• 제목/요약/키워드: obstruction

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Ileal Fecaloma Presenting with Small Bowel Obstruction

  • Yoo, Ha Yeong;Park, Hye Won;Chang, Seong-Hwan;Bae, Sun Hwan
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제18권3호
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    • pp.193-196
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    • 2015
  • A fecaloma refers to a mass of accumulated feces that is much harder than a mass associated with fecal impaction. Fecalomas are usually found in the rectosigmoid area. A 10-year-old male with chronic constipation was admitted because of increasing abdominal pain. An abdominal computed tomography scan and a simple abdominal x-ray revealed rapidly evolving mechanical obstruction in the small intestine. Most of the fecalomas are successfully treated by conservative methods such as laxatives, enemas and rectal evacuation. When conservative treatments have failed, surgical intervention may be needed. In this case, an emergency operation was performed and a $4{\times}3{\times}2.5cm$ fecaloma was found in the distal ileum. We thus report a case of ileal fecaloma inducing small bowel obstruction in a patient with chronic constipation, who required surgical intervention. When symptoms of acute small intestinal obstruction develop in a patient with chronic constipation, a fecaloma should be considered in differential diagnosis.

요실금 수술후 발생한 요도 폐색에서 외요도구 상방 질벽을 통한 요도 박리술: 치험 1례 보고 (Suprameatal Transvaginal Urethrolysis in Urethral Obstruction Associated with Anti-incontinence Surgery: A Case Report)

  • 유진욱;정희창;박동춘
    • Journal of Yeungnam Medical Science
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    • 제16권2호
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    • pp.376-379
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    • 1999
  • 저자들은 전자궁적축술과 요실금 수술후 요도폐색이 발생한 43세의 여자 환자에서 장기간의 간헐적 자가도뇨법과 약물요법으로 치료되지 않아, 외요도구 상방을 통한 요도 박리술을 시행하여 좋은 결과를 볼 수 있었다. 저자들의 견해로는 과거에 부인과 수술과 동반해서 시행하거나 혹은 복측으로 치골후방으로 접근하여 시행한 요실금수술이나 요도하부 슬링수술등의 방법으로 인해 요도 폐색이 발생시 외요도구 상방을 통한 요도박리술이 바람직할 것으로 사료된다.

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엽절제술 후 기관지 꺾임에 의하여 발생한 기관지 폐쇄 1예 (A Case of Bronchial Obstruction Due to Bronchial Angulation after Upper Lobectomy)

  • 이호수;임지혜;김우진;신지훈;오연목
    • Tuberculosis and Respiratory Diseases
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    • 제66권3호
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    • pp.216-219
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    • 2009
  • 저자들은 우상엽의 거대 공기집을 제거하는 우엽절제술 후 우중간기관지의 꺾임에 의한 기관지 폐쇄가 발생하여 기관지 스텐트 삽입술로 폐쇄를 호전시킨 1예를 경험 하였기에 문헌고찰과 함께 보고하는 바이다.

누낭비강문합술(Dacryocystorhinostomy)을 이용한 비루관폐쇄 교정술식에 관한 고찰 (CLINICAL STUDY OF DACRYOCYSTORHINOSTOMY IN THE NASOLACRIMAL DUCT OBSTRUCTION PATIENT)

  • 허원실;이민정;오상윤;강승우;백경식
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제14권4호
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    • pp.322-326
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    • 1992
  • Epiphora is overflow of tears due to obstruction of lacrimal duct. Dacryocystorhinostomy is the most common procedure to eliminate the epiphora secondary to complete or partial obstruction of the nasolacrimal duct. The procedure is to artificially create passage between lacrimal sac and nasal cavity. Especially, epiphora would be accompany often by nasolacrimal duct obstruction when trauma of oromaxillofacial area lead to nasal fracture, medial wall fracture of orbit. Therefore in this case there are many case to perform dacryocystorhinostomy because probing and tubing is difficult to resolve the epiphora. We performed 4 cases of dacryocystorhinostomy for adult nasolacrimal duct obstruction from May 1991 to October 1991. The results were very satisfactory in all the case. Epipora disappeared in all case.

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3세 여아에서 발견된 십이지장 격막에 의한 십이지장 폐쇄: 증례 보고 (Duodenal Obstruction due to Duodenal Web in Three-year-old Girl: A Case Report)

  • 남소현;임윤정
    • Advances in pediatric surgery
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    • 제20권2호
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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.

코질환과 수면무호흡증 (Nasal Diseases and Its Impact on Sleep Apnea and Snoring)

  • 김창희;이재서
    • 수면정신생리
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    • 제11권1호
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    • pp.17-21
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    • 2004
  • Nasal congestion is one of the most common symptoms of medical complaints. Snoring is caused by vibration of the uvula and the soft palate. Nasal obstruction may contribute not only to snoring and obstructive sleep apnea (OSA) but also impair application of continuous nasal positive airway pressure (CPAP), which is the most widely employed treatment for OSA. Total or near-total nasal obstruction leads to mouth breathing and has been shown to cause increased airway resistance. However, the exact role of the nasal airway in the pathogenesis of OSA is not clear and there is no consensus about the role of nasal obstruction in snoring and sleep apnea. Some reports have failed to demonstrate any correlation between snoring and nasal obstruction. On the other hand, opposing reports suggest that nasal disease may cause sleep disorders and that snoring can be improved after nasoseptal surgery. Reduced cross-sectional area causes increased nasal resistance and predisposes the patient to inspiratory collapse of the oropharynx, hypopharynx, or both. Discrete abnormalities of the nasal airway, such as septal deformities, nasal polyps, and choanal atresia and with certain mucosal conditions such as sinusitis, allergic rhinitis and inferior turbinate hypertrophy can cause snoring or OSA. Thus, these sources of nasal obstruction should be corrected medically or surgically for the effective management of OSA and adjunctive for CPAP.

