• Title/Summary/Keyword: enema

Search Result 145, Processing Time 0.029 seconds

Nationwide Population-Based Epidemiologic Study on Childhood Intussusception in South Korea: Emphasis on Treatment and Outcomes

  • Lee, Eun Hye;Yang, Hye Ran
    • Pediatric Gastroenterology, Hepatology & Nutrition
    • /
    • v.23 no.4
    • /
    • pp.329-345
    • /
    • 2020
  • Purpose: This was a nationwide population-based study conducted to investigate the epidemiology, treatment, disease outcomes, and associated factors of childhood intussusception in South Korea. Methods: Data from the Korean National Health Insurance Service database on all patients <18 years old diagnosed with intussusception from 2007 to 2017 were analyzed. Results: A total of 34,688 cases were identified among 30,444 patients. The overall incidence was 28.3/100,000 person-years with a male predominance. Most cases (83.1%) occurred in children <3 years old, with an annual incidence of 195.2, 200.1, and 118.6 cases per 100,000 children in their first, second, and third year of life, respectively. The median age at the first occurrence was 18.7 months, and it was higher in boys than in girls. The post-discharge recurrence rate was 10.6% (3,226/30,444) and the in-hospital recurrence rate was 6.1% (1,842/30,444). The total recurrence rate (post-discharge recurrence and/or in-hospital recurrence) was 15.0% (4,580/30,444). Enema reduction was successful in 90.0% of cases. Enema reduction was more successful in girls than in boys. A total of 3,296 (10.8%) patients underwent 3,481 surgeries, including 735 (21.1%) laparoscopic surgeries. Post-discharge recurrence and surgery were significantly affected by age, sex, and hospital type. Mortality was noted in nine cases (0.03%). Conclusion: Our study provides accurate epidemiologic data on the treatment and outcomes of intussusception through complete enumeration during an 11-year-period.

Clinical Features and Role of Viral Isolates from Stool Samples of Intussuception in Children

  • Lee, Yong Wook;Yang, Soo In;Kim, Ji Myoung;Kim, Jae Young
    • Pediatric Gastroenterology, Hepatology & Nutrition
    • /
    • v.16 no.3
    • /
    • pp.162-170
    • /
    • 2013
  • Purpose: To detect major acute gastroenteritis virus (rotavirus, norovirus, astrovirus, and enteric adenovirus) and non-enteric type of adenovirus (AdV) in the stools of intussusception patients and to investigate the clinical role of detected viruses. Methods: From March 2012 to February 2013, major acute gastroenteritis virus and non-enteric type of AdV were isolated from stool samples that collected from 44 patients treated for intussusception in Chungnam National University Hospital. Patients were divided according to age and isolated virus. Results: Virus was detected in 28 (63%) stool specimens. The virus detection rate was significantly lower in patients aged under 12 months (p = 0.04). Twenty-two patients (78.6%) had non-enteric adenovirus, 4 (14.3%) had norovirus, 1 (3.6%) had sapovirus, and 1 (3.6%) had astrovirus. AdV subgroup C (AdV 1, 2, 5, and 6) comprised the majority with 20 cases (90.9%). A monthly increment-and-decrement pattern of intussusception was similar to that of viral detection in the stool samples. Enema reductions were successful in 39 patients and surgical manual reductions were performed in 5 patients. Virus was detected in 24 patients (61.5%) of enema reduction group and 4 patients (80.0%) of surgical manual reduction group. All of the detected viruses were non-enteric adenovirus subgroup C (AdV 1, 5, and 6) in surgical reduction patients. Conclusions: The virus detection rate was high in the stools of intussusception patients. The pattern of seasonal intussusception occurrence rate was parallel with seasonal these viral detection rate in the stool samples. These findings suggest that viral infection plays an important role in the development of intussusception and further research is warranted.

Oral Administration of Nonionic Water-Soluble Contrast Media to Treat Meconium Obstruction in Premature Infants: A Preliminary Study

  • Hong, Hyun Sook;Kim, Sung Shin;Park, Ga Young
    • Neonatal Medicine
    • /
    • v.28 no.1
    • /
    • pp.22-28
    • /
    • 2021
  • Purpose: Meconium obstruction of prematurity (MOP) predisposes premature infants to intestinal perforation and prolonged hospitalization if not diagnosed and treated promptly. A standard contrast enema is less effective to treat infants with distal ileal obstructions because the contrast may not reach the obstructed areas. In an effort to avoid risky surgery, we administered oral contrast media to seven clinically diagnosed patients with MOP whose obstructions were not relieved via conventional sonography-guided contrast enema. We retrospectively evaluated whether oral nonionic water-soluble contrast media relieves MOP. Methods: Seven of 67 premature infants with MOP were administered oral contrast media from June 2015 to January 2019. Patients were followed-up radiographically for bowel distention and evacuation of contrast media after oral administration. We recorded radiographic improvements, meconium evacuation, time to first feeding after oral contrast media administration, maternal history, and neonatal clinical factors. Results: We evaluated five male and two female infants. The median gestational ages and body weights at birth were 27+5 weeks and 890 g, respectively. Radiography in five infants revealed multiple distended intestinal loops without air-fluid interfaces. Two infants had gasless abdomens, in which only stomach gas was visible. Oral contrast media (median, 2.5 mL) were administered at a median age of 7 days; five infants (5/7, 71.4%) responded to this treatment. The remaining two infants, who had ileal stenosis and hypoganglionosis, were surgically managed. Five infants (5/7, 71.4%) had maternal risk factors, and two (28.6%) were small for gestational age. Conclusion: Nonionic oral water-soluble contrast medium can serve as a valuable adjunct treatment in premature infants with meconium obstruction.

