• Advances in pediatric surgery
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• v.1 no.2
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• pp.177-180
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• 1995

A 2-day-old male (Premie, Large for gestational age(LGA), Intrauterine period(IUP) 33 weeks, birth weight 2,955 gram) was transferred with marked abdominal distention, bilious return via the orogastric tube, respiratory difficulty, and generalized edema (hydrops fetalis). He was born by cesarean section to a 36 year-old mother. Antenatal ultrasonogram at IUP 31 weeks demonstrated multiple dilated bowel loops suggestive of intestinal obstruction. There was no family history of cystic fibrosis. Simple abdominal films disclosed diffuse haziness and suspicious fine calcifications in the right lower quadrant. Barium enema demonstrated a microcolon. Sweat chloride test was not available in our institution. At laparotomy, there noted 1) a segmental volvulus of the small bowel with gangrenous change, associated with meconium peritonitis, 2) an atresia of the ileum at the base of the volvulus, and 3) the terminal ileum distal to the volvulus was narrow and impacted with rabbit pellets-like thick meconium. These findings appeared to be very similar to those of a complicated meconium ileus. In summary, the ileal atresia and meconium peritonitis seemed to be caused by antenatal segmental volvulus of the small intestine in a patient with probable meconeum ileus.

• Journal of Chest Surgery
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• v.17 no.4
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• pp.729-734
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• 1984

Bochdalek hernia is a type of congenital diaphragmatic defect in the posterolateral portion of the diaphragm. The defect is usually Lt. sided due to protective effect of liver on right. Sex distribution is male preponderance [2:1] and it is diagnosed during neonate, mostly first 24 hours, due to severe respiratory distress. We experienced a rare case of old aged female patient with congenital Bochdalek hernia on Rt. side which was found incidentally during treatment of spontaneous pneumothorax of Rt. side. 17 year old female patient was admitted to CS department for chest discomfort on right and mild dyspnea with duration of 20 days. Under the diagnosis of spontaneous pneumothorax, Rt. closed thoracostomy and underwater sealed drainage with continuous suction was applied. On follow-up chest x-ray, poorly defined hazy increased density with multiple air-fluid levels in Rt. lower lung field and Lt. subphrenic free air were noted. So, Barium enema was done under the impression of Rt. diaphragmatic hernia, and nearly entire colon proximal to sigmoid was demonstrated in the Rt. hemithorax. Operation was done-for surgical repair of defected diaphragm through Rt. posterolateral thoracotomy. Operative findings were as follows; 1.Hypoplastic Rt. lung, esp. RML & RLL. 2.Nearly entirely intestines were herniated. 3.Diaphragmatic defect was located on posterolateral portion of the diaphragm, about 10x3cm in size with blunt smooth margin. 4.A large bleb on apex of RUL of lung. Herniated intestines were repaired into abdominal cavity manually and defect of diaphragm was repaired with No. I black silk interrupted sutures directly, and bleb was resected. Postoperative courses were uneventful and the patient was discharged with good condition on POD 14th.

• Journal of Chest Surgery
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• v.2 no.1
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• pp.59-64
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• 1969

Three cases of traumatic diaphragmatic hernia were repaired in this department from June 1967 to Nov.1968. The first case, a 14 year old girl, was diagnosed as diaphragmatic hernia during the operation of the diffuse peritonitis from jejunaI perforation 3 days after the traffic accident at local clinic and she was transfered to this hospital after the closure of the perforated jejunum. Herniated stomach, transverse colon, spleen and left lobe of the liver were repositioned and the diaphragmatic rupture at the posterolateral portion of the left diaphragm was repaired with two layer sutures by transthoracic approach. The second case. a 26 year old man. was diagnosed immediately after the traffic accident at local clinic and transfered to this hospital 24 hours later. Herniated and distended stomach, transverse colon and jejunum were repositioned and the large diaphragmatic rupture, about 9 cm in length, from the posterolateral portion to the base of the pericardium was directly repaired with two layer sutures. The third case, a 26 year old man, who had a history of stab wound at left lower lateral chest two years ago,was admitted with the sudden onset of abdominal pain and vomiting. The diaphragmatic hernia was confirmed with barium enema. The herniated stomach and transverse colon through the defect, about 3.5 cm in diameter, at anterolateral portion of the left diaphragm, were repositioned and the defect was repaired with two layer sutures. All of the cases recovered uneventfully.

• Advances in pediatric surgery
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• v.10 no.2
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• pp.112-116
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• 2004

Midgut volvulus secondary to intestinal malrotation usually presents within the first month of life. Diagnostic delay may result in midgut infarction and mortality. In this retrospective study, we review seventeen cases of midgut volvulus to assess the importance of early recognition for midgut volvulus in pediatric patients of any age.. These patients were diagnosed as having a midgut volvulus by operation at Ewha Womans University Hospital. Eleven patients (64.7 %) were less than 1 month of age, and fifteen were boys (88.2 %). The mean gestational age was 38.3 weeks and the birth weight was 3.1 kg. Eight patients (47.1 %) had one or more combined anomalies such as heart malformation, brain ischemia, Down's syndrome or duodenal atresia. Vomiting was the most common symptom. Only thirteen patients underwent preoperative diagnostic procedures; 13 abdominal sonography demonstrated the whirlpool sign in 8 patients, upper gastrointestinal tract roentgenography showed a cork-screw pattern in 7 patients, and barium enema or small bowel series demonstrated positive findings in 7 patients. A Ladd's procedure was was formed on all patients.. There was no mortality or severe morbidity such as short bowel syndrome. Midgut volvulus should be included in the differential diagnosis in any infant or child who presents with the symptoms of acute abdomen, especially with vomiting.

