• Title/Summary/Keyword: lower abdominal pain

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The Effect of Ultrasound-guided TAPB on Pain Management after Total Abdominal Hysterectomy

  • Gharaei, Helen;Imani, Farnad;Almasi, Fariba;Solimani, Massoud
    • The Korean Journal of Pain
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    • v.26 no.4
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    • pp.374-378
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    • 2013
  • Background: Incisional pain is particularly troublesome after hysterectomy. A method called transversus abdominis plane block (TAPB) has shown promise in managing postoperative pain. In this study, we evaluated the analgesic efficacy of ultrasound-guided TAPB after hysterectomy at different time points and at each time point separately for 48 hours. Methods: Forty-two patients (ASA I, II) who were electively chosen to undergo total abdominal hysterectomy were divided into 2 groups, control (group C) and intervention (group I). Twenty-one patients underwent TAPB (group I) and 21 patients received only the standard treatment with a fentanyl pump (group C). Both groups received standard general anesthesia. For patients in group I, following the surgery and before emergence from anesthesia, 0.5 mg/kg of ropivacaine 0.2% (about 20 cc) was injected bilaterally between the internal oblique and transverse abdominis muscles using sonography. Pain scores using the Visual Analogue Scale (VAS) and drug consumption were measured at 2, 6, 12, 24, and 48 hours after TAPB. Results: There were no significant differences in demographics between the two groups. VAS scores appeared to be lower in group I, although there was no interaction with time when we compared mean VAS measurements at different time points between group I and group C (P > 0.05). The amount of fentanyl flow was consistently higher in group C, but when we compared the two groups at each time point separately, the observed difference was not statistically significant (P < 0.053). The incidence of vomiting was 10% in group I and 28% in group C. There were no complaints of itching, and sedation score was 0 to 3. There were no complications. Conclusions: This study showed that TAPB did not result in a statistically significant decrease in VAS scores at different time points. TAPB did lead to decreased fentanyl flow, but when we compared the two groups at each time point separately, the observed difference was not statistically significant.

The Effects of Abdominal Meridian Massage on Menstrual Cramps and Dysmenorrhea in Full-time Employed Women (복부 경락마사지가 직장여성의 생리통 및 월경곤란증에 미치는 영향)

  • Kim Jung-Soon;Jo Young-Ja;Hwang Sun-Kyung
    • Journal of Korean Academy of Nursing
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    • v.35 no.7
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    • pp.1325-1332
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    • 2005
  • Purpose: This study was designed to examine the effects of abdominal meridian(Kyongrak) massage on menstrual cramps and dysmenorrhea. Method: Eighty-five women (of 110 screened) enrolled in this study and were employed full-time with more than 6.0 points(in $0\~10.0$ VAS scale) in menstrual cramps or more than 20 points on the dysmenorrhea scale(range $13\~52$). The forty-two participants in the experimental group received abdominal meridian massage for 5 minutes per day during 6 days from the fifth day before menstruation to the first day of menstruation and the forty-three participants in the control group didn't receive any treatment. Data were collected from June 1st to August 30th, 2003 and analyzed using descriptive statistics, $x^2-test$, and t-test. Result: Menstrual cramps and dysmenorrhea of the experimental group were significantly lower after abdominal meridian massage than those of the control group (p<.001). Conclusion: Abdominal meridian(Kyongrak) massage was very effective for relief of menstrual cramps and dysmenorrhea. Therefore, we suggest that abdominal Kyongrak massage can be a useful nursing intervention for women with menstrual cramps or dysmenorrhea.

The Effect of Seating Surface Angle on the Deep Abdominal Muscle and Lower Limb Muscle Thickness in Normal Adults (앉는 면의 각도가 정상성인의 심부 복근과 다리근육 두께에 미치는 영향)

  • Ha, Seong-Yeong;Kim, Kyoung;Im, Sang-Cheol
    • Journal of The Korean Society of Integrative Medicine
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    • v.10 no.3
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    • pp.131-140
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    • 2022
  • Purpose : Although many studies have explored the effect of seating side angles on the spinal curve and surrounding muscles during seating, only a few studies have investigated the effect of different seating face angles on different lower limb and deep trunk muscles. Therefore, this study investigated the effects of seating surface angles (0 degrees, 10 degree anterior, and 10 degree rear) on lower extremity and deep trunk muscles in healthy adults. Methods : Thirty people were asked to sit once on each seating surface three times during the day, and their muscle thicknesses were measured by ultrasound while sitting. The method of sitting was the same when sitting on the three seating surfaces. Results : From the comparison results of the muscle thicknesses according to the seating surface angles, a significant difference existed in the muscle thicknesses of the vastus medialis, vastus medialis oblique, vastus intermedius, soleus and gastrocnemius (p<.05). However, no significant difference was found in the transversus abdominis, internal obliques, rectus femoris and vastus lateralis (p>.05). Conclusion : Our findings revealed that the lower back load decreases, the leg load increases, and the legs specific muscles are affected as the body tilts forward when sitting on the seating surface inclined forward. Therefore, it is possible to suggest a forwardly inclined seating surface that reduces lower back loads and utilizes the posture-maintaining muscles of the legs when sitting in a person with a poor sitting posture or lower back pain at ordinary times.

