• Title/Summary/Keyword: abdominal wall

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Impact of Initial Helical Abdominal Computed Tomography on the Diagnosis of Hollow Viscus Injury and Blunt Abdominal Traumare (복부 둔상 및 유강장기 손상에 있어서 초기 나선형 복부전산화 단층촬영의 진단적 가치)

  • Cho, Young-Duck;Hong, Yun-Sik;Lee, Sung-Woo;Choi, Sung-Hyuk;Yoon, Young-Hoon;Lim, Sung-Ik;Jang, Ik-Jin;Baek, Seung-Won
    • Journal of Trauma and Injury
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    • v.21 no.1
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    • pp.28-35
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    • 2008
  • Purpose: This study was conducted to examine the clinical significance IV-contrasted helical abdomen computed tomography (CT) as a diagnostic screening tool to evaluate hollow viscus injury in blunt abdominal trauma patients. Methods: This is a retrospective study encompassing 108 patients, presenting to Korea University Medical Center (KUMC) Emergency Department (ED) from January 2007 to December 2007, with an initial CT finding suggestive of intra-abdominal injury. An initial non-enhanced abdomen CT was taken, followed by an enhanced CT with intravenous contrast. Patients' demographic data, as well as the mechanisms of injury, were inquired upon and obtained, initial diagnosis, as dictated by specialized radiologists, were added to post-operational (post-OP) findings and to additional CT findings acquired during their hospital stays, and all were combined to arrive at final diagnosis. Initial CT findings were further compared with the final diagnosis, yielding values for sensitivity, specificity, and accuracy, as well as positive and negative predictive values. Patients were further divided into two groups, namely, those that underwent operational intervention and those that did not. The initial CT findings of each group were subsequently compared and analyzed. Results: Initial CT scans revealed abnormal findings in a total of 212 cases - solid organ injuries being the most common finding, as was observed in 97 cases. Free fluid accumulation was evident in another 69 cases. Based on the CT findings, 77 cases (71.3%) were initially diagnosed as having a solid organ injury, 20 cases (18.5%) as having a combined (solid organ + hollow viscus) injury, and 11 cases (10.2%), as having an isolated hollow viscus injury. The final diagnosis however, were somewhat different, with only 67 cases (62.0%) attributed to solid organ injury, 31 cases (28.7%) to combined injury (solid + hollow), and 10 cases (9.3%) to hollow viscus injury. The sensitivity (CI 95%) of the initial helical CT in diagnosing hollow viscus injury was 75.6%, and its specificity was 100%. The accuracy in diagnosing hollow viscus injury was also meaningfully lower compared to that in diagnosis of solid organ injury. Among patients initially diagnosed with solid organ injuries, 10 patients (2 from follow-up CT and 8 from post-OP finding) turned out to have combined injuries. A total of 38 patients underwent an operation, and the proportion of initial CT findings suggesting free air, mesenteric hematoma or bowel wall thickening turned out to be significantly higher in the operation group. Conclusion: Abdominal CT was a meaningful screening test for hollow viscus injury, but the sensitivity of abdominal CT was significantly lower in detecting hollow viscus injury as compared to solid organ injury. This calls for special consideration and careful observation by the ED physicians when dealing with cases of blunt abdominal trauma.

Malignant Fibrous Histocytoma Originating from the Chest Wall (흉부에서 발생한 악성 섬유성 조직구종)

  • Lee, Chul-Burm;Chung, Tae-Yul;Halm, Shee-Young;Kim, Hyuk;Jung, Won-Sang;Kim, Young-Hak;Kang, Jung-Ho;Jee, Heng-Ok;Park, Yong-Wook
    • Journal of Chest Surgery
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    • v.33 no.4
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    • pp.333-337
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    • 2000
  • Malignant fibrous histiocytoma(MFH) is a deep-seated pleomorphic sarcoma, which occurs principally as a mass of the extremities, abdominal cavity, or retroperitoneum in adults. However, it only rarely occurs in the chest wall. An 85-year-old man had undeergone excision of a small mass on the right posterior chest wall under local anesthesia 14 months age. However, the lesion did not heal and the mass recurred. He was referred to our hospital after the mass had grown to a size of 10.5$\times$8$\times$4cm with a 3$\times$3cm skin defect. Intraoperative frozen biopsy revealed MFH. An en-bloc wide resection and thin-thickness skin graft from his thigh were performed. Although distant metastasis to the lund developed 14 months later and the patient died 2 months later, there was no local recurrence. Thin-thickness skin graft is a simple method for a wide range skin defect, especially in the old age. He recovered in good condition without any physical disabilities.

