• Title/Summary/Keyword: physical examination of abdomen

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Traumatic Cervical Spinal Cord Injury Patient with Jejunal Perforation (외상성 경부 척수 손상 환자에서 동반된 소장 천공 : 증례보고)

  • Go, Seung Je;Yoon, Jeung Seuk;Yun, Jung Ho
    • Journal of Trauma and Injury
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    • v.26 no.4
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    • pp.319-322
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    • 2013
  • A 66 year-old woman had cervical spinal cord injury by an automobile. We performed emergency operation for partial quadriplegia. She recovered from motor weakness gradually, but complained of abdominal distension and mild dyspnea. A physical examination of her abdomen did not have tenderness and rebound tenderness. She underwent a decubitus view of chest X-ray due to aggravated dyspnea at postoperative 4 days. We detected free air gas of abdomen and immediately identified a cause of pneumoperitoneum by abdominal computed tomography. We performed an emergent laparotomy and confirmed a jejunal perforation. After an operation, she recovered well and is under rehabilitation.

Primary Omental Torsion (대망염전)

  • Kim, Seong-Chul;Kim, In-Koo
    • Advances in pediatric surgery
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    • v.3 no.1
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    • pp.68-70
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    • 1997
  • One case of primary omental torsion in a 10 year-old, 43 kg boy is presented. He presented with a history of acute, continuous pain in the upper abdomen, aggravated by changes of position. Physical examination of his abdomen showed board-like rigidity. tenderness and rebound tenderness over the entire abdomen. The preoperative diagnosis was perforated peptic ulcer. Exploratory laparatomy revealed torsion of the greater omentum. The torsed omentum was excised and the outcome was good. Omental torsion is a rare surgical condition and is difficult to diagnose prior to operation. Therefore, in case of negative exploration for acute abdomen, the omentum should be included among the organs examined. In addition, careful search for an inflammatory focus should be made, because secondary omental torsion with intraabdominal sepsis is much more common than primary torsion.

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Diagnostic Strategy of Primary Site in Metastatic Bone Tumor (전이성 골종양에서 원발병소의 진단)

  • Shin, Kyoo-Ho;Suh, Ki-Won;Jahng, Jun-Seop
    • The Journal of the Korean bone and joint tumor society
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    • v.3 no.2
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    • pp.98-104
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    • 1997
  • We carried out a prospective study of the effectiveness of a diagnostic strategy in thirty consecutively seen patients who had skeletal metastasis. The diagnostic strategy consisted of the recording of a medical history, physical examination, routine laboratory analysis, plain radiography of the involved bone and chest, whole-body technetium-99m-phosphonate bone scintigraphy, abdominal ultrasound, computed tomography of the chest, abdomen and pelvis, fiberbronchoscopy and fibergastroscopy. After this evaluation, a biopsy of the most accessible osseous lesion was done in twenty four patients. On the basis of the our diagnostic strategy, we were able to identify the primary site of the malignant tumor in nineteen patients(63%). The laboratory values were non-specific in all patients. The history and physical examination revealed the occult primary site of the malignant tumor in one patient(3.3%) who had carcinoma of the breast. Plain radiographs of the chest established the diagnosis of carcinoma of the lung in three patients(9.9%). Computed tomography of the chest identified an additional three primary carcinoma of the lung(9.9%). Fiberbronchoscopy identified an additional one primary carcinoma of the lung(3.3%). Abdominal ultrasound established the diagnosis in three patients(9.9%). Computed tomography of the abdomen and pelvis established the diagnosis in four patients(13.2%). Fibergastroscopy established the diagnosis in two patients(6.6%). Examination of the biopsy tissue established the diagnosis in one patient(3.3%). So we recommend to perform plain radiographs of chest, abdominal ultrasound, chest C-T, abdomino-pelvic C-T, fiber-bronchoscopy, fibergastroscopy sequentially.

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Suspected Unilateral Renal Dysplasia in a Cat with Intermittent Hematuria (혈뇨를 보이는 고양이의 편측성 신장이형성 증례)

  • Han, Jae-Ik;Na, Ki-Jeong
    • Journal of Veterinary Clinics
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    • v.32 no.1
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    • pp.91-93
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    • 2015
  • A 6-month-old, castrated male, Korean short-haired cat was referred with intermittent hematuria. Physical and laboratory examination including complete blood count and serum biochemistry profiles showed no specific findings. Ultrasonography revealed a cystic lesion of the mid-abdomen, which was approximately $2{\times}2cm$ in size. FNA cytology of cystic fluid showed numerous cholesterol crystals of varying size and shape and granulomatous inflammation. CT examination showed fluid-filled large cystic lesion in the left side of the abdomen. Taken together, this case was diagnosed as unilateral (left) renal dysplasia and cystic inflammation led by cholesterol crystallization in the left kidney.

고양이에서 발생한 Perinephric pseudocysts와 선천성 Peritoneo-pericardial Kiaphragmatic Hernia in Cat

  • 김상기
    • Journal of Veterinary Clinics
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    • v.14 no.1
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    • pp.6-10
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    • 1997
  • An 8-year old castrated domestic long-hair cat was presented with a two week history of abdominal distension. Physical examination revealed a non-painful, fluctuant, palpable mass in the right craniodorsal abdomen, and unilaterally muffled heart sounds on the right thorax. Routine clinico-pathological values were unremarkable apart from mild azotemia with a concurrent urine specific gravity of 1.031, which reflect a degree of renal dysfunction. Radiographic and ultrasound examinations of the thorax revealed the cardiac enlargement to be due to the congenital peritoneo-pericardial diaphragmatic hernia with liver occupying the right half of the pericardial sac. There was also a mild gypertrophy of the heart. Radiography and ultrasonography of the abdomen showed the mass to be composed of a large fluid filled cystic structures surrounding the right and left kidneys, and the kidneys themselves were of increased echogenecity. A diagnosis of perinephric pseudocysts was made. The patient responded well to the surgical procedures. Perinephric pseudocysts and peritoneo-pericardial diaphragmatic hernia in the cat are rare, and a case is described and the literature is reviewed in this report.