The Effects of Changes In Body Composition Through High Intensity Circuit Training On Spine Curvature And Low Back Pain Among Middle-Aged Men With Abdominal Obesity (고강도서키트트레이닝에 의한 신체조성의 변화가 복부비만 중년남성의 척추만곡도와 요부통증에 미치는 영향)

  • Kim, Chae-Won;Kim, Jung-Hoon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.5
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    • pp.346-356
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    • 2018
  • Overweight and abdominal obesity caused by sedentary lifestyle may induce deconditioned and atrophied extensor musculature of the lumbar spine and be a potential risk factor for low back pain (LBP). Therefore, this study was conducted to evaluate the validity of high intensity circuit training (HICT) on weight loss and subsequent alleviation of spine curvature (SC) and visual analog scale (VAS) among middle aged men with abdominal obesity. The training program (1 exercise session for 30 minutes, three times a week for 12 weeks) consisted of 12 different functional exercises based on core strengthening multiple joint circuit training. Portions of the obesity index related to body composition were positively changed, which improved the angles of thoracic kyposis and lumbar lordosis, which appeared to effectively reduce lower back pain. Taken together, HICT specifically designed for LBP effectively decreased obesity related body composition and was superior to other treatments for decreasing aggravation of the spine curvature and LBP caused by abdominal obesity; however, weight loss should be the primary treatment target for LBP patients.

Changing Prevalence of Helicobacter pylori Infections in Korean Children with Recurrent Abdominal Pain

  • Jang, Kyung Mi;Choe, Byung-Ho;Choe, Jae Young;Hong, Suk Jin;Park, Hyo Jung;Chu, Mi Ae;Cho, Seung Man;Kim, Jung Mi
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.18 no.1
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    • pp.10-16
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    • 2015
  • Purpose: The aim of this study is to investigate the changing prevalence rate of Helicobacter pylori infection in children, of different age groups, with recurrent abdominal pain over a 10-year period. Methods: Children with recurrent abdominal pain who visited the pediatric outpatient clinic at university hospital were screened for H. pylori. Children were divided into 3 age categories of 4-5, 6-11, and 12-16 years. To study the changes in the annual prevalence rates of H. pylori infection, the study period was divided into 3 time periods: 2004-2007, 2008-2010, and 2011-2014. Urea breath test was performed for all children aged 4-16 years, with a cut-off value of 4.0‰ for children aged ${\geq}6$ years and 7‰ for children aged <6 years. Results: A total of 2,530 children (1,191 boys) with a mean age of $10.0{\pm}3.0years$ (range, 4.0-16.9 years) were included in the study. The total prevalence of H. pylori infection was 7.4% (187/2,530). The prevalence rate of H. pylori infection in children with recurrent abdominal pain was 8.0% (70/873) in 2004-2007, 7.7% (51/666) in 2008-2010, and 6.7% (66/991) in the 2011-2014. Nevertheless, a significant difference was observed in the prevalence rate between children <12 years old and ${\geq}12$ years of age (p=0.018). Conclusion: The prevalence of H. pylori infection in Korean children with recurrent abdominal pain was 7.4%, showing no significant decrease in the last 11 years; however, the prevalence rate in children <12 years old was significantly lower than that in those ${\geq}12$ years old.

Nineth Rib Syndrome after 10th Rib Resection

  • Yu, Hyun Jeong;Jeong, Yu Sub;Lee, Dong Hoon;Yim, Kyoung Hoon
    • The Korean Journal of Pain
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    • v.29 no.3
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    • pp.185-188
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    • 2016
  • The $12^{th}$ rib syndrome is a disease that causes pain between the upper abdomen and the lower chest. It is assumed that the impinging on the nerves between the ribs causes pain in the lower chest, upper abdomen, and flank. A 74-year-old female patient visited a pain clinic complaining of pain in her back, and left chest wall at a 7 on the 0-10 Numeric Rating scale (NRS). She had a lateral fixation at T12-L2, 6 years earlier. After the operation, she had multiple osteoporotic compression fractures. When the spine was bent, the patient complained about a sharp pain in the left mid-axillary line and radiating pain toward the abdomen. On physical examination, the $10^{th}$ rib was not felt, and an image of the rib-cage confirmed that the left $10^{th}$ rib was severed. When applying pressure from the legs to the $9^{th}$ rib of the patient, pain was reproduced. Therefore, the patient was diagnosed with $9^{th}$ rib syndrome, and ultrasound-guided $9^{th}$ and $10^{th}$ intercostal nerve blocks were performed around the tips of the severed $10^{th}$ rib. In addition, local anesthetics with triamcinolone were administered into the muscles beneath the $9^{th}$ rib at the point of the greatest tenderness. The patient's pain was reduced to NRS 2 point. In this case, it is suspected that the patient had a partial resection of the left $10^{th}$ rib in the past, and subsequent compression fractures at T8 and T9 led to the deformation of the rib cage, causing the tip of the remaining $10^{th}$ rib to impinge on the $9^{th}$ intercostal nerves, causing pain.