Feasibility of Laparoscopic Surgery for Intussusception in Pediatric Patients and Risk of Bowel Resection

  • Song, Eun Ju;Nam, So Hyun
    • Journal of Minimally Invasive Surgery
    • /
    • v.21 no.4
    • /
    • pp.154-159
    • /
    • 2018
  • Purpose: Intussusception is a common cause of intestinal obstruction in children. While most patients can be treated by enema reduction, about 20% require surgery. We investigated the usefulness and feasibility of laparoscopic surgery and the intraoperative risk of bowel resection. Methods: We retrospectively reviewed pediatric patients who underwent surgery for intussusception from 2010 to 2017. We collected data for age, gender, body weight, associated symptoms, duration of symptoms, white blood cell count, operating time, and postoperative complications. Results: Of 155 patients, 37 (23.8%) underwent surgery due to enema reduction failure in 29 (78.3%), recurrence in 6 (16.3%), a suspicious lead point in 1, and suspicious ischemic change observed on ultrasonography in 1. The mean age was $26.8{\pm}18.9$ months (range, 3.5~76.7 months), and the mean body weight was $12.9{\pm}3.9kg$ (range, 5.4~22.2 kg). Laparoscopic surgery was successful in 29 patients (78.4%), and 7 (18.9%) needed bowel resection and anastomosis. The mean operating time was $56.7{\pm}32.8min$. A lead point was found in 3 patients in the bowel resection group (p=0.005); in addition, the operating time and hospital stay were longer in this group. There were no intra- or postoperative complications. Conclusion: Laparoscopic surgery was successful in 78.4% of the patients with a short hospital stay and early oral intake. The only predictive factor for bowel resection was the presence of a lead point. Laparoscopic surgery may be an optimal treatment intervention for children with intussusception, except for those who show initial peritonitis.

A Survey on the Treatments used in Oriental Obsterics & Gynecology (한방부인과질환에 사용되는 치료방법에 대한 조사연구)

  • Lee, In-Seon;Bae, Kyung-Mi
    • The Journal of Korean Obstetrics and Gynecology
    • /
    • v.22 no.1
    • /
    • pp.203-230
    • /
    • 2009
  • Purpose: In order to know therapies used in the field of Obsterics & Gynecology of Oriental medicine. Methods: This survey investigated papers about clinical study, literature investigation for therapeutic methods and treatment reports published from 1999. 2${\sim}$2008. 11. Results: In the clinical studies, acupuncture is more frequently used than herbal medicine. But in the treatment reports, herbal medicine is most frequently used except some cases. Besides acupuncture and moxibustion was used frequently. In the treatment reports various acupuncture methods were used except vaginal bleeding or abdominal pain cases. Whole body acupuncture was used mainly. Pharmacopuncture, Sa-am Acupuncture, auricular acupuncture was also used frequently. And Dong's acupuncture, Hwa acupuncture was used sometimes. Moxibustion was tend to be used for dysfunctional uterine bleeding, menopausal disorder, urinary incontinence, vaginal bleeding or abdominal pain during pregnancy period, hyperemesis, recurrent miscarriage, postpartum disease, lochiorrhea. Also other treatment methods was used such as external therapy, aromatherapy, herbal retention enema, fumigation, electric lipolysis acupuncture, Chuna manual medicine, obesity management, acupuncture at uterus cervix, magnetic innervation therapy, exercise, cupping and physical therapy. Conclusion: These results suggests that acupuncture, moxibustion and herbal medicine are most frequent therapy in the field of Obsterics & Gynecology of Oriental medicine. And other therapy are used such as external therapy, aromatherapy, herbal retention enema, fumigation and so on.