• Childhood Kidney Diseases
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• v.8 no.1
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• pp.86-90
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• 2004

Hemolytic uremic syndrome(HUS) is characterized by acute renal failure, microangiopathic hemolytic anemia, and thrombocytopenia and the most common pathogen is Escherichia coli (E. coli) O157 : H7. Ischemic colitis, which rarely occurs in children, is due to the reduced local blood flow to the intestine, tissue necrosis and secondary bacterial infection. We describe a patient who was admitted with abdominal pain, vomiting and hematochezia, and diagnosed as ischemic colitis by barium enema. This patient showed hemolytic anemia, thrombocytopenia and progressive renal failure and was subsequently diagnosed as hemolytic uremic syndrome. After hemodialysis, the patient showed improvement of symptoms and resolution of renal failure and ischemic colitis.

• The Korean Journal of Nuclear Medicine
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• v.32 no.2
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• pp.172-177
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• 1998

We report a case of gastro-colic fistula caused by ectopic gastric mucosa developed at transverse colon. Fistula was detected by colonofiberscopy. And fistulous tract was proved by barium enema. Meckel's diverticulum scan finding was similar to that of GI bleeding; e.g. injected radioactivity was secreted into the lumen and moved along the lumen. There was no bleeding. And there was no diverticulum in the colon. Absence of diverticular pouch may explain this unusual GI bleeding-like scan finding rather than focal collection of radioactivity, which is typical of ectopic gastric mucosa found in the Meckel's diverticulum. Ectopic gastric mucosa was confirmed by colonofiberscopic biopsy. We suggest GI bleeding-like pictures should be included in differential diagnosis of $^{99m}TcO_4$ (ectopic gastric mucosa or Meckel's diverticulum) scan.

• Advances in pediatric surgery
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• v.20 no.2
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• pp.65-68
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• 2014

Congenital duodenal obstruction is a one of the emergent surgical conditions in neonates. Almost of them were diagnosed with double-bubble sign in prenatal ultrasonography. However, partial obstruction caused from duodenal web could be overlooked. We reported a duodenal web in early childhood. A three-year-old girl visited at our pediatric clinic for constipation. She had been showed non-bilious vomiting after weaning meal since 6 months old of her age, but her weight was relevant for 50-75 percentile of growth curve. Barium enema was initially checked, but any abnormal finding was not found. We noticed the severely distended stomach and 1st portion of duodenum. Upper gastrointestinal series revealed partial obstruction in 2nd portion of duodenum. After laparotomy, we found the transitional zone of duodenum and identified a duodenal web via duodenotomy. We performed duodeno-duodenostomy without any injury of ampulla of Vater. She was recovered uneventfully. During 6 months after operation, she does well without any gastrointestinal symptoms or signs, such as vomiting or constipation.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.2 no.2
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• pp.250-255
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• 1999

Isolated rectal adenomatous polyp without genetic background is rarely found in children. A 4-year and 5 month-old girl was admitted for intermittent bloody stools lasting 4 months. A $1.5{\times}1.2\;cm$ sized rectal polyp was found by air contrast barium enema. Endoscopic polypectomy was performed without complications. In histopathologic examination, it was found to be a tubulovillous adenoma. Typical radiologic, colonoscopic, and pathological pictures are presented.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.13 no.2
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• pp.199-203
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• 2010

Sigmoid volvulus may cause acute or subacute colonic obstruction. Excessive length of the sigmoid colon may be a contributing factor. Typically, the patient develops bilious vomiting and marked gaseous abdominal distension. We report a case of sigmoid volvulus in a 9-year-old boy who presented with recurrent, sudden onset abdominal pain, abdominal distension, and vomiting for 1 year, which was diagnosed by simple abdominal X-ray, barium enema, computed tomography, and colonoscopic examination. Colonoscopic reduction failed and a sigmoid colectomy with primary repair was performed. The intra-operative findings showed that the sigmoid colon was noted to be dilated, and redundant with a lax mesentery. Two clear areas of compression (proximal and distal) were present. After sigmoidectomy, the symptoms resolved. After 5 years of follow-up, he had no new symptoms.

• Asian Oncology Nursing
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• v.12 no.2
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• pp.166-174
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• 2012

Purpose: Even though the incidence of colorectal cancer (CRC) has increased in Korea, the colorectal cancer screening (CRCS) is lower than that of other cancer screenings. The purpose of this study was to identify CRCS rate and to predict factors in blue-color workers. Methods: A descriptive survey design was employed. Data were collected with 327 workers, recruited from 32 companies, aged 40 and over using questionnaire from August 2010 to January 2011. Collected information included CRCS, demographic characteristics, job characteristics, health behaviors, and interpersonal relationship. The definition of CRCS included fecal occult blood test (FOBT), colonoscopy, or double contrast barium enema (DCBE). Results: Among 94 workers receiving CRCS, workers having FOBT were 37, colonoscopy were 28, and DCBE was 6 in the past. Workers who aged over 50 (OR=2.30, 95% CI=1.11-4.77), middle school educated (OR=0.30, 95% CI=0.14-0.65), less working hours (OR=0.98, 95% CI=0.96- 0.99), and had family members who carried out regular cancer screening (OR=1.89, 95% CI=1.01-3.55) were more likely to perform CRCS. Conclusion: The findings suggest that the information and notice about CRCS to increase screening uptake, providing the accessible screening method, and involving company administrators or health managers might be useful to increase the CRCS rate in workers.