• Title/Summary/Keyword: 장간막

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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.

Pharyngoesophageal Reconstruction Using Modified Jejunomesenteric Composite Free Flap (변형된 공장-장간막 복합 유리피판을 이용한 인두식도 재건)

  • Lim, Jin Soo;Yoo, Gyeol
    • Archives of Craniofacial Surgery
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    • v.9 no.2
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    • pp.110-113
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    • 2008
  • Purpose: The jejunal free flap is the most standard and reliable procedure of reconstruction of the circumferential pharyngoesophageal defect because it provides pliable, elastic, secreting mucosa and posses reliable vascular anatomy. In this report, the authors introduce the modification of jejunal free flap for decreasing the complications in fatty complicated patients. Method: After harvesting the jejunum with mesentery and mesenteric vessels, both ends of jejunum were excised remaining the mesenteric portion. The jejunal portion of this composite flap was placed to reconstruct esophagopharyngeal defect area and the mesenteric portion was used to obliterate the dead space at paratracheal region and to cover the vital structure and the vascular anastomotic region. Result: A 72 year-old man with recurrent hypopharyngeal cancer who had about 15 cm sized circumferential pharyngoesophageal defect after total pharyngectomy was reconstructed with jejunomesenteric composite free flap without any complications. Conclusion: The mesenteric flaps at both side of jejunomesenteric composite free flap provide the advantages that could obliterate dead space, that could provide cover for the vital cervical vascular structure in case of vascularity was compromised due to previous radiation therapy, and that could preserve as much vascularity at both ends of jejunal flap as possible.

Non-occlusive Mesenteric Ischemia (NOMI) Secondary to Traumatic Hemorrhagic Shock: Case Report (외상성 출혈성 쇼크 환자에서 발생한 비 폐쇄성 장간막 허혈)

  • Lim, Kyoung Hoon;Jung, Hee Kyung;Cho, Jayun;Lee, Sang Cjeol;Park, Jinyoung
    • Journal of Trauma and Injury
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    • v.27 no.4
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    • pp.204-207
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    • 2014
  • Non-occlusive mesenteric ischemia (NOMI) encompasses all forms of mesenteric ischemia with patent mesenteric arteries. NOMI is commonly caused by decreased cardiac output resulting in hypoperfusion of peripheral mesenteric arteries. We report a case of NOMI secondary to hemorrhagic shock and rhabdomyolysis due to trauma. A 42-year-old man presented to our trauma center following a pedestrian trauma. On arrival, he was drowsy and in a state of hemorrhagic shock. He was found to have multiple fractures, both lung contusion and urethral rupture. An initial physical examination and abdominal computed tomography (CT) scan revealed no evidence of intra-abdominal injury. High doses of catecholamine were administered for initial 3 days due to unstable vital sign. On day 25 of hospitalization, follow-up abdominal CT scan demonstrated that short segment of small bowel loop was dilated and bowel wall was not enhanced. During exploratory laparotomy, necrosis of the terminal ileum with intact mesentery was detected and ileocecectomy was performed. His postoperative course was uneventful and is under rehabilitation.

Scutellaria baicalensis Modulates Cytokine Production, T Cell Population and Immunoglobulin Level by Mesenteric Lymph Node Lymphocytes in Experimental Mice with Colitis (한약재인 황금의 궤양성 실험동물에 대한 장간막 임파절 임파구의 면역글로블린 수준, T세포집단, 사이토카인 생성의 조절작용)

