• Title/Summary/Keyword: acute abdomen

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The study on the Paeoniae Radix Alba's efficacy in "Sanghanron(傷寒論)" prescription ("상한론(傷寒論)" 처방(處方) 속의 작약(芍藥) 효능(效能)에 대한 연구(硏究))

  • Bang, Jung-Kyun
    • Journal of Korean Medical classics
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    • v.23 no.1
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    • pp.47-58
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    • 2010
  • "Sanghanron(傷寒論)" can be approached through the understanding of the formulas. It is very important to correlate the efficacy of drugs and pathogenesis of syndrome. In this sense, the author examines the Paeoniae Radix Alba's efficacy. The Paeoniae Radix Alba[芍藥] used in Gyejitang(桂枝湯), Galgeuntang(葛根湯), Sogeonjungtang (小建中湯), Jagyakgamchotang(芍藥甘草湯) all have a similar effect. The Paeoniae Radix Alba supplies the tendon and blood meridian with bodily fluids, so it treats the stiffness and pain of the head and neck[頭項强痛], stiffness of the neck and back[項背强几几] and acute pain in the abdomen[腹中急痛] etc. Meanwhile, the Paeoniae Radix Alba treats difficulty in urination. It moistens the path to the excretion of urine included among drugs which increase digestion and transformation.

Spontaneous Rupture of the Intraperitoneal Metastatic Hepatocellular Carcinoma: a Case Report with Magnetic Resonance Imaging Findings

  • Kim, Hee Jeong;Park, Mi-hyun
    • Investigative Magnetic Resonance Imaging
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    • v.22 no.3
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    • pp.177-181
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    • 2018
  • Intraperitoneal metastatic hepatocellular carcinoma (HCC) is uncommon. Although rare, it can spontaneously rupture and cause hemoperitoneum similar to primary HCC in the liver. We present a case of intraperitoneal metastatic HCC that had spontaneously ruptured and appeared as an irregularly margined hemorrhagic mass with T1 high and T2 dark signal intensities on magnetic resonance imaging. Ruptured HCC is a life-threatening emergency with high mortality rate. Spontaneously ruptured intraperitoneal metastatic HCC should be considered if a patient with a history of HCC presents with acute abdomen, although rare.

Laparoscopic Excision of an Intraabdominal Cystic Lymphangioma: a Case Report (복강내 낭성 림프관종의 복강경 절제술 1예)

  • Kim, Hea-Eun;Seo, Jeong-Meen;Lee, Suk-Koo
    • Advances in pediatric surgery
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    • v.14 no.2
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    • pp.196-199
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    • 2008
  • Intraabdominal cystic lymphangioma is an uncommon lesion. It is usually found incidentally in patients presenting with an acute abdomen. Laparoscopic excision of intraabdominal cystic lymphangioma is an easy and safe procedure in children. We report one case of cystic lymphangioma in a 6.year-old female. The lesion was located on the left side of the transverse mesocolon. Laparocopic excision of the cyst was performed without complications.

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A Case Report of Chylous Mesenteric Cyst (유미성 장간막 낭종 1예 보고)

  • Joo, In-Ho;Chun, Yong-Soon;Lee, Nan-Joo;Yoon, Won-Hwa
    • Advances in pediatric surgery
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    • v.14 no.1
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    • pp.98-103
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    • 2008
  • Chylous mesenteric cyst is a rare variant of mesenteric cystic lesions. Pathologically there is lack of communication of the main lymphatic vessels, resulting in cystic mass formation. Clinical presentation is diverse and can range from an incidentally apparent abdominal mass to symptoms of an acute abdomen. A 5-year-old girl presented with abdominal distension without pain. CT scan showed a huge and thin-walled cystic mass without solid portion. Laparotomy showed a $20{\times}18cm$ sized huge mesenteric cyst containing chylous fluid. Pathological diagnosis was cystic lymphangioma.

