• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.2 no.2
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• pp.256-261
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• 1999

Ileus caused by impaction of hardened residual barium stagnated in the colon, a rare complication of barium-enema examination, constitutes a particularly serious problem when it occurs in congenital megacolon patients. The administration of gastrografin in such case has proven efficacy in dissolution of impacted barium refratory to routine means of evacuation. We experienced a case of barium-impaction occurred in 6-months old male who had congenital megacolon. Gastrografin enema was a safe and simple method used in the management of this case.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.12 no.2
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• pp.124-145
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• 1999

Anal Therapy is taken valid compound of herb med and has many kinds of treatments. As one of the anal therapy, retention enema is most common and useful way. This study was performed in order to literatural basements of clinical treatments. we had cleared manifest about the origin and literatural basement of anal therapy, methods of management, classification of indication, clinical application and so forth. The results were summerised as follows. 1. It explained relationships between anus and Ojang-yukbu(五臟六腑), Sibie-geongmaek(十二經脈). But in fact the origin of anal therapy is Milgeon-dobub(蜜煎導法) and Jedamjib-dobub(猪膽汁導法) in Sanghan-jabbyungron(傷寒雜病論) of Han Dynasty. 2. The effect of anal therapy can be reached to the destination through theory of the organism which is called Jung-chei theory(整體論) and local medical action. We can find a little in Naegeong(內經), which is basement of Hang-jang therapy. 3. Anal Therapy have Kwanjaogbub(灌腸法), Guhangbub(灸肛法), Dohangbub(塗肛法), Hoonhangbub(熏肛法), Saekhangbub(塞肛法), Youkhangbub(浴肛法), Jwajeombub(坐점法) e.t.c. 4. Anal Therapy is available when person can't taken by mouth. Its benefits are fast effect and low side effect about liver because it is not taken trough liver mostly. 5. Anal Therapy has been used for the treatment of diseases such as stroke, high fever, pneumonia, ulcerative colitis, prostatitis, renal failure, pelvic inflammation. cancer and so on.

• Journal of Digestive Cancer Research
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• v.4 no.1
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• pp.17-20
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• 2016

Colorectal cancer is the 2^nd most common cancer in men, and the 3^rd most common cancer in women in Korea. This incidence has been increasing steadily since the data analysis began in 1999. Guidelines from many countries including Korea recommend annual or biennial fecal occult blood test as a national colorectal cancer screening program, however, colonoscopy, stool DNA test, double contrast barium enema, and sigmoidoscopy are recommended in some countries. I will summarize the Korean National Screening Guideline for colorectal cancer revised by multi-society expert committee in Korea last year. They recommend annual or biennial fecal immunochemical test between 45 and 80 year-old asymptomatic average risk people. Selective use of colonoscopy is recommended, taking into consideration of individual preference and the risk of colorectal cancer. There is no evidence for the risks or benefits of double contrast barium enema or computed tomographic colonography for colorectal cancer screening.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.14 no.1
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• pp.52-58
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• 2011

Purpose: Mecnoium obstruction in very low birth weight infants (VLBWI), which delays enteral feeding and is one of the major causes of bowel obstruction, can be diagnosed and treated with hyperosmolar water-soluble contrast enema. The purpose of this study was to observe the clinical findings of meconium obstruction, the improvement of small bowel obstruction after contrast enema, and the complications related to the enema. Methods: Hypersolmolar water-soluble contrast enemas were performed in 14 VLBWIs with meconium obstruction. Clinical findings, radiologic findings, feeding intolerance, effectiveness, and complications of enemas were observed. Also, clinical findings related to meconium obstruction were compared with 18 VLBWIs without meconium obstruction. Results: 1) Fourteen VLBWIs with meconium obstruction had significantly lower 5 minutes Apgar scores than 18 VLBWIs without meconium obstruction (p<0.05). Moreover, the day of last meconium passing, and the day of the first trial and full enteral feeding were delayed significantly. 2) A total of 18 enemas were performed in the 14 infants. The contrast medium passed the ileocecal valve and reached the terminal ileus in 12 enemas. Of the 12 enemas, 11 were successful, but 1 infant underwent an ileotomy, even though the contrast medium reached the terminal ileum. 3) Intestinal obstruction was not relieved in three of five infants, in whom the contrast medium failed to pass the ileocecal valve. Obstruction was relieved after repeated enemas in which the contrast medium reached the terminal ileum. 4) No complications associated with water-soluble contrast enemas were observed. Conclusion: Hyperosmolar water-soluble contrast enema is considered to be safe and therapeutic for meconium obstruction in VLBWIs.

