• Title/Summary/Keyword: perforation

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Clinical Review of Spontaneous Gastric Perforation in the Newborn (신생아 위 자연천공에 대한 임상적 고찰)

  • Hwang, Seung-Wook;Park, Jin-Young;Chang, Soo-Il
    • Advances in pediatric surgery
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    • v.9 no.1
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    • pp.30-34
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    • 2003
  • Spontaneous gastric perforation in the newborn is a rare disease that requires early diagnosis and prompt surgical treatment. Between 1988 and 2001 at the Department of Pediatric Surgery. Kyungpool National University Hospital, 9 cases of spontaneous gastric perforation were treated. Seven were males and two females. The mean gestational age and birth weight were 36.7 weeks and 2,455 g respectively. All patients presented with severe abdominal distention and pneumoperitoneum on cross table lateral film of the abdomen. Perforations were located on the anterior wall along the greater curvature of the stomach in six and on the posterior wall along the greater curvature in two. One case showed two sites of perforation on the anterior and posterior wall along the greater curvature. Six patients were managed with debridement and primary closure and the others with debridement and partial gastrectomy. Peritoneal drainage was not performed. There were four deaths; two from sepsis due to leakage from the anastomotic site, one as a result of acute renal failure, and the other by associated respiratory distress syndrome. Spontaneous gastric perforation in the newborn is usually located along the greater curvature. Elevated intragastric pressure is a possible cause of the perforation. Poor prognosis is related to associated diseases and prematurity.

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Management of Esophageal Perforation: Analysis of the Risk Factors Affecting the Outcome (식도 천공의 치료와 예후에 영향을 미치는 인자의 분석)

  • Park, Kyoung-Taek;Han, Il-Yong;Cho, Kwang-Hyun
    • Korean Journal of Bronchoesophagology
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    • v.16 no.2
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    • pp.126-130
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    • 2010
  • Background: The esophageal perforation is related to high morbidity and mortality rates if the diagnosis and treatment are delayed. The aim of this study is to evaluate the affecting factors on outcome and prognosis of the patients who suffer from esophageal perforation. Material and Methods: Twenty-six patients were treated with esophageal perforation in our institute from Jan. 1992 to Feb. 2010. We retrospectively reviewed the results of treatment for esophageal perforation to understand the risk factors affecting survival in patients. Results: The subjects are 26 patients suffered with esophageal perforation and the mean age is $52{\pm}17.8$ years old. 16 esophageal perforations were caused spontaneously, 25 cases were treated surgically. The mortality rate is higher in the cases o pre-operative mediastinitis. Conclusion: The shortness time interval until the beginning of treatment should be achieved to reduce the incidence of fatal post-treatment morbidity and mortality.

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Periodontal healing following non-surgical repair of an old perforation with pocket formation and oral communication

  • Asgary, Saeed;Verma, Prashant;Nosrat, Ali
    • Restorative Dentistry and Endodontics
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    • v.43 no.2
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    • pp.17.1-17.7
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    • 2018
  • Iatrogenic perforations negatively impact the outcome of endodontic treatments. Studies on prognostic factors showed that perforations in the coronal third of the root with periodontal pocket formation have an unfavorable prognosis. A 36-year-old female was referred for endodontic evaluation of tooth #13 with a history of an iatrogenic perforation, happened 3 years ago. There was a sinus tract associated with perforation, 10 mm probing on the mesial and mesio-palatal, bleeding on probing, radiolucent lesion adjacent to the perforation and complete resorption of the interdental bone between teeth #13 and #12. After the treatment options were discussed, she chose to save the tooth. The tooth was accessed under rubber dam isolation, the perforation site was cleaned and disinfected using 0.5% sodium hypochlorite and sealed with calcium-enriched mixture cement. Eighteen months after treatment the tooth was functional and asymptomatic. The probing depths were normal without bleeding on probing. Radiographically, the interdental crestal bone formed between teeth #13 and #12. Despite all negative prognostic factors in this case (i.e., perforations in the coronal third, pocket formation, and radiolucent lesion), healing was unexpectedly achieved via non-surgical repair of the perforation. Further research on biological aspects of healing in the periodontium following iatrogenic perforations are recommended.