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Limitations of 99mTc-DMSA scan in diagnosing acute pyelonephritis in children (이해관계 선언)

  • Kim, Byung Gee;Kwak, Jae Ryoung;Park, Ji Min;Pai, Ki Soo
    • Clinical and Experimental Pediatrics
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    • v.53 no.3
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    • pp.408-413
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    • 2010
  • Purpose : We aimed to prove the relative limitation of $^{99m}Tc-DMSA$ scintigraphy (DMSA) compared to computed tomography (CT) in diagnosing acute pyelonephritis (APN) in children. Methods : Since September 2006, after a 64-channel CT was imported, 10 DMSA false-negative patients have been identified: these patients underwent a CT scan for acute abdomen or acute febrile symptoms and were diagnosed as having APN; however, their DMSA scans were clear. We focused on these 10 DMSA false-negative patients and analyzed their clinical findings and CT results. We used Philips Brilliance Power 64-channel CT scanner for the CT scan and Siemens Orbitor Nuclear Camera 60 Hz for the DMSA scan. Results : The 10 DMSA false-negative patients were mostly males (80%) and infants (80%). They had fever for a mean of 1.1-day duration before admission and showed increase in acute reactants: leukocyte, erythrocyte sedimentation rate, and C-reactive protein. The CT findings of renal lesions were focal in 6 (60%) cases and diffuse in 4 (40%) cases, and most of the lesions were unilateral in 80% of patients. CT proved that 22 renal lesions were neglected by DMSA. Differential renal function test by DMSA was also of no use in the evaluation of renal lesions. Conclusion : In this study, DMSA scan showed limitation in finding renal cortical lesions of CT-proven APN patients. DMSA false-negative results seem to occur at early-phase disease of infantile age, but more prospective studies are needed to determine the reasons and their prevalence.

Pneumatosis Cystoides Intestinales and Portomesenteric Venous Gas following Anticholinesterase Pesticide Poisoning (항콜린에스테라아제 살충제 음독 후 발생한 창자벽공기낭증과 문맥장간막정맥가스 1례)

  • Lee, Suk Hee;Lee, Kyung-Woo;Jung, Jin Hee
    • Journal of The Korean Society of Clinical Toxicology
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    • v.15 no.1
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    • pp.56-59
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    • 2017
  • Pneumatosis cystoides intestinalis and portomesenteric venous gas are uncommon radiological findings, but are found commonly in cases of bowel ischemia, or as a result of various non-ischemic conditions. A 72-year-old man visited an emergency center with altered mental status 2 hours after ingestion of an unknown pesticide. On physical examination, he showed the characteristic hydrocarbon or garlic-like odor, miotic pupils with no response to light, rhinorrhea, shallow respiration, bronchorrhea, and sweating over his face, chest and abdomen. Laboratory results revealed decreased serum cholinesterase, as well as elevated amylase and lipase level. We made the clinical diagnosis of organophosphate poisoning in this patient based on the clinical features, duration of symptoms and signs, and level of serum cholinesterase. Activated charcoal, fluid, and antidotes were administered after gastric lavage. A computerized tomography scan of the abdomen with intravenous contrast showed acute pancreatitis, poor enhancement of the small bowel, pneumatosis cystoides intestinalis, portomesenteric venous gas and ascites. Emergent laparotomy could not be performed because of his poor physical condition and refusal of treatment by his family. The possible mechanisms were believed to be direct intestinal mucosal damage by pancreatic enzymes and secondary mucosal disruption due to bowel ischemia caused by shock and the use of inotropics. Physicians should be warned about the possibility of pneumatosis cystoides intestinalis and portomesenteric venous gas as a complication of pancreatitis following anticholinesterase poisoning.