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Mineralized Undifferentiated Duodenal Carcinoma in a Shih-Tzu Dog

  • Lee, Jiyeong;An, Soyon;Hwang, Gunha;Go, Woohyun;Lee, Jong-Bong;Noh, Seul Ah;Lee, Dongbin;Song, Joong-Hyun;Hwang, Tae Sung;Lee, Hee Chun
    • Journal of Veterinary Clinics
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    • v.39 no.5
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    • pp.258-263
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    • 2022
  • An eight-year-old, intact female, Shih-Tzu, weighing 4.5 kg presented with complaints of anorexia, pale mucous membrane, and vomiting for the past 5 days. On physical examination, nausea, abdominal pain, and melena were noted. On hematologic examination, severe anemia and thrombocytosis were identified. On radiographs examination, soft tissue opacity with small faint mineral opacity mass in the mid-abdomen and two mineral opacity regions in the cranial aspect of mass were identified. Ultrasonographic findings showed thickening of descending duodenal wall with loss of layering and mineralization within the duodenal wall and mesentery adjacent to the duodenal lesion. Computerized tomography showed circumferential wall thickening of descending duodenum with mineralization. Mineralization of the mesentery and mesenteric lymph nodes was identified. Based on the diagnostic imaging, the tentative diagnosis was descending duodenal tumor with dystrophic mineralization. Endoscopy revealed mucosal hemorrhage and erythema within the descending duodenum and stomach. Surgery was performed, and mineralization in the pancreatic tail to duodenum and mesentery was found. Resection of the duodenum, regional lymph node, and mineralized pancreatic region and the duodenal anastomosis were performed. The histologic examination revealed a high-grade undifferentiated duodenal carcinoma with metastases to the regional lymph node and mesentery. The patient was managed with supportive therapy for 8 days and discharged. The patient was followed up for 5 months and there were no complications.

Modeling of Hemodynamics in Stenosed Artery (협착 동맥혈관의 혈류유동 모델링)

  • Kim, Seong-Jong;Park, Young-Ran;Kim, Shagn-Jin;Kang, Hyung-Sub;Kim, Jin-Shang;Oh, Sung-Hoon;Kang, Sung-Jun;Kim, Gi-Beum
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.5
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    • pp.2285-2290
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    • 2012
  • This study is about atherosclerosis which occupies the highest rate in many diseases people have and we have studied about atherosclerosis for abdominal aorta. Atherosclerosis is the phenomenon which blood vessel gets narrower, harder and thicker due to the stenosis of colesterol in blood vessel. If it becomes worse, arteries will be hard and blood can't flow smoothly, and even it can reach to death. In this study, the geometric models of the considered stenotic blood flow are two different types of constriction of cross-sectional area of blood vessel; 20 and 45% of constriction in each elastic wall and rigid wall. We have modeled by using finite element method to observe the changes of velocity and pressure. In case of the diameter of blood vessel decreased 45% in elastic wall model, the values of velocity and pressure were higher than the case of 20% and in case of the diameter of blood vessel decreased 45% in rigid wall model, the values of velocity and pressure were higher than the case of 20%. In cases of elastic wall models of the diameters of blood vessels decreased each of 20% and 45%, recirculation zones appeared. This results show understanding of hemodynamic properties depending on stenosed blood vessels.

Usefulness of MRI Scoring System for Differential Diagnosis between Xanthogranulomatous Cholecystitis and Wall-Thickening Type Gallbladder Cancer (황색육아종성 담낭염과 벽비후형 담낭암의 감별진단을 위한 자기공명영상 점수체계의 유용성)

  • Soul Han;Young Hwan Lee;Youe Ree Kim;Eun Gyu Soh
    • Journal of the Korean Society of Radiology
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    • v.85 no.1
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    • pp.147-160
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    • 2024
  • Purpose To define an MRI scoring system for differentiating xanthogranulomatous cholecystitis (XGC) from wall-thickening type gallbladder cancer (GBC) and compare the diagnostic performance of the scoring system with the visual assessment of radiologists. Materials and Methods We retrospectively analyzed 23 and 35 patients who underwent abdominal MRI and were pathologically diagnosed with XGC and wall-thickening-type GBC after surgery, respectively. Three radiologists reviewed all MRI findings. We defined a scoring system using these MRI findings for differentiating XGC from wall-thickening type GBC and compared the area under the curve (AUC) of the scoring system with the visual assessment of radiologists. Results Nine MRI findings showed significant differences in differentiating the two diseases: diffuse gallbladder wall thickening (p < 0.001), mucosal uniformity (p = 0.002), intramural T2-high signal intensity (p < 0.001), mucosal retraction (p = 0.016), gallbladder stones (p < 0.001), T1-intermediate to high-signal intensity (p = 0.033), diffusion restriction (p = 0.005), enhancement pattern (p < 0.001), and phase of peak enhancement (p = 0.008). The MRI scoring system showed excellent diagnostic performance with an AUC of 0.972, which was significantly higher than the visual assessment of the reviewers. Conclusion The MRI scoring system showed better diagnostic performance than the visual assessment of radiologists to differentiate XGC from wall-thickening-type GBC.

