• Advances in pediatric surgery
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• 제15권2호
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• pp.103-112
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• 2009

Catheter related and perianal problems are common surgical complications encountered during the treatment of pediatric malignancies. However acute surgical abdominal emergencies are rare. The aim of this study is to review acute surgical abdominal complications that occur during the treatment of childhood malignancies. Out of a total of 1,222 patients who were newly diagnosed with malignant disease, between January 2003 and May 2008, there were 10 patients who required surgery because of acute abdominal emergencies. Their medical records were reviewed retrospectively. Hematologic malignancies were present in 7 patients (4 leukemia, 2 lymphoma, 1 Langerhans cell histiocytosis) and solid tumors in 3 patients (1 adrenocortical carcinoma, 1 desmoplastic small round cell tumor, 1 rhabdomyosarcoma). Seven patients had intestinal obstruction, two had gastrointestinal perforation and one, typhlitis. Intestinal obstructions were treated with resection of the involved segment with (N=2) or without (N=3) enterostomy. Two patients had enterostomy alone when resection could not be performed. Intestinal perforation was treated with primary repair. Typhlitis of the ascending colon was treated with ileostomy. Right hemicolectomy was necessary the next day because of the rapidly progressing sepsis. Three patients are now alive on chemotherapy and one patient was lost to followed-up. Among six patients who died, five died of their original disease progression and one of uncontrolled sepsis after intestinal perforation. Although rare, acute surgical abdominal complications can occur in childhood malignancies. Rapid and accurate diagnosis and appropriate operation are required for effective treatment of the complications.

• The Korean Journal of Pain
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• 제1권2호
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• pp.164-170
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• 1988

상북부 통증을 호소하는 암성통증 환자 18예, 만성 췌장염환자 4 예에서 통증제거 목적으로 60% dehydrated ethanol 30~50ml을 방척추법으로써 복강신경총의 지각전도를 차단한 후 얻은바 결론을 다음과 같이 요약한다. 1. 위암, 간암, 췌장암등으로 인한 상복부 통증에 대해서 86%의 우수한 진통효과가 있었다. 2. 만성췌장염 환자에서도 양호한 효과를 얻을 수 있었다. 3. 진통효과의 지속시간은 55%에서 약 4개월 내지 7개월간 지속되었다. 4. 시술후 일시적인 기립성 혈압하강이 16%에서 나타났다. 5. 시술후 합병증은 경미한 정도에서 안면홍조 혈압하강 요통등이 있었다. 6. 시술전 마약성 약물 사용이 습관화된 경우는 시술후 마약성 약물 투여금단 효과를 억제하기 어려웠다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제24권3호
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• pp.273-278
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• 2021

Purpose: Percutaneous endoscopic gastrostomy (PEG) is a safe method to feed patients with feeding difficulty. This study aimed to compare the outcomes of conventional PEG and laparoscopic-assisted PEG (L-PEG) placement in high-risk pediatric patients. Methods: In our tertiary pediatric department, 90 PEG insertions were performed between 2014 and 2019. Children with severe thoracoabdominal deformity (TAD), previous abdominal surgery, ventriculoperitoneal (VP) shunt, and abdominal tumors were considered as high-risk patients. Age, sex, diagnosis, operative time, complications, and mortality were compared among patients who underwent conventional PEG placement (first group) and those who underwent L-PEG placement (second group). Results: We analyzed the outcomes of conventional PEG placement (first group, n=15; patients with severe TAD [n=7], abdominal tumor [n=6], and VP shunts [n=2]) and L-PEG placement (second group, n=10; patients with VP shunts [n=5], previous abdominal surgery [n=4], and severe TAD [n=1]). Regarding minor complications, 1 (6.6%) patient in the first group underwent unplanned PEG removal and 1 (10%) patient in the second group had peristomal granuloma. We observed three major complications: colon perforation (6.6%) in a patient with VP shunt, gastrocolic fistula (6.6%) in a patient with Fallot-tetralogy and severe TAD, and pneumoperitoneum (6.6%) caused by early tube dislodgement in an autistic patient with severe TAD. All the three complications occurred in the first group (20%). No major complications occurred in the second group. Conclusion: In high-risk patients, L-PEG may be safer than conventional PEG. Thus, L-PEG is recommended for high-risk patients.

• Korean Journal of Radiology
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• 제22권1호
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• pp.41-62
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• 2021

Radiologic imaging is important for evaluating extrahepatic bile duct (EHD) cancers; it is used for staging tumors and evaluating the suitability of surgical resection, as surgery may be contraindicated in some cases regardless of tumor stage. However, the published general recommendations for EHD cancer and recommendations guided by the perspectives of radiologists are limited. The Korean Society of Abdominal Radiology (KSAR) study group for EHD cancer developed key questions and corresponding recommendations for the radiologic evaluation of EHD cancer and organized them into 4 sections: nomenclature and definition, imaging technique, cancer evaluation, and tumor response. A structured reporting form was also developed to allow the progressive accumulation of standardized data, which will facilitate multicenter studies and contribute more evidence for the development of recommendations.

