• Title/Summary/Keyword: acute abdomen

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'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.

Body Fat Distribution and Blood Pressure according to Anthropometric Change in Korean Patients with Non-Insulin Dependent Diabetes Mellitus(NIDDM) (한국 인슐린 비의존형 당뇨병 환자의 체형 변화 유형에 따른 체지방 분포와 혈압)

  • Park Hye-Ja;Kim Se-Hyun;Kim Eun-Jeong
    • Journal of Korean Academy of Nursing
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    • v.36 no.5
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    • pp.837-844
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    • 2006
  • Purpose: This study was done to identify fat distribution and blood pressure according to anthropometric change patterns between NIDDM patients and control subjects. Methods: Cross-sectionally 167 NIDDM patients and 87 controls were studied. Previous maximal body weight and acute weight loss was obtained. Current height, body weight, BMI, waist-hip ratio(WHR), skinfold thicknesses(abdomen, subscapular & triceps), and blood pressure was measured. Three anthropometric change patterns were categorized by BMI changes from the maximum lifetim's BMI to the current time (obese-obese, obese-nonobese and nonobese-nonobese: obese: BMI$\geq$25kg/m$^2$, nonobese: BMI<25kg/m$^2$). The data was analyzed by $X^2$, t-test, age adjusted ANCOVA and Least Squares Means(LSM) for multiple comparison. Result: Acute body weight loss(p=0.01), anthropometric change types (p=0.001), WHR (p=0.05), and skinfold thickness (p=0.002) of NIDDM were significantly higher than those of the controls. The mean arterial pressure, WHR and skinfold thicknesses were greater in both obese-obese and obese-nonobese NIDDM and control subjects compared with both nonobese-nonobese NIDDM and control subjects. (all p's<0.05). Conclusion: NIDDM patients had more central and upper body adiposicity. Also both obese-obese and obese-nonobese NIDDM and control subjects had higher mean arterial pressures and central body obesity.

Review on the Globus Hystericus in View of Hyungsang Medicine (매핵기(梅核氣)의 형상의학적(形象醫學的) 고찰(考察))

  • Jung, Heung-Shik;Lee, Yong-Tae
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.20 no.3
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    • pp.516-521
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    • 2006
  • The following conclusions are drawn from Hyungsang medicinal review on th globs hystericus through Donguibogam and other literatures. The globs hystericus appears in the throat and the epigastric region. It is a subjective sensation as if a plum pit is stick in the throat and is compressed, usually ac companied by stuffiness in chest, depression, nausea, and hiccup. But the throat is not marked with redness and swelling. Because Gi stagnation due to seven emotions is the main cause, the globs hystericus is usually followed by Seven Gi injuries, Pain and depressive syndrome due to disorder of Gi, palpitation due to fright, continuous violent palpitation, Gi phlegm, precordial pain with palpitation, epigastric pain due to seven emotions, cough and dyspnea due to disorder of Gi, and six kinds of stagnations. When head and body or chest and abdomen is compared to heaven and earth, the blockage of Gi between heaven and earth is common to the persons with the following charcteristics in Hyungsang; Dam type rather than Bankwang type, Gi type and Shin type rather than deer type and fish type, Taeum and Yangmyeong meridian types out of six meridian types, manly women, womanly man, too long or short neck, and signs of stagnation between the eyebrows. The globus hystericus needs, distinguishing from aphonia, acute tonsilitis, goiter, and pectorial pain with stuffiness. The affected area of aphonia and acute tonsilitis is the throat but they are not cause by the disturbance of seven emotions. Goiter can be distinguished by the changes in the appearance of neck. Even though the symptoms are similar, globus hystericus is caused by the stagnation of Gi, but the pectorial pain with stuffiness, by the insufficiency of the Heart blood. The general prescriptions are Chilgitang, Sachiltang, Gamisachiltang, Gamiijintang, and Sinihwan.

Added Value of Diffusion Weighted Imaging for Detecting Pancreatic Abnormality in Patients with Clinically Suspected Acute Pancreatitis