  • Lim, Beong-Ou;Park, Pyo-Jam;Choi, Wahn-Soo;Kim, Jong-Dai
    • Korean Journal of Medicinal Crop Science
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    • v.16 no.2
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    • pp.100-105
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    • 2008
  • We previously examined extracts, isolated from Scutellaria baicalensis (SB), chemical mediators, and IgE by mesenteric lymph node (MLN) lymphocytes in rats. The present study was to evaluate the effects of extracts of SB on the MLN lymphocytes function of mice given orally by 20 mg/kg for 2 weeks with dextran sulfate sodium (DS)-induced colitis. Results show that IgE levels in MLN lymphocytes was low, while IgA was high, in mice given SB compared to that fed water. Concentrations of $Inteferon-{\gamma}$ and interleukin (IL)-2 of T cells by concanavalin A treatment was significantly higher in the SB fed group than the normal group. Activation-induced IL-4 and IL-10 secretion was lower in SB fed mice compared control mice after DS-induced colitis. These results suggested that SB suppresses the inflammation in DS-induced colitis through the modulation of Th1/Th2 balance to down-regulate $Th_2$ response in MLN lymphocytes.

Comparative Anatomy of the Korean Native Goat 2. Mesenteric mast cell (한국 재래 산양의 비교해부학적 연구 2. 장간막 비만세포에 대하여)

  • Lee, Heung Shik;Kim, Chang Ki
    • Korean Journal of Veterinary Research
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    • v.14 no.2
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    • pp.151-157
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    • 1974
  • This study was carried out to investigate on the morphology, distribution and stainability of the mast cells in the Korean Native goat. For the study, the experimental animals were anesthetized with pentobarbital sodium and opened the anterior abdomianl wall to remove immediately the specimens with a minimum of mechanical effects. The mesenteries were fixed in 10% neutral formalin, 4% basic lead acetate, absolute alcohol and ethlene glycol monoethyl ether. Following 24 hours of fixation, the toto preparation stained with 0.4% toluidine blue, 1% methylene blue, 1.5% bismark brown, saturated thionine and thionlne-methylene blue complex solution. The preparation were observed from 10 microscopic field with 450 magnification. The results were as follows: 1. The form of the mesenteric mast cell was found 2 types. One was spindle form in larger number around vessels, the other was ovoid or spherical form in connective tissue far from blood vessels. 2. The average size was $18.63{\pm}5.75{\mu}m$ in length, $10.61{\pm}3.39{\mu}m$ in width and number was $105.50{\pm}18.45$. 3. Ethylene glycol monoethyl ether was particularly useful in preserving the mast cell granules. 4. Thione-methylene blue complex solution might be recommended to stain of granules.

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Inferior Mesenteric Plexus Block for Lower Abdominal Cancer Pain (하복부 암성통증에 대한 하 장간막신경총 차단)

  • Oh, Hung-Kun;Yoon, Duck-Mi;Chung, So-Young
    • The Korean Journal of Pain
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    • v.6 no.2
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    • pp.199-203
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    • 1993
  • Inferior mesenteric plexus block(IMPB) is a nerve block for lower abdominal pain originating from GI tract of distal transverse colon to sigmoid colon and other polvic organ where the inferior mesenteric plexus contains visceral afferent fibers of that organ. We performed IMPB on two patients with lower abdominal pain. Case I: 61 year old female diagnosed with cancer of stomach and uterine cervix and carcinomatosis, experienced complete relief from pain for a period of 7 months after IMPB. Case II: male, 28 years old, who had contracted cancer of the descending colon with obstructive jaundice and pancreatitis had complained of pain in the whole of the abdominal area. IMPB was performed for lower abdominal pain. Seven days after, a celiac plexus block was also performed for upper abdominal pain. The patient complained of recurring pain in the left & upper lower abdomen 30 days after the IMPB. The intensity of the pain was visual analogue scale 4 and it was managed by continuous epidural block. Conclusion: It is our recommendation that IMPB is a reliable method for treatment of lower abdominal pain originating from malignant condition of GI tract from distal transverse colon to sigmoid colon and urinary bladder.