• Journal of Korean Neurosurgical Society
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• 제48권3호
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• pp.276-280
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• 2010

Liposarcomas are malignant tumors of the soft tissue, with myxoid liposarcoma being the second most common subtype, tending to occur in the limbs, particularly in the thighs. Myxoid liposarcomas have an intermediate prognosis between well-differentiated and pleomorphic tumors. Spinal metastasis is usual but intradural involvement is extremely rare. We present an unusual case of a multicentric myxoid liposarcoma with intradural involvement. A 41-year-old woman complained of tingling sensation on her left arm. Radiological evaluation revealed multiple masses in her cervical spine, abdominal wall, liver, heart and right thigh, all of which were resected. She was histologically diagnosed with small round cell myxoid sarcoma and underwent adjuvant chemotherapy. However, magnetic resonance imaging analysis after 1 year revealed a large metastatic mass with bony invasion at the C6-T1 level. This mass consisted of extradural and intradural components causing severe compression of the spinal cord. She underwent resection via a posterior facetectomy of C6-7 and an anterior C7 corpectomy. However, the patient died of multiple metastases 18 months after the first diagnosis.

• Advances in pediatric surgery
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• 제4권1호
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• pp.55-60
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• 1998

Six children with solid and papillary epithelial neoplasm of the pancreas were studied retrospectively. There were 2 boys and 4 girls. The mean age at operation was 11 years(range; 8-13years). Three patients had incidental abdominal mass, in two patients the mass was non-tender, in one patient the mass was tender. The minimum size of tumor was $6.5{\times}6.0$ cm and the maximum was $10.5{\times}8.0$ cm. Five tumors were located in the head of the pancreas, and the other one in the tail. Local invasion or metastasis was not noticed. Tumors were removed completely by performing the following operations: 3 pylorous preserving pancreaticoduodenectomy, 2 Whipple's operation and 1 distal pancreatectomy. There was no mortality. The histologic findings were characteristic. There were no recurrences during a follow-up of 0.5 to 12 years (mean; 5.0 years).

• 한국임상수의학회지
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• 제33권1호
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• pp.43-47
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• 2016

A 7-year-old castrated male Schnauzer was presented with melena and inappetence. Laboratory examination revealed mild anemia. Abdominal ultrasonography showed abnormal enlargement of intestinal segment and a oval mass with soft tissue density. After surgical resection of the enlarged intestine including the mass, histopathologic examination showed that the mass was tentatively diagnosed as synchronous occurrence of gland cell- and mesenchymal cell-origin tumors. Subsequently, immunohistochemistry showed positivity to cytokeratin AE1/AE3 in the gland cells and positivity to ${\alpha}-smooth$ muscle-specific actin, but negative expression of c-Kit, suggesting the co-existence of adenocarcinoma and leiomyosarcoma. Follow-up examination after 3-year of the surgery confirmed that the dog remained healthy and did not show recurrence of the tumors.

• Journal of Yeungnam Medical Science
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• 제28권2호
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• pp.165-172
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• 2011

Gastric glomus tumor is a rare mesenchymal tumor that originates from modified smooth muscle cells of the glomus body. Glomus tumors are commonly observed in peripheral soft tissue, such as dennis or subungal region, but rarely in the gastrointestinal tract. A 39-year-old woman was admitted due to epigastric soreness. Upper gastrointestinal endoscopy revealed a subepithelial mass measuring 3.5 cm with central ulceration at the lesser curvature-posterior wall of the antrum. Characteristically, contrast enhanced abdominal computed tomography scan demonstrated high enhancement of the submucosal mass up to the same level of the abdominal aorta in the arterial phase; this enhancement persisted to delayed phase. Due to the risk of bleeding and malignancy, wedge resection of the submucosal tumor was performed. Histologic findings were compatible with a glomus tumor.

• Advances in pediatric surgery
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• 제6권2호
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• pp.139-142
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• 2000

Pancreatoblastoma is uncommon in children and is exceedingly rare in adults. Prognosis is good if the tumor is removed prior to metastasis. Complete tumor resection is the most important factor for long survival. We report two cases of pancreatoblastoma in 4 and 7 years old girls. Palpable abdominal mass was accidentally found by their parents. Abdominal CT scan showed a huge retroperitoneal mass of unknown origin in one case and a mass involving the pancreas in the other case. At laparotomy, well encapsulated tumor mass($10{\times}10$ cm in maximum dimension) was noted in the body of pancreas in one case, and in the tail of pancreas in the other case( $8{\times}7$ cm). We resected the tumor and preserved the spleen in both cases. Histological examination revealed that the tumors were pancreatoblastoma. Patients received postoperative chemotherapy with 6 cycles of cisplatinum, adriamycin, ifosfamide and etoposide and are alive in good condition 19 months and 17 months after operation.

• The Korean Journal of Pain
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• 제2권1호
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• pp.36-41
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• 1989

Splanchnic nerve block is performed to relieve intractable upper abdominal pain caused by carcinoma of the pancreas, stomach, liver, or colon; and upper abdominal metastasis of tumors having more distant origins. We have performed splanchnic nerve blocks under control of X-ray fluoroscopy, for all cases of alcohol splanchnic nerve block at $L_1$ vertebra, to determine both the position of the needle tips and the spread of contrast media. During the period from December 1987 to August 1988, this method was used in 40 cases of malignancy at Severance Hospital and we clinically evaluated the location of the needle tip and the spread of contrast media. The results were as follows: 1) Our method was a retrocrural approach, the splanchnic nerve block, in all cases. 2) Most of the inserted needle points were located in the upper and anterolateral part of the $L_1$ vertebra on the antero posterior roentagenogram and in the upper quarter anteriorly on the lateral roentgenogram. 3) There was no specific relationship between the location of the needle and the spread of the contrast media. 4) The contrast media was spread around the needle and then upward along the anterior margin of the vertebral body in most of the cases. 5) Pain relief was obtained immediately in 37 cases (92.5%), but in 3 cases only after a second splanchnic nerve block.