  • Nam, In Chul;Kim, Seung Ho;Kim, Seon-Jeong;Lim, Yun-jung
    • Investigative Magnetic Resonance Imaging
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    • v.20 no.4
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    • pp.241-249
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    • 2016
  • Purpose: To evaluate the added value of diffusion weighted imaging (DWI) to computed tomography (CT) for detecting pancreatic abnormality in patients with clinically suspected acute pancreatitis (AP). Materials and Methods: 203 patients who underwent abdomen CT and subsequent DWI to do a workup for epigastric pain were analyzed. Two blinded radiologists independently performed an interval reading based on CT image sets first, then based on combined CT and DWI image sets. The diagnostic criterion on DWI was the increased signal intensity in the pancreas to that of the spleen. For quantitative analysis, the third radiologist measured ADC value of the pancreas in each patient. Results: For AP (n = 43), the sensitivity for detecting pancreatic abnormality increased, from 42% to 70% for reader 1 (P < 0.05) and from 44% to 72% for reader 2 (P < 0.05). For borderline pancreatitis (n = 42), the sensitivity also increased, from 10% to 26% for reader 1 (P < 0.05) and from 7% to 29% for reader 2 (P < 0.05). The mean ADC values (unit, ${\times}10^{-3}mm^2/s$) were significantly different among the three groups (for AP, $1.09{\pm}0.16$; for borderline pancreatitis, $1.28{\pm}0.2$; for control, $1.46{\pm}0.15$, P < 0.05). Conclusion: Sensitivity for detecting pancreatic abnormality increased significantly after adding DWI to CT in patients with clinically suspected AP.

Renal Lymphoma with Mesenteric Lymphomatosis in a Cat

  • Jeon, Jin-ha;Song, Doo-won;Ro, Woong-bin;Kim, Heyong-seok;Lee, Ga-won;Cho, Jun-ho;Jeong, Woo-chang;Kim, Soo-hyeon;Sur, Jung-hyang;Park, Hee-myung
    • Journal of Veterinary Clinics
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    • v.37 no.4
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    • pp.208-212
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    • 2020
  • A 6-year-old castrated male Russian Blue cat was presented for evaluation of dyschezia. Abdominal ultrasound revealed hyperechoic nodules in both kidneys, heterogeneous mass in abdomen, and extensive mesenteric thickening with multiple hypoechoic nodules. Computed tomography showed multiple hypodense lesions in both kidneys and diffuse nodular infiltration around the mesentery. Fine needle aspirates (FNA) acquired under ultrasound guidance from the mesentery consisted of large lymphocytes which have round to irregular nuclei with granular chromatin, prominent nucleoli and a small amount of basophilic cytoplasm. Polymerase chain reaction (PCR) for antigen receptor gene rearrangement result of FNA sample revealed a T-cell malignancy. The cat died from acute renal failure after 1 cycle of modified Madison-Wisconsin L-CHOP protocol. Postmortem examination revealed bilaterally enlarged lumpy-bumpy shaped kidneys. Histopathologic examination showed an infiltration of malignant lymphocytes into the renal parenchyma and mesentery. Immunohistochemical staining of the renal sample displayed a negative expression of CD3, PAX5, MUM-1, and CD79. The clinical features and prognosis of the cat with renal lymphoma with mesenteric lymphomatosis have been described in this report.

The Comparison of Appropriateness of Abdominal Computed Tomography (CT) and Abdominal Radiography Imaging Modality for Patients with Acute Nontraumatic Abdominal Pain (비외상성 급성 복부 통증 환자에게 시행한 복부 전산화단층촬 영과 복부 단순 촬영의 적정성 비교)

  • Song, Jung-Hup;Ryeom, Hun-Kyu
    • Quality Improvement in Health Care
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    • v.24 no.2
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    • pp.15-25
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    • 2018
  • Purpose: To compare the Appropriateness of abdominal CT to abdominal radiography as an imaging modality in terms of the diagnostic value, medical costs and decision making times for patients presented to the emergency department with nontraumatic abdominal pain. Methods: This study used the records of 530 cases presented to the emergency department(ED) with nontraumatic abdominal pain from February to March 2012. Imaging modalities were categorized into abdominal radiography and CT (radiography first or CT first) or radiography alone or CT alone. The diagnostic value, total medical costs and effect on decision making time of the each imaging modalities were compared. Especially, in retrospective review, to evaluate the predictability of the abdominal radiography, alit was assumed that all the 530 cases performed that exam as initial imaging. Results: Among 530 cases, 255 cases underwent abdominal radiography only, 28 cases underwent abdominal CT only and the remnant 247 cases underwent abdominal CT with plain abdominal radiography. The diagnostic value was higher in the cases with abdominal CT (268/275, 97.5%) than in the cases with plain abdominal radiography (19/255, 7.5%).The number of cases predicted by abdominal radiography only as initial imaging were 39/530 (7.4%). In cases where the patients performed the abdominal CT as the first imaging modality thereby omitting the abdominal radiography, the total diagnostic imaging fee was lower than in cases with plain abdominal radiography first followed by the abdominal CT (277,140 vs. 284,226(mean, Korean Won)). Although diagnostic value of the plain abdominal radiography as first imaging modality was lower than the abdominal CT, Decision making time, average duration of hospital stay was longer and the total medical costs was higher than abdominal CT. Conclusion: As an imaging modality in the ED for patients with acute nontraumatic abdominal pain, plain abdominal radiography is an avoidable procedure when viewed in terms of the diagnostic value and total medical costs and decision making times comparing with abdominal CT.