A Retrospective Analysis of Inpatients who Received Traditional Korean Medicine Treatment after a Traffic Accident during Pregnancy (임신 중 교통사고로 한방 치료를 받은 입원 환자에 대한 후향적 분석)

  • Yoon, Hee-Jae;Yoo, Jeong-Eun
    • The Journal of Korean Obstetrics and Gynecology
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    • v.34 no.2
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    • pp.31-47
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    • 2021
  • Objectives: This study aimed to report the effectiveness and outcome on the prognosis of pregnancy of traditional Korean medicine treatment for inpatients who had a traffic accident during pregnancy. Methods: The study is conducted by analyzing the medical records of hospitalized patients in a Korean medicine hospital. Seventy-six pregnant patients who got into car accidents from March 2015 to February 2020 were included. We performed statistical analysis by using Statistical Package for the Social Sciences(SPSS) ver. 25.0. To verify the effect of traditional Korean medicine treatment for traffic accidents during pregnancy, we analyzed improvement of symptoms. Also, we analyzed the prognosis of pregnancy and signs of premature birth or miscarriage during treatment to verify the applicability of traditional Korean medicine treatment for traffic accidents during pregnancy. Results: Among the symptoms of pain, there was a statistically significant decrease in lower back pain, post neck pain, headache, pelvic pain, knee pain, lower limb pain, wrist pain, and upper limb pain. Other systemic symptoms showed statistically significant improvement in nausea, abdominal pain, dizziness, and lower limb numbness. All confirmed cases reported normal pregnancy maintenance and delivery, and no miscarriage was reported. Two cases that showed signs of premature birth or miscarriage during treatment were unrelated or unclear with traditional Korean medicine treatment. Conclusions: Traditional Korean medicine treatment is effective and applicable for pregnant women injured by traffic accidents. Further studies are needed to identify the effectiveness and safety of traditional Korean medicine treatment for the sequelae of traffic accidents during pregnancy.

Sertoli-Leydig Cell Tumor of the Ovary in a 4 year-old Girl - A Case Report - (4세 영아의 난소에서 발생한 Sertoli-Leydig 세포 종양 -1예 보고-)

  • Kim, Hye-Jin;Choe, Byung-Ho;Park, Jin-Young
    • Advances in pediatric surgery
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    • v.15 no.1
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    • pp.73-79
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    • 2009
  • Sertoli-Leydig cell tumor is a rare sex-cord stromal tumor of the ovary. They make up less than 0.5 % of all ovarian tumors. We experienced a case of an ovarian Sertoli-Leydig cell tumor in a 4 year-old girl who presented with nausea, vomiting, and lower abdominal pain of 2 days' duration. On physical examination, there was mild tenderness in the right lower quadrant of the abdomen. Abdominal ultrasonography and computed tomography (CT) scan revealed a pelvic mass measuring $5{\times}3cm$ that appeared to arise from the right ovary. At exploratory laparotomy, a $6{\times}5{\times}3cm$ solid right ovarian mass without torsion was found. A right salpingo-oophorectomy was performed. The postoperative course was uneventful. The child was discharged 5 days after surgery.

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Infected Abdominal Aortic Aneurysm (감염성 복부 대동맥류 -수술치험 1례 보고-)

  • 김경렬;최세영
    • Journal of Chest Surgery
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    • v.29 no.3
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    • pp.342-345
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    • 1996
  • Mycotic anuerysms are uncommon but it is a fulminant infectious process frequently resulting in rupture and death if not properly treated. Commonly known it as infected aneurysm caused by noncardiogenic bacteremia. We experienced a case of infected aneurysm of the abdominal aorta that ruptured into the retroperitoneum. A 57 year old man was admitted with lower back pain, fever and palpable mass. It was identified as an inf cted abdominal aneurysm with staphylococcal septicemia. He underwent resection of aneurysm and replacement with a prosthetic graft and prolonged postoperative organism-specific antibiotics therapy. He recovered well and discharged without complications postoperatively.

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Surgical Repair of Aortocaval Fistula Presenting with Cardiogenic Shock

  • Kim, In Ha;Min, Ho-Ki;Kim, Ji Yong;Kim, Dong-Kie;Kang, Do Kyun;Jun, Hee Jae;Hwang, Youn-Ho
    • Journal of Chest Surgery
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    • v.51 no.6
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    • pp.406-409
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    • 2018
  • Aortocaval fistula (ACF) occurs in <1% of all abdominal aortic aneurysms (AAAs), and in 3% to 7% of all ruptured AAAs. The triad of clinical findings of AAA with ACF are abdominal pain, abdominal machinery bruit, and a pulsating abdominal mass. Other findings include pelvic venous hypertension (hematuria, oliguria, scrotal edema), lower-limb edema with or without arterial insufficiency or venous thrombus, shock, congestive heart failure, and cardiac arrest. Surgery is the main treatment modality. We report successful surgical treatment in a patient with a ruptured AAA with ACF who presented with cardiogenic shock.