• Advances in pediatric surgery
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• v.18 no.2
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• pp.75-82
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• 2012

In one-stage transanal endorectal pull-through operation (TERPT) for Hirschsprung disease, preoperative evaluation by contrast enema (CE) is important tool in aspect of planning of surgical procedure as well as diagnosis. This study was to evaluate the significance of CE for identifying the extent of aganglionic bowel. A retrospective analysis was performed in 40 patients who underwent TERPT between 2003 and 2011. The authors reviewed the CE studies and their correlation with pathologic extent of aganglionosis. Total 66 contrast enemas were performed in 40 patients. Twenty patients underwent single CE, but 20 patients required multiple CEs. In single CE group, 17 had clear radiographic transition zone, but 3 had less definite transition zone. In multiple CE group, 17 patients who had equivocal finding in first or second CE had definite radiographic transition zone, but 3 patients of this group had less definite radiographic transition zones. Overall, 34 patients (85%)had clear radiographic transition zone by single or repeated CE. One (2.9%) out of 34 patients with clear radiographic transition zone had discordance between radiographic and pathologic transition zone. In contrast 4 (66.7%) out of 6 patients with equivocal radiographic transition zone had discordance between radiographic and pathologic transition zone. Observation of clear radiographic transition zone is important in preparation of TERPT, and repeated CE is helpful to reduce the discordance between radiographic and pathologic transition zone. Awareness of the possibility of discordance is also important if radiographic transitional zone is not clear.

• Journal of radiological science and technology
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• v.34 no.2
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• pp.117-122
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• 2011

The purpose of this study was to evaluate the effects of education and test information provision on anxiety, discomfort, and satisfaction of patients during double contrast barium enema. The experiments were conducted from October 11, 2010 to November 5, 2010. Among all patients who visited the hospital to receive colon study in the outpatient radiology clinic of one general hospital located in Seoul, a total of 50 patients fit for selection criteria were divided into an experimental group (25) and a control group (25). After providing education and test information to the experimental group, we evaluated patients' levels of anxiety and discomfort, as well as satisfaction. The experimental group and the control group had different anxiety scores: 3.76 versus 6.04 respectively (P<0.05). In addition, the levels of abdominal pain and anal pain in the experimental group were lower than those of the control group (P<0.05). Lastly, the scores of test satisfaction between two groups were 89.6 and 67.4 respectively (P<0.05). Education and test information provision about the colon study decreased the levels of patients' anxiety and discomfort and increased satisfaction level of the test.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.12 no.2
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• pp.194-198
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• 2009

Purpose: Severe abdominal distension is not uncommon symptom in the neonate. Two major causes of this symptom are benign transient intestinal ileus (BTII) and Hirschsprung`s disease (HD). But it is difficult to differentiate BTII from HD based on the symptoms and simple abdominal x-ray findings. The aim of this retrospective study was to assess the clinical aspects and diagnostic tests differencing two diseases. Methods: From August 2004 to March 2009, nineteen patients with severe abdominal distension, who underwent barium enema, anorectal manometry, and rectal suction biopsy (triple tests) due to a suspicion of HD, were enrolled. A comparison of clinical data associated with BTII and HD based on the clinical features and results of triple tests. Results: The age of onset of symptom was between 2 and 6 weeks in BTII and within 3 weeks in HD. On the barium enema, transitional zone revealed in 6 (50%) patients in BTII and 4 (57.1%) in HD. On anorectal manometry, the anorectal inhibitory reflex was present in 11 (91.7%) patients in BTII and 1 (14.3%) in HD. On rectal suction biopsy, ganglion cell was present in 9 (75%) patients in BTII and 0 (0%) in HD. Abdominal distension was improved within 3 months of life in all cases of BTII. Conclusion: We think that anorectal manometry may be more simple and useful diagnostic method than barium enema and rectal suction biopsy for differential diagnosis of transient intestinal ileus and Hirschsprung's disease.

• Advances in pediatric surgery
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• v.8 no.1
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• pp.1-5
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• 2002

Diagnosing Hirschsprung's disease is a clinical challenge. Hirschsprung's disease should be considered in any child who has a history of constipation dating back to the newborn period. We examined diagnostic methods and their results retrospectively in 37 neonates and infants who underwent both barium enema and anorectal manometry for the diagnosis of Hirschsprungs disease at Asan Medical Center between January 1999 and April 2001. Two radiologists and a surgeon repeatedly reviewed both of the diagnostic results. In anorectal manometry, thirty-four studies were in agreement with the definitive diagnosis, giving an overall diagnostic accuracy of 91.9 % (neonate; 100 %, infant; 85.7 %). The accuracy and specificity of barium enema was lower than those of anorectal manometry, but sensitivity was higher. There was no significant difference between the two methods. Both studies showed findings consistent with the final diagnosis. However, discordant results needed further evaluation or close observation to diagnose accurately. We conclude that Hirschsprungs disease should not be diagnosed by only one diagnostic method.