Clinical Features of Acute Nonspecific Mesenteric Lymphadenitis and Factors for Differential Diagnosis with Acute Appendicitis (급성 비특이성 장간막 림프절염의 임상 소견과 급성 충수돌기염과의 감별 인자)

  • Shin, Kyung Hwa;Kim, Gab Cheol;Lee, Jung Kwon;Lee, Young Hwan;Kam, Sin;Hwang, Jin Bok
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.1
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    • pp.31-39
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    • 2004
  • Purpose: Although acute nonspecific mesenteric lymphadenitis (ANML) is probably common cause of abdominal pain in children, which can be severe enough to be an abdominal emergency, the clinical features of mesenteric lymphadenitis are not clear. Also, a differential diagnosis with acute appendicitis (APPE) is indispensable to avoid serious complications. The clinical features of ANML were determined, and the risk factors for differential diagnosis with APPE were analyzed. Methods: Between November 2000 and May 2001, data from 26 patients (aged 1 to 11 years) with ANML and 21 patients (aged 2 to 13 years) with APPE were reviewed. ANML was defined as a cluster of five or more lymph nodes measuring 10 mm or greater in their longitudinal diameter in the right lower quadrant (RLQ) without an identifiable specific inflammatory process on the ultrasonographic examination. There were risk factors on patient's history, physical examination, and laboratory examination; the location of abdominal pain, abdominal rigidity, rebound tenderness, fever, nocturnal pain, the vomiting intensity, the diarrhea intensity, the symptom duration, and the peripheral blood leukocytes count. Results: Of the 26 ANML patients and 21 APPE patients, abdominal pain was noted on periumbilical (76.9% vs 14.2%), on RLQ (11.5% vs 71.4%), with abdomen rigidity (7.6% vs 80.9%), with rebound tenderness (0.0% vs 76.1%)(p<0.05), in the lower abdomen (11.5% vs 14.2%), and at night (80.8% vs 100.0%) (p>0.05). The clinical symptoms were vomiting (38.4% vs 90.4%), the vomiting intensity ($1.5{\pm}0.7$ [1~3]/day vs $4.5{\pm}2.9$ [1~10]/day), diarrhea (65.3% vs 28.5%) (p<0.05), and fever (61.5% vs 76.2%)(p>0.05). The period to the subsidence of abdominal pain in the ANMA patients was $2.5{\pm}0.5$ (2~3) days. The laboratory data showed a significant difference in the peripheral blood leukocytes count ($8,403{\pm}1,737[5,900{\sim}12,300]/mm^3\;vs\;15,471{\pm}3,749[5,400{\sim}20,800]/mm^3$)(p<0.05). Discriminant analysis between ANML and APPE showed that the independent discriminant factors were a vomiting intensity and the peripheral blood leukocytes count and the discriminant power was 95.7%. Conclusion: The clinical characteristics of ANML were abrupt onset of periumbilical pain without rigidity or rebound tenderness, a mild vomiting intensity, normal peripheral leukocytes count, and relatively short clinical course. If the abdominal pain persist for more than 3 days, and/or the vomiting intensity is more than 3 times/day, and/or the peripheral leukocytes count is over $13,500/mm^3$, abdominal ultrasonography is recommended to rule out APPE.

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Morgagni Hernia in a 3-year Old Boy - a Case Report - (3세 남아에서 발생한 Morgagni 탈장 - 1예 보고 -)

  • Jeong, Hye-Yeon;Kim, Ae-Suk;Choi, Sung-Min;Park, Jin-Young
    • Advances in pediatric surgery
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    • v.13 no.1
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    • pp.81-86
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    • 2007
  • A 3-year-old boy with purulent otitis media received a chest radiograph as the part of a routine work up. The patient was normal appearing, in no acute distress. The patient's lung and heart sounds were clear and normal. The patient's abdomen was soft, non-distended, and non-tender. An anterior cardiophrenic mass was incidentally identified on the lateral chest radiograph. A computed tomography scan demonstrated a diaphragmatic hernia with bowel loops in the retrosternal space. An exploratory operation revealed a diaphragmatic defect (4 cm in diameter) on the left side of the falciform ligament, through which transverse colon was protruded. There was no hernia sac, and the defect was closed with interrupted No. 2 silk sutures. The child was discharged on the 8th postoperative day without any complications. During 6 months of follow-up period, recurrence was not noticed.

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