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Clinical Features of Acute Nonspecific Mesenteric Lymphadenitis and Factors for Differential Diagnosis with Acute Appendicitis (급성 비특이성 장간막 림프절염의 임상 소견과 급성 충수돌기염과의 감별 인자)

  • Shin, Kyung Hwa;Kim, Gab Cheol;Lee, Jung Kwon;Lee, Young Hwan;Kam, Sin;Hwang, Jin Bok
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.1
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    • pp.31-39
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    • 2004
  • Purpose: Although acute nonspecific mesenteric lymphadenitis (ANML) is probably common cause of abdominal pain in children, which can be severe enough to be an abdominal emergency, the clinical features of mesenteric lymphadenitis are not clear. Also, a differential diagnosis with acute appendicitis (APPE) is indispensable to avoid serious complications. The clinical features of ANML were determined, and the risk factors for differential diagnosis with APPE were analyzed. Methods: Between November 2000 and May 2001, data from 26 patients (aged 1 to 11 years) with ANML and 21 patients (aged 2 to 13 years) with APPE were reviewed. ANML was defined as a cluster of five or more lymph nodes measuring 10 mm or greater in their longitudinal diameter in the right lower quadrant (RLQ) without an identifiable specific inflammatory process on the ultrasonographic examination. There were risk factors on patient's history, physical examination, and laboratory examination; the location of abdominal pain, abdominal rigidity, rebound tenderness, fever, nocturnal pain, the vomiting intensity, the diarrhea intensity, the symptom duration, and the peripheral blood leukocytes count. Results: Of the 26 ANML patients and 21 APPE patients, abdominal pain was noted on periumbilical (76.9% vs 14.2%), on RLQ (11.5% vs 71.4%), with abdomen rigidity (7.6% vs 80.9%), with rebound tenderness (0.0% vs 76.1%)(p<0.05), in the lower abdomen (11.5% vs 14.2%), and at night (80.8% vs 100.0%) (p>0.05). The clinical symptoms were vomiting (38.4% vs 90.4%), the vomiting intensity ($1.5{\pm}0.7$ [1~3]/day vs $4.5{\pm}2.9$ [1~10]/day), diarrhea (65.3% vs 28.5%) (p<0.05), and fever (61.5% vs 76.2%)(p>0.05). The period to the subsidence of abdominal pain in the ANMA patients was $2.5{\pm}0.5$ (2~3) days. The laboratory data showed a significant difference in the peripheral blood leukocytes count ($8,403{\pm}1,737[5,900{\sim}12,300]/mm^3\;vs\;15,471{\pm}3,749[5,400{\sim}20,800]/mm^3$)(p<0.05). Discriminant analysis between ANML and APPE showed that the independent discriminant factors were a vomiting intensity and the peripheral blood leukocytes count and the discriminant power was 95.7%. Conclusion: The clinical characteristics of ANML were abrupt onset of periumbilical pain without rigidity or rebound tenderness, a mild vomiting intensity, normal peripheral leukocytes count, and relatively short clinical course. If the abdominal pain persist for more than 3 days, and/or the vomiting intensity is more than 3 times/day, and/or the peripheral leukocytes count is over $13,500/mm^3$, abdominal ultrasonography is recommended to rule out APPE.

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Pneumatosis Cystoides Intestinales and Portomesenteric Venous Gas following Anticholinesterase Pesticide Poisoning (항콜린에스테라아제 살충제 음독 후 발생한 창자벽공기낭증과 문맥장간막정맥가스 1례)

  • Lee, Suk Hee;Lee, Kyung-Woo;Jung, Jin Hee
    • Journal of The Korean Society of Clinical Toxicology
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    • v.15 no.1
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    • pp.56-59
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    • 2017
  • Pneumatosis cystoides intestinalis and portomesenteric venous gas are uncommon radiological findings, but are found commonly in cases of bowel ischemia, or as a result of various non-ischemic conditions. A 72-year-old man visited an emergency center with altered mental status 2 hours after ingestion of an unknown pesticide. On physical examination, he showed the characteristic hydrocarbon or garlic-like odor, miotic pupils with no response to light, rhinorrhea, shallow respiration, bronchorrhea, and sweating over his face, chest and abdomen. Laboratory results revealed decreased serum cholinesterase, as well as elevated amylase and lipase level. We made the clinical diagnosis of organophosphate poisoning in this patient based on the clinical features, duration of symptoms and signs, and level of serum cholinesterase. Activated charcoal, fluid, and antidotes were administered after gastric lavage. A computerized tomography scan of the abdomen with intravenous contrast showed acute pancreatitis, poor enhancement of the small bowel, pneumatosis cystoides intestinalis, portomesenteric venous gas and ascites. Emergent laparotomy could not be performed because of his poor physical condition and refusal of treatment by his family. The possible mechanisms were believed to be direct intestinal mucosal damage by pancreatic enzymes and secondary mucosal disruption due to bowel ischemia caused by shock and the use of inotropics. Physicians should be warned about the possibility of pneumatosis cystoides intestinalis and portomesenteric venous gas as a complication of pancreatitis following anticholinesterase poisoning.

