• Advances in pediatric surgery
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• 제4권1호
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• pp.79-84
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• 1998

We have treated a case of pseudocyst of transverse mesocolon in 3-year-old male child. Operative findings demonstrated that the pseudocyst originated in the transverse mesocolon, and was not connected to the pancreas. A colonic duplication was found incidentally near the pseudocyst. On microscopic examination, ectopic pancreatic tissue was noted in the transverse mesocolon. This pseudocyst was thought to have originated from the ectopic pancreas of the transverse mesocolon. This is the first reported case of pseudocyst originated from ectopic pancreas of the transverse mesocolon, combined with a colonic duplication. The pathogenesis is discussed.

• Parasites, Hosts and Diseases
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• 제53권6호
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• pp.725-730
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• 2015

We report here an ectopic case of Fasciola hepatica infection confirmed by recovery of an adult worm in the mesocolon. A 56-year-old female was admitted to our hospital with discomfort and pain in the left lower quadrant of the abdomen. Abdominal CT showed 3 abscesses in the left upper quadrant, mesentery, and pelvic cavity. On surgical exploration, abscess pockets were found in the mesocolon of the sigmoid colon and transverse colon. A leaf-like worm found in the abscess pocket of the mesocolon of the left colon was diagnosed as an adult fluke of F. hepatica. Histologically, numerous eggs of F. hepatica were noted with acute and chronic granulomatous inflammations in the subserosa and pericolic adipose tissues. Conclusively, a rare case of ectopic fascioliasis has been confirmed in this study by the adult worm recovery of F. hepatica in the mesocolon.

• Journal of Trauma and Injury
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• 제35권4호
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• pp.291-296
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• 2022

The therapeutic approach for colon injury has changed continuously with the evolution of management strategies for trauma patients. In general, immediate laparotomy can be considered in hemodynamically unstable patients with positive findings on extended focused assessment with sonography for trauma. However, in the case of hemodynamically stable patients, an additional evaluation like computed tomography (CT) is required. Surgical treatment is often required if prominent mesenteric extravasation, free fluid, bowel infarction, and/or colon wall perforation are observed. However, immediate intervention in hemodynamically stable patients without indications for surgical treatment remains questionable. Three patients with colon and mesocolon injuries caused by blunt trauma were treated by nonoperative management. At the time of admission, they were alert and their vital signs were stable. Colon and mesocolon injuries, large hematoma, colon wall edema, and/or ischemia were revealed on CT. However, no prominent mesenteric extravasation, free fluid, bowel infarction, and/or colon wall perforation were observed. In two cases, conservative treatment was performed without worsening abdominal pain or laboratory tests. Follow-up CT showed improvement without additional treatment. In the third case, follow-up CT and percutaneous drainage were performed in considering the persistent left abdominal discomfort, fever, and elevated inflammatory markers of the patient. After that, outpatient CT showed improvement of the hematoma. In conclusion, nonoperative management can be considered as a therapeutic option for mesocolon and colon injuries caused by blunt trauma of selected cases, despite the presence of large hematoma and ischemia, if there are no clear indications for immediate intervention.

• Advances in pediatric surgery
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• 제10권1호
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• pp.47-51
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• 2004

Visceral lipoma originating from the mesentery is very rare in childhood. A 29-month-old male presented with painless abdominal distension. Abdominal ultrasonography and CT revealed a huge multilobulated hypodense mass in the peritoneal cavity. Exploratory laparotomy showed a $26{\times}25{\times}5cm$ sized encapsulated, lobulated, homogenous mass, which originated from the transverse mesocolon. Histologic examination revealed a lipoma. The postoperative course was uneventful.

• 대한영상의학회지
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• 제81권4호
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• pp.1013-1018
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• 2020

회충증은 Ascaris lumbricoides에 의하여 유발되는 장 질환이다. 대부분의 회충증 환자는 무증상이지만 장내 유충이 많은 경우에는 장 폐색, 폐쇄성 황달, 담관염, 담낭염, 췌장염과 같은 합병증이 생길 수 있다. 저자들은 컴퓨터단층촬영(이하 CT)에서 구불창자간막에 혈종과 활동성 출혈이 발생하여 회충증으로 진단된 74세 남자의 사례를 경험하였다. 이후에 환자가 시행한 CT에서는 이와 더불어 구불창자의 천공 발생이 확인되었다. 복강경을 통한 저위전방절제술이 시행되었고 구불창자간막에 큰 혈종이 있었으며 장간막 지방 조직에서 현미경적으로 회충이 확인되었다. 이러한 회충증의 드문 임상적, 영상의학적 소견은 기생충이 장관의 내강 안에서 복강 내로 이동하는 과정에서 발생한 순차적인 합병증들을 보여준다.

• Journal of Trauma and Injury
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• 제28권4호
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• pp.262-265
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• 2015

An arteriovenous fistula (AVF) from the renal artery following a penetrating abdominal trauma is not common. We report the case of a 19-year-old male who presented with a knife stab wound in the right upper quadrant. Due to unstable vital signs and to the protrusion of the mesentery through the stab wound, providing definite evidence of peritoneal violation, an emergent exploratory laparotomy was carried out. There were injuries at the proximal transverse mesocolon and the second portion of the duodenum, with bile leakage. There was also a mild amount of retroperitoneal hematoma near the right kidney, without signs of expansion or pulsation. The mesocolon and the duodenum were repaired. After the operation, abdominal computerized tomography (CT) was performed, which revealed contrast from the right renal artery shunting directly into the vena cava. Transcatheter arterial embolization with a coil and vascular plug was performed, and the fistula was repaired. The patient recovered completely and was discharged without complication. For further and thorough evaluation of an abdominal trauma, especially one involving the retroperitoneum, a CT scan is recommended, when possible, either prior to surgery or after surgery when the patient is stabile. Furthermore, a lateral retroperitoneal hematoma and an AVF after a penetrating trauma may not always require exploration. Sometimes, it may be safely treated non-operatively or with embolization.