Mediastinal pancreatic pseudocyst naturally drained by esophageal fistula (식도 누공으로 자연 배액된 종격동 췌장성 가성낭종)

  • Park, Soo Ho;Park, Seung Keun;Kim, Sang Hyun;Choi, Won Kyu;Shim, Beom Jin;Park, Hee Ug;Jung, Chan Woo;Choi, Jae Won
    • Journal of Yeungnam Medical Science
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    • v.34 no.2
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    • pp.254-259
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    • 2017
  • Mediastinal pancreatic pseudocyst is a rare complication of acute or chronic pancreatitis. Pleural effusion and pneumonia are two of the most common thoracic complications from pancreatic disease, while pancreaticopleural fistula with massive pleural effusion and extension of pseudocyst into the mediastinum is a rare complication of the thorax from pancreatic disease. To the best of our knowledge, there have been no case reports of mediastinal pancreatic pseudocyst-induced esophageal fistula in Korea to date. Here in, we report a case about 43-year-old man of mediastinal pancreatic pseudocyst-induced esophageal fistula presenting with chest pain radiating toward the back and progressive dysphagia. The diagnosis was confirmed by an esophagogastroduodenoscopy and abdomen computed tomography (CT). The patient was treated immediately using a conservative method; subsequently, within 3 days from treatment initiation, symptoms-chest pain and dysphagia- disappeared. In a follow-up gastroscopy 7 days later and abdomen CT 12 days later, mediastinal pancreatic pseudocyst showed signs of improvement, and esophageal fistula disappeared without any complications.

'Studies on diagnosis and Treatment of tumor.abscess.ulcer in intestinal carbuncle' (장옹(腸癰)에 있어서 종양(腫瘍).농양(膿瘍).궤양(潰瘍)의 진단(診斷)과 치료(治療)에 관(關)한 고찰(考察))

  • Han, Gyu-Eon;Ryu, Bong-Ha;Park, Dong-Won;Ryu, Gi-Won;Jang, In-Gyu
    • The Journal of Internal Korean Medicine
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    • v.11 no.1
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    • pp.93-107
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    • 1990
  • Studies on diagnosis and treatment of tumor . abscess . ulcer in intestinal carbuncle were carried out. The result of studies were summerized as follows: 1. By Nai-Gyung carbuncle-tumor arose from disharmony between nutrient and defensive because of cold, abscess arose from fever victory between cold and fever, ulcer arose from decreasing function of Bi-Kam year. By latter literature Bi-Kam year could be interpreted that spleen stomach was invaded evil influence from unattainable vital force of the earth. 2. Sites of intestinal carbuncle were large intestine, small intestine, intestinal inside or outside between large and small intestine, Intestinal carbuncle was common name of a disease about large intestinal carbuncle, small intestinal carbuncle, pelvic intestinal carbuncle, shrink leg intestinal carbuncle etc.. Pain appeared Chunchu-Hyul in large intestinal carbuncle, and Gwanweon-Hyul in small intestinal carbuncle. 3. On abdominal diagnosis tumor had indistinct pain of Gwanweon Chunchu, edema and heary feeling in low abdomen, no excessive pain by hand press and intestinal boiling sound. In abscess pain descended from right side of low abdomen to huckle, and there was rejection against press, feeling about fever,water sound with flank movement. In ulcer hand approach was difficult since excessive pain diffuse to whole abdomen, and perforating ulcer sometimes caused a serious symptom of umbilical pus. 4. On fecal and urinary diagnosis in tumor urine was yellowish red pollakiuria like gonorrhoea and occasional constipation. In abscess uncomfortable rough pain short red early urine like gonorrhoea appeared during urination, and constipation with stinging pain appeared during defecation. In ulcer red rough pyuria appeared, and stinging and pain with puruloid blood appeared during defecation. 5. On treatment in tumor Daiwhang-Tang Daisenggi-Tang Dangui-Jun by dissipation method, calming down method, interior reliance maturation method, in abscess Mokdan-San Euiiin-Tang Jeokduiin-Tang by the method of water repelling pus discharge, acute breaking, in ulcer Takridanggui-Tang Paljin-Tang Bojungikki-Tang were each used by the method of interior reliance, virulence astriction, supplement vital force and blood, supplement spleen stomach. 6. On treatment patient may have to be careful of excessive moving and suprising anxiety. Abuse of acupuncture and moxibustion made patient worse, misuse of analgesics purgative intestinal irrigation etc. could provoke difficult diagnosis and perforation. So you must treat after exact diagnosis. 7. Prognosis of ease tumor ease abscess ease ulcer and ease astriction was good. If the intestinal carbuncle were not to promote to abscess and ulcer for a long time, its prognosis was bad and it could metastasize to cancer because of dark purple with hardness. So tumor abscess ulcer in intestinal carbuncle may be significant of precancerous lesion.