A Suggested New Clinical Classification for Pediatric Intussusception (소아 장중첩증의 새로운 임상적 분류의 제안)

  • Park, Moon Ho;Shon, Su Min;Choe, Byung Kyu;Kim, Yeo Hyang;Lee, Hee Jung;Choi, Won Joung;Kim, Ae Suk;Hwang, Jin-Bok
    • Pediatric Gastroenterology, Hepatology & Nutrition
    • /
    • v.9 no.1
    • /
    • pp.39-47
    • /
    • 2006
  • Purpose: We proposed a new classification of pediatric intussusception based on clinical and radiologic findings. Methods: Data from 88 consecutive patients with intussusception were reviewed. We retrospectively analyzed six factors; patient age, sites of intussusception, symptoms, therapeutic methods, existence of enlarged mesenteric lymph nodes, and ultrasonographic (US) findings from clinical records. Results: 1) There was one neonatal case (1.1%), the others (98.9%) were infants and children. 2) These 87 infant and child cases consisted of 14 cases (16.1%) of small bowel intussusception (SBI) and 73 cases (83.9%) of ileo-colic intussusception (ICI). Of the 14 SBI cases, 12 cases were symptomatic and 2 cases were asymptomatic. The symptomatic group comprised 8 transient cases (66.7%), 3 operative cases (25.0%), and 1 enema-reduction case (8.3%). Two asymptomatic cases were incidentally captured by computed tomography. Of the 73 ICI cases, 19 cases (26.0%) required operation, and 54 (74.0%) enema-reduction. 3) When transient SBI cases were compared with operated SBI cases, enema-reduced and operated ICI cases, the age ($38.0{\pm}22.9$ months) of transient SBI cases were significantly higher than those of the others (p=0.003). Mean mass size ($20.8{\pm}2.7mm$) in transient SBI was significantly smaller than in the others (p=0.0001). 4) No correlation was found between the existence of enlarged mesenteric lymph nodes and therapeutic method or concomitant illness. 5) Most of the target types observed by US were in transient SBI cases, the remainder were in the enema-reduced ICI cases. In terms of the doughnuts type, all 8 cases (34.8%) with an external hypoechoic rim thickness of >8.9mm were treated surgically. Conclusion: Pediatric intussusception may be classified based on clinical and radiologic findings, which are likely to indicate appropriate therapies.

  • PDF

Small bowel obstruction caused by an anomalous congenital band in an infant (신생아에서 발생한 선천성 밴드에 의한 장폐색증 1예)

  • Sung, Tae-Jung;Cho, Ji-Woong
    • Clinical and Experimental Pediatrics
    • /
    • v.51 no.2
    • /
    • pp.219-221
    • /
    • 2008
  • Intestinal obstruction is not uncommon in infants. The common causes of intestinal obstruction in the neonatal period are Hirschsprung disease, intestinal atresia, meconium ileus, and intussusception. However, small bowel obstruction caused by a congenital band is very rare. We report a 27-day-old baby who was admitted with abdominal distension and fever. The abdominal X-ray revealed massive bowel dilatation and the contrast gastrografin enema suggested a distal small bowel obstruction. The explolaparotomy showed small bowel entrapment due to an unusual anomalous congenital band.

Bochdalek hernia in adults: a report of 3 cases (성인에서 발견된 Bochdalek 허니아치험 3)

  • 남구현
    • Journal of Chest Surgery
    • /
    • v.17 no.3
    • /
    • pp.531-536
    • /
    • 1984
  • Bochdalek hernia is common in infants and children, but extremely rare is adults. So diagnosis and treatment have been many problems. These are case reports of Bochdalek hernia in adults which were evaluated and corrected at the Department of Thoracic and Cardiovascular Surgery, College of Medicine, Chungnam National University during the past 7 years from June 1976 to August 1983. 1.Among the three cases, one was male and the others were female. 2.At first, they were diagnosed as G-I or respiratory disorders and treated symptomatically. But confirmed with UGI and barium enema. 3.All cases had ipsilateral hypoplasia of entire lung or lower lobe as combined anomaly and corrected as simple closure in two cases, pericardial patch closure in one case. 4.Postoperative course was smooth and uneventful.

  • PDF

Knowledge of Colorectal Cancer Screening among Young Malaysians

  • Al-Naggar, Redhwan Ahmed;Bobryshev, Yuri V.
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.14 no.3
    • /
    • pp.1969-1974
    • /
    • 2013
  • The objective of this study was to determine the knowledge and associated factors regarding colorectal cancer screening among university students in Malaysia. The questionnaire consisted of three parts: socio-demographic characteristics, lifestyle practice and knowledge of colorectal screening. A cross-sectional study was conducted among 300 students ($21.3{\pm}1.4$ years old). The majority of the participants were Malay with a monthly family income of less than 5,000 Ringgit Malaysia (equal to 1,700 USD) (67.0% and 76.0%, respectively). Regarding their lifestyle practices, the majority were non-smokers and had never consumed alcohol (83.7%, and 88.0%, respectively). The majority of the participants had no knowledge of digital rectal examination, colonoscopy, barium enema and fecal occult blood screening (63.3%, 60.7%, 74.0% and 62.3%, respectively). Univariate and multivariate analysis revealed that their age and the discipline which the students were studying significantly influenced their level of knowledge about colorectal screening. The present study results indicate that education campaigns about colorectal cancer should be promoted.