• The Journal of Korean Obstetrics and Gynecology
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• v.18 no.1
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• pp.81-93
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• 2005

Purpose : There are various oriental medicine therapy of treating Pelvic Inflammatory Disease(PID) in clinics. We made the PID mice model by injection Lipopolysaccharide (LPS) in vagina, and investigate anti-inflammatory effects of Hongdeung-Tang among oral medication, retention enema therapy and herbal-acupuncture treatment. Method : The ICR(20-30g) mice(♀) were used. To examine the occurrence of inflammation, LPS in different concentration was injected into the vagina of the mice, and White Blood Cell(WBC) in blood was counted. To examine anti-inflammatory effects, 6 mice were assigned to each of the normal group, the control group and the sample group. Hongdeung-Tang was medicated in oral and rectal with 1.0g/kg low dose and 3.0g/kg high dose and by herbal acupucture for 5 days, 2 days before LPS injection. After 3days from LPS injection, blood was collected from retro-orbital plexus, and WBC, Interleukin-6(IL-6), Tumor Necrosis Factor-${\alpha}$(TNF-${\alpha}$) in the blood was counted. Result : After LPS injection with each dose, WBC count showed significant increase depending on LPS concentration from $100{\mu}g/kg$, and it was maximized at 3 or 4 days after LPS injection. the Hongdeung-Tang treatment groups, The number of WBC was decreased significantly only in low dose and high dose oral medication, and IL-6 concentration showed significant decrease in oral and rectal medication as well as in herbal acupuncture treatment. TNF-${\alpha}$ concentration was decreased significantly in oral and rectal medication of low dose and high dose. herbal-acupuncture treatment group datas showed reductive tendency. Conclusion : Based on above results, we made the PID mice model by injection LPS in vagina, and demonstrated anti-inflammatory effect of Hongdeung-Tang of oral medication, retention enema therapy and herbal-acupuncture treatment.

• Korean Journal of Radiology
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• v.21 no.4
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• pp.422-430
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• 2020

The Korean Society of Urogenital Radiology (KSUR) aimed to present a consensus statement for patient preparation, standard technique, and pain management in relation to transrectal ultrasound-guided prostate biopsy (TRUS-Bx) to reduce the variability in TRUS-Bx methodologies and suggest a nationwide guideline. The KSUR guideline development subcommittee constructed questionnaires assessing prebiopsy anticoagulation, the cleansing enema, antimicrobial prophylaxis, local anesthesia methods such as periprostatic neurovascular bundle block (PNB) or intrarectal lidocaine gel application (IRLA), opioid usage, and the number of biopsy cores and length and diameter of the biopsy needle. The survey was conducted using an Internet-based platform, and responses were solicited from the 90 members registered on the KSUR mailing list as of 2018. A comprehensive search of relevant literature from Medline database was conducted. The strength of each recommendation was graded on the basis of the level of evidence. Among the 90 registered members, 29 doctors (32.2%) responded to this online survey. Most KSUR members stopped anticoagulants (100%) and antiplatelets (76%) one week before the procedure. All respondents performed a cleansing enema before TRUS-Bx. Approximately 86% of respondents administered prophylactic antibiotics before TRUS-Bx. The most frequently used antibiotics were third-generation cephalosporins. PNB was the most widely used pain control method, followed by a combination of PNB plus IRLA. Opioids were rarely used (6.8%), and they were used only as an adjunctive pain management approach during TRUS-Bx. The KSUR members mainly chose the 12-core biopsy method (89.7%) and 18G 16-mm or 22-mm (96.5%) needles. The KSUR recommends the 12-core biopsy scheme with PNB with or without IRLA as the standard protocol for TRUS-Bx. Anticoagulants and antiplatelet agents should be discontinued at least 5 days prior to the procedure, and antibiotic prophylaxis is highly recommended to prevent infectious complications. Glycerin cleansing enemas and administration of opioid analogues before the procedure could be helpful in some situations. The choice of biopsy needle is dependent on the practitioners' situation and preferences.