• Advances in pediatric surgery
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• 제14권2호
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• pp.153-163
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• 2008

Inflammatory myofibroblastic tumor (IMT) is a rare reactive lesion characterized by the feature of myofibroblasts and a mixed inflammatory infiltrate that rarely undergoes malignant transformation. Extrapulmonary IMTs in children have been described involving the mesentery, omentum, retroperitoneum, abdominal soft tissues, liver, bladder, mediastinum, head and neck, extremity, appendix, and kidney. Medical records of children treated with abdominal IMT between 1985 and 2005 were reviewed retrospectively. Seven children were treated for IMT with the mean age of 3 y 2 m (range, 1 y 1 m to 14 y). Tumors were located in transverse mesocolon (n=2), omentum (n=1), porta hepatis (n=2), complex site (antrum, duodenum, common bile duct, porta hepatis) (n=2). The symptoms included abdominal mass, fever, jaundice, abdominal pain and anemia. The masses were excised totally in transverse mesocolon, omentum IMT and there is no evidence of recurrence (follow-up periods: 6 y 8 m, 8 y 9 m, 4 y 10 m). In porta hepatis IMT, liver transplantations were performed and there is no evidence of recurrence (follow period: 6 y 8 m, 8 y 7 m). In one case of complex site IMT, partial excision of mass was performed and he still survived with no change of the residual tumor during follow-up period. The other one of complex site IMT denied further treatment after the biopsy. In conclusion, complete surgical excision including liver transplantation and close follow-up are mandatory for the abdominal IMT in child.

• Advances in pediatric surgery
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• 제8권2호
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• pp.138-142
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• 2002

Mesenteric and omental cysts are rare intra-abdominal lesions in childhood, and may present various clinical features such as an asymptomatic mass or an acute abdomen. Therefore, these entities are frequently misdiagnosed preoperatively or are found only incidentally at operation for other conditions. We analyzed our experiences of 19 cases in a 19 year period from 1981 to 1999, at College of Medicine, Catholic University of Korea. There were 12 boys and 7 girls with a mean age of 4.8 years (range, 3 days to 15 years). Common presenting symptoms were abdominal pain (47%), abdominal distension (31%), abdominal mass (24%), vomiting (15%) and fever (10%). Ultrasonography was the most preferred method of diagnosis. Other diagnostic modalities include CT, MRI, and abdominal ascites tapping in selected patients. Location of the mesenteric cysts was small bowel mesentery in nine, the right mesocolon and retroperitoneum in one, the left mesocolon in one, and the jejunum, sigmoid-colon mesentery in one. Most of the patients underwent cyst excision, but six patients required concomitant bowel resection for complete removal of the lesions, and two patients underwent unroofing and simple aspiration respectively. There was one mortality case due to sepsis.

• Advances in pediatric surgery
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• 제14권2호
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• pp.196-199
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• 2008

Intraabdominal cystic lymphangioma is an uncommon lesion. It is usually found incidentally in patients presenting with an acute abdomen. Laparoscopic excision of intraabdominal cystic lymphangioma is an easy and safe procedure in children. We report one case of cystic lymphangioma in a 6.year-old female. The lesion was located on the left side of the transverse mesocolon. Laparocopic excision of the cyst was performed without complications.

• Parasites, Hosts and Diseases
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• 제35권1호
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• pp.63-66
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• 1997

고래회충의 유충감염증은 주로 위장관을 침범하여 육아종을 형성하고 급성복통 등 임상증상을 유발한다. 그러나 감염 일부에서 유충은 위장관 벽을 통과하고 복강내 기관에서 육아종을 형성하는 경우가 있으며 일본에서는 이러한 장외감염이 전체 고래회충중의 0.4%를 차지한다고 보고된 바 있다. 우리나라에서는 이와 같은 증례가 보고된 바 없어 이를 기록하고자 한다. 환자는 43세된 남자로 서울에 거주하며 입원 3주일 전부터 피곤감과 식욕녁진 증상이 나타나고 3일전부터는 혈 변이 있어서 복부 전산화 단층촬영을 시행한 결과 위 중간부 전벽에서 종양이 발견되었다. 종괴를 수술하는 과정에서 횡행결장간막의 림프절이 커진 것이 발견되어 생검하였다. 림프절의 크기는 $0.8{\;}{\times}{\;}0.6{\;}cm$였으며, 조직병리학적 검색 결과 호산구의 침윤이 심한 육아종이었고 육아종 중심에서 선충의 절편이 발견되었다. Y-자 모양의 측선 근육세포의 수와 모양, 배설세포의 모양과 크기, 전체 절편의 크기 등을 기초로 고래회충(Anisakis species) 유충으로 진단하였다. 그러나 이 환자의 주병변과 고래회충의 장외감염과는 관련이 없다고 생각하였다.