A case report of gastrointestinal perforation in patient after biliary stent insertion and the overview of gastrointestinal perforation (담도 스텐트 시술 후 장천공 증례보고 및 장천공에 대한 고찰)

  • Ga-Young Lee;Chan-Ran Park;Jung-hyo Cho;Chang-gue Son;Nam-hun Lee
    • The Journal of Korean Medicine
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    • v.43 no.3
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    • pp.195-203
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    • 2022
  • Objectives: This study aimed to emphasize the importance of accurate and timely diagnosis of acute abdominal pain with simple radiography by reporting a case of gastrointestinal perforation. Methods: We closely observed the diagnosis and progress of acute abdominal pain after biliary stent and reviewed the outline of gastrointestinal perforation. Results: Patient diagnosed with urethral cancer metastasis to lung and peritoneum was treated with complex Korean medicinal treatments to deal with anorexia, abdominal pain, jaundice and oliguria. During hospitalization, the patient's acute abdominal pain after biliary stent was diagnosed with gastrointestinal perforation by using plain chest and abdominal radiography. Conclusion: Using simple radiography to find out the emergency diseases such as perforation in acute abdominal pain is important clinically.

Vibrations and stress analysis of perforated functionally graded rotating beams

  • Alaa A. Abdelrahman;Hanaa E. Abd-El-Mottaleb;Mohamed G. Elblassy;Eman A. Elshamy
    • Steel and Composite Structures
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    • v.49 no.6
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    • pp.667-684
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    • 2023
  • In the context of finite element method, a computational simulation is presented to study and analyze the dynamic behavior of regularly perforated functionally graded rotating beam for the first time. To investigate the effect of perforation configurations, both regular circular and squared perforation patterns are studied. To explore impacts of graded material distributions, both axial and transverse gradation profiles are considered. The material characteristics of graded materials are assumed to be smoothly and continuously varied through the axial or the thickness direction according the nonlinear power gradation law. A computational finite elements procedure is presented. The accuracy of the numerical procedure is verified and compared. Resonant frequencies, axial displacements as well as internal stress distributions throughout the perforated graded rotating cantilever beam are studied. Effects of material distributions, perforation patterns, as well as the rotating beam speed are investigated. Obtained results proved that the graded material distribution has remarkable effects on the dynamic performance. Additionally, circular perforation pattern produces more softening effect compared with squared perforation configuration thus larger values of axial displacements and maximum principal stresses are detected. Moreover, squared perforation provides smaller values of nondimensional frequency parameters at most of vibration modes compared with circular pattern.

Cervical Esophageal Perforation after Blunt Trauma (둔상에 의한 경부 식도 파열)

  • Cho, Hyun-Min;Kim, Young-Jin
    • Journal of Trauma and Injury
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    • v.24 no.1
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    • pp.45-47
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    • 2011
  • Esophageal perforation due to blunt trauma is rare. A 67-year-old male presented to Konyang University Hospital with painful neck swelling. His neck was injured by blunt trauma at work. Esophageal perforation was detected by neck CT and esophagography. We performed primary repair of cervical esophagus through the Lt. neck approach. The postoperative course was uneventful and the patient was discharged at postoperative day 15.

Sigmoid Colon Perforation by a Distal Ventriculoperitoneal Shunt Catheter (뇌실복강간단락술 원위 도관에 의한 구불결장의 천공)

  • Shin, Dong-Keun;Kim, Seong-Ho
    • Journal of Yeungnam Medical Science
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    • v.25 no.2
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    • pp.171-174
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    • 2008
  • We report an unusual case of a sigmoid colon perforation after ventriculoperitoneal shunt surgery. Distal catheters are known to cause perforation in the setting of colonoscopy. The exact pathogenesis of this complication is not clear, but it can cause serious complications. Hence, patients require prompt and aggressive management, including laparotomy with bowel wall repair, catheter removal, and antibiotic therapy.

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Rupture of the Esophagus by Compression Air; A Case Report (압축공기에 의한 식도 파열;1례 보고)

  • 구자홍
    • Journal of Chest Surgery
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    • v.26 no.6
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    • pp.507-509
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    • 1993
  • Esophageal perforation, regardless of the etiology, is a catastrophic event. The importances of early diagnosis and an aggressive surgical approach in the management of such a potentially lethal situation are stressed, in fact the mortality rate is directly related to the interval between perforation and initiation of treatment. We experienced a rare case of esophageal rupture caused by compressed air which produce a rupture of the colon not infrequently, which was treated successfully by an aggressive surgical approach consisting of closure of the perforation and adequate drainage.