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Diagnosis of Cholangiocellular Carcinoma in a Dog (개에 발생한 간내 담관상피암의 진단예)

  • 이현범;장인호;장종식
    • Journal of Veterinary Clinics
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    • v.14 no.1
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    • pp.123-125
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    • 1997
  • A 5-years-old female pointer dog was submittedto the hospital with the disease history of gradual distension of abdomen and emaciation for two months. An applesized hard mass was palpated on the right costal arch on physical examination. On blood chemical analysis, the marked elevation of SALT and decrease in serum albumin were detected. On paracentesis, a large volume of blood tinged fluid was detected. The peritoneal fluid contained tumor cells and the numerous blood cells. At autopsy the tumor mass located in the left medial lobe of liver was whitish and firm, and was consisted of many cysts. Histologically the tumor was identified as typical cholangiocellular carcinoma. Metastatic lesions of the tumor were detected in the lung, stomach, spleen, diaphragm, and lymph glands. This observation indicates that the cytological examination of the abdominal fluid have a diagnostic significance in the clinical examination of patients with abdominal tumors.

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Clinical and Radiologic Characteristics of Caudal Regression Syndrome in a 3-Year-Old Boy: Lessons from Overlooked Plain Radiographs

  • Kang, Seongyeon;Park, Heewon;Hong, Jeana
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.24 no.2
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    • pp.238-243
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    • 2021
  • Caudal regression syndrome (CRS) is a rare neural tube defect that affects the terminal spinal segment, manifesting as neurological deficits and structural anomalies in the lower body. We report a case of a 31-month-old boy presenting with constipation who had long been considered to have functional constipation but was finally confirmed to have CRS. Small, flat buttocks with bilateral buttock dimples and a short intergluteal cleft were identified on close examination. Plain radiographs of the abdomen, retrospectively reviewed, revealed the absence of the distal sacrum and the coccyx. During the 5-year follow-up period, we could find his long-term clinical course showing bowel and bladder dysfunction without progressive neurologic deficits. We present this case to highlight the fact that a precise physical examination, along with a close evaluation of plain radiographs encompassing the sacrum, is necessary with a strong suspicion of spinal dysraphism when confronting a child with chronic constipation despite the absence of neurologic deficits or gross structural anomalies.

Study on the Development of a Questionnaire Software for Health Examination in Oriental Medicine (한방건강검진 소프트웨어 개발에 관한 연구)

  • Moon, Jin-Seok;Park, Kyung-Mo;Choi, Sun-Mi
    • Korean Journal of Oriental Medicine
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    • v.13 no.2 s.20
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    • pp.135-142
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    • 2007
  • General health exanimation comes into operation to focus on physical inspection for industrial workers and doesn't contain oriental health care. Thus we need information of health status and disease prevention, so develop a questionnaire software for health examination in oriental medicine. Items of this soft ware consists of personal information and symptoms to could check oneself , pulse and tongue diagnosis by oriental medical doctor. Symptoms are made up of syndrome differentiation about Qi and blood, Yin and Yang, body fluid, five Zang organs, Sasang Constitutional Medicine. And we reconstruct 116 items by whole body, chest and abdomen, urine and feces, head, limbs, waist and back, five sensory organs, objective signs. A subject enter symptoms and a oriental medical doctor input diagnosis of pulse and tongue, then this software return the result of health index and explanation for oriental health care. This software would be used as tool not only health examination but also clinical research.

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Mesenteric torsion in a Miniature Schnauzer (Miniature Schnauzer에서 발생한 장간막 염전 1증례)

  • Choi, Jihye;Kim, Hyunwook;Kim, Jinkyung;Jang, Jaeyoung;Kim, Junyoung;Yoon, Junghee
    • Korean Journal of Veterinary Research
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    • v.48 no.1
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    • pp.125-130
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    • 2008
  • Mesenteric torsion was diagnosed in a 2-year-old, spayed female Miniature Schnauzer. The patient was presented with acute depression, vomiting, lethargy and hematochezia. On physical examination, severe dehydration, tachycardia, tachypnea, weak femoral pulse, delayed capillary refill time and pale mucous membrane were found and the dog was in shock. Radiography and ultrasonography revealed intestines distended with gas, ascites and the "C" shaped distended intestine. Medical treatments including fluid therapy, analgesics, antibiotics and lidocaine for reducing reperfusion injury were applied. And then, the mesenteric torsion was definitively diagnosed through exploratory laparotomy and intestinal resection and anastomosis were performed. The dog made an uneventful recovery and was free of clinical sign one week after surgery. Mesenteric torsion is an unusual and life-threatening disease in dogs. It has usually been described in the middle and large breed dogs, especially German Shepherds. However, the mesenteric torsion should be included in the differential diagnostic lists for acute abdomen even in small breed dog. The mortality rate of mesenteric torsion can be reduced through prompt diagnosis, proper preventive therapy for shock and reperfusion injury and emergency surgery.

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.