection of echogenic gas bubbles in the wall of bowel using ultrasound may be helpful in detecting PI.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.7 no.1
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• pp.102-107
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• 2004

About 20% of intestinal tuberculosis have active pulmonary tuberculosis. Intestinal tuberculosis can develop by swallowing sputum which have active pulmonary tuberculosis and by ingestion of contagious milk. We report a case of intestinal tuberculosis complicated with pulmonary tuberculosis in a 15-year old aldelescent who could not cough out sputum because of known cerebral palsy. He was admitted because of 3 day history of fever and bloody stool. Chest PA showed both upper lobe consolidation. AFB stain and AFB PCR was positive for tuberculosis. Colon study showed abscence of haustral marking and lead pipe appearance due to stenosis of ascending colon and mucosal edema. Abdominal CT scan showed mild wall thickening in ascending colon. Despite the anti-tuberculosis therapy with first line drugs, fever accompanying pleural effusion developed. Second line drug with Isoniazid and Rifampin improved clinical manifestation. After the report on sensitivity, we readjusted the regimen, and clinical manifestations improved gradually.

• Journal of Chest Surgery
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• v.7 no.1
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• pp.23-30
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• 1974

During the 35 month period from November 1966 to November 1967 and from June 1971 to March 1973 I had experienced 127 cases of non fatal wounds of chest in Viet-Nam. .Among these 127 cases, 62[45.4%] were gun shot wounds, 49[35.8%] were shrapnel wounds and the other were traffic accident. stab wounds and miscellanous. Approximately 21% of gun shot wound were perforating and 79% were penetrating but all cases of shrapnel wounds were penetrating. Of these 127 cases. 90% evacuated to hospital within 6 hours and average time 2.5 hours. The tranfusion requirement of these cases ranged from zero to 36 pints of whole blood with an average of 2.600cc. Initial intrathoracic findings were hemopneumothorax and hemothorax mostly. and the incidence of open thoracotomy was 9.5%[12cases] and closed thoracotomy was 82.8%[104cases], which were contrast to the reports from Korean conflict. I had experienced 24 cases with complication, such as large hematoma in lung parenchyme[8 cases], atelectasis[4 cases], pyothorax [3 cases], pneumonia [3 cases], fibrothorax [3 cases], pleural effusion [2 cases] and wound infection [2 cases]. Mortality rate for entire group was 4.7% but the cases associated with brain injury was 100%, with spinal cord injury was 50%, with large vessel 50%, and abdominal injury was 33.3%, and nobody died solely of thoracic injury.

• Journal of Chest Surgery
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• v.24 no.10
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• pp.973-978
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• 1991

From January, 1982, to December, 1990, 15 patients underwent pericardiectomy for chronic constrictive pericarditis on Department Of Thoracic and Cardiovascular Surgery, School of Medicine, Pusan National University. There were 9 male and 6 female patients [male to female ratio was 1.5: 1] ranging from 15 years to 63 years old [mean age 35.0]. All patients underwent pericardiectomy through a median sternotomy, partial cardiopulmonary bypass was performed on two patients. There were 3 postoperative death [20%]. Six cases [40%] were tuberculous origin 5 cases [34%] were Idiopathic [nonspecific chronic inflammatory change was considered to idiopathic], 2 cases [13%] were malignant origin, 2 cases [13Yo] were pyogenic origin. Dyspnea on exertion was evident in all patients and abdominal distention, general weakness, palpitation, peripheral edema were found. Eleven patients showed low voltage of QRS wave, 7 patients showed diffuse ST-T wave change, 2 patients showed atrial fibrillation on EKG. There were 6 patient showed pericardial thickening, 5 patients showed evidence of restriction, 5 patients showed pericardial effusion, 4 patients showed low cardiac output on preoperative echocardiogram. Hemodynamic response to pericardiectomy were observed; preoperative CVP 26.8 cmH2O declined to 15.0 cmH2O. Preoperative NYHA Functional class showed class II - 1, class III - 10, class IV - 4, postoperative NYHA functional class showed class I - 7, class II - 4, class Ill - l.

• Journal of Veterinary Clinics
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• v.40 no.6
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• pp.452-456
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• 2023

This report presents two rare cases of gallbladder rupture in dogs with small gallbladders that did not result in bile leakage and their subsequent surgical treatment. The report includes a 5-year-old spayed female Chihuahua weighing 3.5 kg and a 9-year-old castrated male Poodle weighing 5.3 kg. Both dogs had elevated liver enzyme levels on blood chemistry. However, only the second dog (2) (Poodle) presented with hyperbilirubinemia and jaundice, whereas the first dog (Chihuahua (1)) did not display any specific clinical signs. Diagnostic imaging revealed a small gallbladder in both dogs, and the dogs were diagnosed with cholecystolithiasis (1) and extrahepatic biliary tract obstruction (2). No bile leakage-related abdominal effusion was observed. Gallbladder rupture and adhesion to the adjacent tissues were confirmed during cholecystectomy.

• Clinical and Experimental Pediatrics
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• v.51 no.6
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• pp.655-659
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• 2008

Intestinal pseudo-obstruction (IPO) is a rare and poorly understood manifestation of systemic lupus erythematosus (SLE), especially in children. The characteristic clinical feature of IPO is obstruction without an identifiable obstructive lesion. The authors a 13-year-old girl whose first symptom of SLE was IPO. The patient presented with a 3-day history of nausea, bilious vomiting, abdominal distention, and no bowel movement. Simple abdominal radiographs revealed mild dilatation with partial air-fluid levels in the small intestine. Abdominal CT and methylcellulose small bowel studies showed massive ascites, engorgement of the small mesenteric vessels, pleural effusion, and diffuse bowel wall thickening of the gastric antrum, duodenum. and jejunum. The delayed passage of contrast for 15 days after the methylcellulose small bowel studies was suggestive of decreased bowel motility. Laboratory findings were positive for ANA, anti-double-stranded DNA, anti-Smith and lymphopenia. After 10-day treatment with high-dose corticosteroids, the symptoms improved. IPO associated with SLE should be considered in the differential diagnosis for patients presenting with symptoms of intestinal obstruction. Early recognition of IPO in SLE and appropriate therapy are important for prevention of complications and unnecessary surgery. This case raises awareness among pediatricians that although rare, IPO can be the presenting symptom of SLE in children.