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Left Coronary Ostial Obstruction by a Dislocated Sutureless Aortic Valve Prosthesis: Redo Aortic Valve Replacement with Hybrid Coronary Revascularization: A Case Report

  • Seungmo Yoo;Hong Rae Kim;Jae Suk Yoo
    • Journal of Chest Surgery
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    • 제56권5호
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    • pp.359-361
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    • 2023
  • Coronary ostium obstruction due to dislodgement of the prosthetic valve is a rare and life-threatening complication, and particular caution is required for sutureless aortic valve replacement (AVR) with concomitant valvular surgery. In general, coronary artery bypass surgery is performed when coronary ostium obstruction occurs after AVR, but other options may need to be considered in some cases. Herein, we present a case of coronary artery occlusion in an 82-year-old female patient who had undergone AVR and mitral valve replacement for aortic valve stenosis and mitral valve stenosis at the age of 77 years. A hybrid procedure involving redo AVR and percutaneous coronary intervention after left main coronary ostium endarterectomy was performed. To summarize, we present a case of hybrid AVR in a patient with coronary artery obstruction after AVR that was successfully managed using this method.

Combining Hough Transform and Fuzzy Unsupervised Learning Strategy in Automatic Segmentation of Large Bowel Obstruction Area from Erect Abdominal Radiographs

  • Kwang Baek Kim;Doo Heon Song;Hyun Jun Park
    • Journal of information and communication convergence engineering
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    • 제21권4호
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    • pp.322-328
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    • 2023
  • The number of senior citizens with large bowel obstruction is steadily growing in Korea. Plain radiography was used to examine the severity and treatment of this phenomenon. To avoid examiner subjectivity in radiography readings, we propose an automatic segmentation method to identify fluid-filled areas indicative of large bowel obstruction. Our proposed method applies the Hough transform to locate suspicious areas successfully and applies the possibilistic fuzzy c-means unsupervised learning algorithm to form the target area in a noisy environment. In an experiment with 104 real-world large-bowel obstruction radiographs, the proposed method successfully identified all suspicious areas in 73 of 104 input images and partially identified the target area in another 21 images. Additionally, the proposed method shows a true-positive rate of over 91% and false-positive rate of less than 3% for pixel-level area formation. These performance evaluation statistics are significantly better than those of the possibilistic c-means and fuzzy c-means-based strategies; thus, this hybrid strategy of automatic segmentation of large bowel suspicious areas is successful and might be feasible for real-world use.

극소저출생체중아에서 태변에 의한 장폐색에 관한 연구 (Meconium Obstruction in Very Low Birth Weight Infants)

  • 홍기배;성인창;이건송;장영표;송희승
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제14권1호
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    • pp.52-58
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    • 2011
  • 목 적: 극소저출생체중아 태변 장폐색은 장관 영양을 지연시키고 장폐색을 유발하는 주요 원인 중 하나로 고삼투압 수용성 조영제 관장이 진단과 치료의 유용성에 대한 원칙은 아직 논란 중이다. 본 연구는 태변 장폐색을 보인 극소저출생체중아의 임상 소견을 관찰하고, 고삼투압 수용성 조영 관장 후 장폐색 증상 호전, 장관영양의 진행, 합병증 등을 관찰하고자 하였다. 방 법: 극소저출생체중아 중에 태변 장폐색으로 고삼투압 수용성 조영제 관장을 시행한 14명의 임상 소견과 방사선 소견, 장관 영양의 진행, 고삼투압 수용성 조영제 관장 치료 후 호전 여부, 고삼투압 수용성 조영제 관장과 연관된 합병증 등을 관찰하였다. 이들의 주요임상 소견을 장폐색 증상 없이 수유 진행이 가능하였던 극소저출생체중아 18명과 비교 하였다. 결 과: 1) 태변 장폐색을 보인 극소저출생체중아에서 태변 장폐색이 없었던 극소저출생체중아에 비해 낮은 5분 Apgar 점수를 보였다(p<0.05). 또한, 출생 후 마지막 태변 배출시기(일), 첫 수유 시작 시기(일), 전 장관 영양 도달 시기(일)들도 의미 있게 지연되었다(p<0.05). 2) 고삼투압 수용성 조영제 관장은 14명에서 18 회를 시행하였다. 18회 중 12회에서 조영제가 회장 말단에 도달하였으며 이 중 11회에서 관장 후 다량의 태변 배출과 함께 장폐색 증상의 호전이 있었으나, 1예는 호전이 없어 회장절개술로 태변을 제거하였다. 3) 조영제가 회장 말단에 도달 못한 5명 중 3명에서 증상의 호전이 없어 조영제 관장을 재시행 하여 조영제가 회장말단에 도달하였고 장폐색 증상이 호전되었다. 4) 고삽투압 수용성 조영제 관장과 연관된 특별한 합병증은 없었다. 결 론: 극소저출생체중아 태변 장폐색에서 고삼투압수용성 조영제 관장은 비교적 안전하게 시행할 수 있는 치료 방법이었다.