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A Case of Tuberculosis Presented with Pseudoaneurysm of the Aorta and Acute Respiratory Distress Syndrome (복부 대동맥 가성동맥류와 급성호흡곤란증후군으로 동시에 발현한 결핵)

  • Lee, Eung-Jun;Cho, Han-Su;Yoon, Hyun-Sung;Lee, Jung-Hyun;Lee, Tae Hoon;Yoo, Kwang Ha;Lee, Kye Young;Kim, Sun Jong
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.4
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    • pp.298-302
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    • 2008
  • We experienced a case of tuberculosis presented simultaneously with pseudoaneurysm of the aorta and ARDS. A 63-year-old man was admitted with complaints of fever and right upper quadrant abdominal pain for a week. Chest X-ray on admission showed a normal finding. Sub-diaphragmatic abscess on abdomen CT scan was suspected and serosanguinous fluid was aspirated from the abscess pocket. On day 2, he was getting more dyspneic and chest X-ray revealed extensive bilateral infiltration. Aspirated fluid revealed AFB. Later, follow-up abdomen CT scan revealed a leakage of dye from the aneurysmal sac of the descending aorta which was previously diagnosed as sub-diaphragmatic abscess. An aortic stent was placed, covering the opening into the aneurysm. The sputum also showed positive AFB. The patient was successfully weaned from the ventilator, and discharged with anti-tuberculous medication on day 42. Follow-up abdomen CT scan 6 months later showed that the aneurymal sac was completely disappeared.

The Effects of Kami-bangpungtongseong-san Extracts on the Mouse Liver and Kidney Toxicated by Mercuric Chloride Subcutaneous Injection (가미방풍통성산(加味防風通聖散)이 수은의 피하 주입으로 중독된 마우스의 간 및 신기능에 미치는 영향)

  • Yang, Joon-Hyoung;Hong, Seong-Ug
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.23 no.2
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    • pp.1-12
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    • 2010
  • Objective : For this study, mice on mercurial toxication were given mercuric subcutaneous injection to their abdomen factitiously. After delivering Kami- bangpungtongseong-san(KBT) extracts to the mice by oral administration, we observed changes from liver and kidney of mice. Method : The BALB/c mice were distributed into three groups: No treated group(Normal group), Mercuric chloride subcutaneous injection group(Control group), Kami-bangpungtongseong-san-treated group (Sample group). KBT Extracts were delivered orally in 7 days. We observed involution of liver, necrosis of liver and cell plate loss of liver, lipid peroxidation CYP1A1 expression. We observed involution of proximal convoluted tubules, hypertrophy of Bowman's capsule, periodic acid-Schiff(PAS)'s positive reaction of proximal convoluted tubules, heat shock protein(HSP)700's positive reaction in glomerulus. For the charting the results, image analysis was taken. The result of image analysis was verified significance by Sigmaplot 2000(P<0.05). Result : The mice' liver on mercurial toxication were relieved involution of liver, necrosis of liver, and cell plate loss of liver and also declined lipid peroxidation and CYP1A1 expression. The mice' kidney on mercurial toxication were relieved involution of proximal convoluted tubules, hypertrophy of Bowman's capsule and increasing PAS's positive reaction of proximal convoluted tubules. On the other hand it was declined HSP700's positive reaction in glomerulus. Conclusion : According to the result of study, we think that we can expect to the effect of KBT extracts' therapeutic action to tissue injuries of the mice' liver and kidney on acute mercurial toxication.