Acute Gastric Necrosis Due to Gastric Outlet Obstruction Accompanied with Gastric Cancer and Trichophytobezoar

  • Lee, Do-Sang;Sung, Ki-Young;Lee, Jun-Hyun
    • Journal of Gastric Cancer
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    • v.11 no.3
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    • pp.185-188
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    • 2011
  • Gastric necrosis due to gastric outlet obstruction is a very rare condition, but it might be fatal if missed or if diagnosis is delayed. Our patient was a 73-year-old male complaining of abdominal pain, distension and dyspnea for 1 day. In plain radiography and computed tomography, a markedly distended stomach and decreased enhancement at the gastric wall were noted. He underwent explo-laparotomy, and near-total gastric mucosal necrosis accompanied by sludge from the soaked laver was noted. A total gastrectomy with esophagojejunostomy was performed, and he recovered without sequelae. Final pathologic examination revealed advanced gastric cancer at the antrum with near-total gastric mucosal necrosis.

Fine Needle Aspiration Cytologic Findings of Gastric Inflammatory Myofibroblastic Tumor- A case report - (위에 발생한 염증성 근섬유모세포성 종양의 세침흡인 세포학적 소견 -1 예 보고-)

  • Lee, Ji-Hye;Shin, Bong-Kyung;Kim, Chung-Yeul;Cho, Seong-Jin;Kim, Han-Kyeom;Kim, In-Sun
    • The Korean Journal of Cytopathology
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    • v.12 no.2
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    • pp.117-120
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    • 2001
  • Inflammatory myofibroblastic tumor, histologically characterized by the presence of bland-locking spindle cells and infiltration of chronic inflammatory cells, is extremely rare in the gastric wall. We report a case of gastric inflammatory myofibroblastic tumor In a 27-month-old boy. The fine needle aspiration biopsy from the mass showed loose clusters or scattered spindle cells and inflammatory cells, predominantly of lymphocytes and plasma cells. The spindle cells resembled fibroblasts or myofibroblasts. Differential diagnosis from benign and malignant diseases involving abdominal cavity was discussed.

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A Case of Intussusception with Acute Appendicitis

  • Kee, Hyung Min;Park, Ji Young;Yi, Dae Yong;Lim, In Seok
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.18 no.2
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    • pp.134-137
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    • 2015
  • In children presenting to hospital with gastrointestinal symptoms, diseases such as intussusception and acute appendicitis require particular attention and careful examination. Early diagnosis and proper treatment are important because of possible severe complications such as peritonitis and death. Intussusception and appendicitis share similar clinical manifestations. More importantly, the presence of acute appendicitis together with intussusception in children is very rare. We describe an interesting case of a 38-month-old boy who presented with abdominal pain in the right lower quadrant. His vital signs were stable and laboratory test findings showed no specific alterations. We detected tenderness in the right lower quadrant. A computed tomography scan showed an ileocolic intussusception with no strangulation and diffuse wall thickening of the appendix trapped within the intussusception. The patient underwent an appendectomy and manual reduction.

Bar Suture for the Treatment of Bovine Abomasal Displacement (소의 제4위전위증 교정을 위한 봉봉합법)

  • Cho Myoung-Rae
    • Journal of Veterinary Clinics
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    • v.9 no.1
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    • pp.261-266
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    • 1992
  • Surgical treatment was performed in 507 heads out of 1078 dairly cows which were diagnosed as abomasal displacement. Out of 507 heads. bar suture was performed in 280 heads. Twelve heads out of 280 heads(4.9%) recurred. Incorrective suture of the reticulum or pylorus instead of abomasum occurred in 3 cows. The cows in which abdominal wall was sutured but the suture was not inserted into the abomasum were 4 heads. The cows in which bar was broken are 4 heads. A cow suffered peritonitis after bar suture. Bar suture technique is thought to be a good method as a first choice for the correction of abomasal displacement.

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Renal Subcapsular Hematoma after Percutaneous Transfemoral Angiography

  • Yi, Jin-Seok;Lee, Hyung-Jin;Lee, Hong-Jae;Yang, Ji-Ho
    • Journal of Korean Neurosurgical Society
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    • v.55 no.2
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    • pp.96-98
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    • 2014
  • Vascular complications after percutaneous angiography include hematoma, pseudoaneurysm, arteriovenous fistula, thromboembolism, arterial laceration and infection. Hematomas may occur in the groin, thigh, retroperitoneal, intraperitoneal, or abdominal wall. A 54-year-old female underwent percutaneous transfemoral angiography for the evaluation of cerebral aneurysm. Renal subcapsular hematoma developed 3 hours after the procedure. Renal subcapsular hematoma after percutaneous angiography is very rare. We investigated the possible causes of renal subcapsular hematoma. To avoid this rare complication, we need to perform guide-wire passage carefully from the beginning of the procedure under full visual monitoring.