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A CLINICAL AND RADIOLOGICAL STUDY ON THE INTERNAL DERANGEMET OF TMJ (악관절 내장증의 임상 및 방사선학적 연구)

  • Han Won-Jeong;Kim Eun-Kyung
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.22 no.2
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    • pp.351-364
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    • 1992
  • Internal derangement of the temporomandibular joint can be defined an abnormal relationships of the meniscus relative to the mandibular condyle, articuar fossa and eminence. This may cause variable mandibular dysfunctions and pain. For diagnosis, arthrography, computed tomography and magnetic resonance imaging are used. In this study, the author reviewed 98 TMJs of 88 patients who were diagnosed as internal derangement througth inferior joint space arthrography at the department of Oral & Maxillofacial Radiology, Dental Hospita, Dankook university through 1986 to 1992. 98 TMJs consisting of 30 disc displcement with reduction, 48 disc displcement without reduction and 20 perforation were studied about clinical and radiological findings. The results were as follows: 1. Internal derangement was found most frequently in the 2nd 3rd decades and the average age of perforation was higher than that of disc displcement with higher than that of disc displcement with reduction. The sexual predilection was 2 times hiher in females. 2. The most frequent chief complaints were TMJ sound in disc displcement with reduction, pain and limitation of mouth opening in disc displcement without reduction and pain in perforation. The duration of the chief complaints was longer in disc displcement with reduction with than in preforation and disc displcement without reduction. 3. Reciprocal click was the most frequently TMJ sound in disc displcement with reduction. History of joint sound in disc displcement without reduction an crepitus in perforation was the most frequent one. 4. The average maximum opening was 45.4㎜ in disc displcement with reduction, 31.4㎜ in disc displcement without reduction and 33.8㎜ in perforation. 5. In the centric occlusion, posterior condylar position was the most frequent in disc displcement with reduction. posterior and concentric condylar position was frequent in disc displcement without reduction, concentric and anterior condylar position in perforation. At 1 inch opening, the same position to articular eminence was most frequently found in disc displcement with reduction, posterior position in disc disp1cement without reduction, posterior and nterior position in perforation was frequently found. 6. Bony changes, especially sclerosis and flattening, was most frequently found in perforation.

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Surgical Evaluation of Iatrogenic Hypopharyngo-esophageal Perforation (의인성 하인두-식도천공에 대한 외과적 고찰)

  • Park Jae Kil;Cho Kyu Do;Park Kuhn;Wang Young Pil
    • Korean Journal of Bronchoesophagology
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    • v.10 no.2
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    • pp.28-34
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    • 2004
  • Background : Esophageal perforation due to a traumatic endoscopy or intubation is exceedingly rare. If riot noticed immediately or treated promptly, however, the morbidity and mortality is significant. We performed a retrospective review of patients with iatrogenic hypopharyngo-esophageal perforation to assess the outcome of current management techniques. Material and Methods : We retrospectively analyzed all cases iatrogenic hypopharyngo-esophageal perforation diagnosed at our hospital from January, 1999, through April, 2004. The study group consisted of 11 patients (4 men) with a mean age of 47.6 years (range, 21-83 yr). We reviewed the 11 patients with perforated injuries of the hypopharynx or esophagus during the diagnostic or therapeutic procedures. Result: Perforations were due to diagnostic gastroscopy ($54.5\%$, 6/11), esophageal dilation ($27.3\%$, 3/11), endoscopic port insertion ($9.1\%$, l/11), and tracheal intrathoracic ($9.1\%$, 1/11). Seven patients had intrathoracic and 4 had cervical perforations. Treatment included incision and drainage (5), resection and reconstruction (4), drainage only (1), and observation (2). Nonfatal complications included transient pneumonia (1), and wound infection (1). They occurred in advanced mediastinal abscess ]patients. Mortality was $9.1\%$ (1/11) in old patient who managed medically in cervical esophageal perforation. Conclusions : Current mortality rates in iatrogenic esophageal perforation were improved compared to previous published rates of $19\%\;to\;66\%$ for all patients with this condition. We concluded that aggressive and definitive surgery for thoracic esophageal perforations improving the survival rate, whether diagnosed early or late.

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