Studies on Intestinal Trematodes in Korea XVI. Infection Status of Loaches with the Metacercariae of Echinostoma hortense (한국의 장흡충에 관한 연구 XVI. 미꾸리의 호르텐스극일흡충 피낭유충 감량상황)

  • 제종일;홍성종
    • Parasites, Hosts and Diseases
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    • v.23 no.1
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    • pp.18-23
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    • 1985
  • The infection stasus of the loaches, Misgurnus anguillicaudatus, with the metacercariae of Echinostoma hortense, was studied in Korea. A total of 154 loaches purchased at 4 local markets (Seoul, Kimhae, Naju-gun and Kangjin-gun) were examined their infection rate as well as the density and location of the metacercariae in the fish body. The results are as follows: 1. The loaches carrying the metacerariae of E. hortense were 64 (41.6%) in total number and the metacercarial density ranged 1-29 per infected loach with an average value of 8.1. The highest infection rate and metacercarial density were obtained from the loaches purchased at Kangjin-gun, Jeonranam-do. 2. The metacercariae of E. hortense were chiefly distributed in the distal intestinal wall and the adjacent mesentery, the perianal tissues, and the head and gill of the loaches examined. From the results, it is concluded that the loach is one of the important second intermediate hosts of E. hortense in Korea, and their infection rate and metacercarial density are considerably high.

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Delayed Presentation of a Post-traumatic Mesenteric Arteriovenous Fistula: A Case Report (외상 후 지연성으로 발생한 장간막 동정맥루: 증례보고)

  • Cho, Jayun;Jung, Heekyung;Kim, Hyung-Kee;Lim, Kyoung Hoon;Chun, Jae Min;Huh, Seung;Park, Jinyoung
    • Journal of Trauma and Injury
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    • v.26 no.3
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    • pp.248-251
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    • 2013
  • Introduction: A post-traumatic mesenteric arteriovenous fistula (AVF) is extremely rare. Case Report: A previously healthy 26-year-old male was injured with an abdominal stab wound. Computed tomography (CT) showed liver injury, pancreas injury and a retropancreatic hematoma. We performed the hemostasis of the bleeding due to the liver injury, a distal pancreatectomy with splenectomy and evacuation of the retropancreatic hematoma. On the 5th postoperative day, an abdominal bruit and thrill was detected. CT and angiography showed an AVF between the superior mesenteric artery (SMA) and the inferior mesenteric vein with early enhancement of the portal vein (PV). The point of the AVF was about 4 cm from the SMA's orifice. After an emergent laparotomy and inframesocolic approach, the isolation of the SMA was performed by dissection and ligation of adjacent mesenteric tissues which was about 6 cm length from the nearby SMA orifice, preserving the major side branches of the SMA, because the exact point of the AVF could not be identified despite the shunt flow in the PV being audible during an intraoperative hand-held Doppler-shift measurement. After that, the shunt flow could not be detected by using an intraoperative hand-held Doppler-shift measuring device. CT two and a half months later showed no AVF. There were no major complications during a 19-month follow-up period. Conclusion: Early management of a post-traumatic mesenteric AVF is essential to avoid complications such as hemorrhage, congestive heart failure and portal hypertension.