• Title/Summary/Keyword: 장중첩증

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A Case of Intussusception Secondary to Ileocecal MALT Lymphoma (장중첩증을 초래한 회맹부의 MALT 림프종 1예)

  • Lee, Won-Hee;Yang, Eun-Seok;Moon, Kyung-Rye
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.10 no.2
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    • pp.197-201
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    • 2007
  • The gastrointestinal (GI) tract is the extranodal location most frequently involved in MALT lymphomas, and although MALT lymphomas can be found in the small intestine, most MALT lymphomas of the GI tract occur in the stomach. In addition, MALT lymphoma occurs predominantly in adults; however, a ten-year old female that was admitted to our hospital due to Rt. lower quadrant abdominal pain 1 month ago,was diagnosed with intussusception secondary to ileocecal MALT lymphoma. A biopsy specimen confirmed lymphocyte infiltration with lymphoepithelial lesions, suggesting a low grade MALT lymphoma. Therefore, we report a case of low-grade MALT lymphoma occurring in a ten-year-old female who presented with ileocecal intussusception.

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A Case of Ileao-ileal Intrauterine Intussusception in a Preterm Neonate (미숙아에서 발견된 태생기 회장-회장형 장중첩증 1예)

  • Lee, Bo Young;Kim, Yeo Hyang;Hwang, Jin Bok;Kim, Chun Soo;Lee, Sang Lak;Kwon, Tae Chan;Lee, Hee Jung;Park, Woo Hyun
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.8 no.2
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    • pp.247-251
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    • 2005
  • Intussusception in a preterm neonate is a very rare disorder. We experienced a case of intrauterine intussusception presented with symptoms of the small bowel obstruction in a preterm infant whose gestational age was $28^{+2}$ weeks. Urgent ultrasonography of abdomen revealed no definite intussuscepted segment. At emergent surgery performed on the 11th days of life under the diagnosis of distal small bowel obstruction, an ileo-ileal intussusception with distal ileal atresia without perforation was found.

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Imaging Findings of Gastrointestinal Emergency in Infants and Young Children (영유아 환자 위장관 응급 질환의 영상 소견)

  • Ji Young Kim
    • Journal of the Korean Society of Radiology
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    • v.81 no.4
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    • pp.794-805
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    • 2020
  • Acute abdomen is a condition with sudden abdominal pain that may require immediate surgical treatment. The causes of acute abdomen in pediatric patients are diverse, and can be categorized in broad range from diseases requiring surgery to diseases requiring medication or clinical observation only. The role of the imaging study in children with acute abdomen is to distinguish between patients who need medication and patients who need surgery by identifying diseases that cause abdominal pain, if possible. Since intussusception and appendicitis are the leading causes of acute abdomen requiring surgical treatment in children, it is important to exclude intussusception in young infants complaining of acute abdominal pain and exclude acute appendicitis in older children with acute abdomen. In this paper, we introduce intussusception, acute appendicitis, midgut volvulus, Meckel's diverticulum and duplication cyst, which has characteristic imaging finding of the disease that can cause acute abdomen in pediatric patients.

Undifferentiated Pleomorphic Sarcoma of the Small Intestine with Distant Endobronchial Metastasis Presenting as Intussusception: A Case Report (장중첩증으로 발현된 기관지 내 전이를 동반한 소장의 미분화성 다형성 육종: 증례 보고)

  • Sung Oh Song;Min Seon Kim;Kyung Hee Lee;Suk Jin Choi
    • Journal of the Korean Society of Radiology
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    • v.82 no.5
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    • pp.1304-1309
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    • 2021
  • Undifferentiated pleomorphic sarcoma (UPS) is a high-grade soft tissue sarcoma that arises from mesenchymal tissue. Primary UPS of the small intestine is extremely rare, and only a few cases have been reported in the literature. Its presentation is usually nonspecific; however, it may occasionally present as intussusception with intermittent abdominal pain. It is a highly aggressive tumor with a propensity for early distant metastasis to the peritoneum, lymph nodes, other abdominal organs, lungs and brain. To our knowledge, there are no reported cases of endobronchial metastasis from small intestine UPS. We report a rare case of UPS of the small intestine with endobronchial metastasis presenting as intussusception.

Small Bowel Intussusception in Children: Spontaneous Resolution vs. Surgical Intervention (소아에서 소장형 장중첩증; 자연 정복과 수술적 치료의 비교)

  • Park, Mi-Ran;Lim, Mi-Sun;Seo, Jeong-Kee;Ko, Jae-Sung;Chang, Ju-Young;Yang, Hye-Ran;Lim, Yoon-Joung;Kim, Woo-Sun
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.13 no.2
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    • pp.128-133
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    • 2010
  • Purpose: Intussusception is one of the most common causes of an acute abdomen in infancy. The majority of pediatric cases of intussusception are of the ileocolic type and usually idiopathic. Small bowel intussusception is rarely diagnosed in children, and few cases have been reported. The purpose of this study was to determine the clinical features and causes of small bowel intussusception in children. Methods: We retrospectively reviewed the clinical and radiologic findings of 21 children with small bowel intussusception who were admitted to Seoul National University Children's Hospital between March 2005 and January 2010. Results: The clinical presentation of small bowel intussusception included abdominal pain or irritability (85%), vomiting (23%), fever (14%), bloody stools (14%), and abdominal masses (4%). Six patients required surgical management. Ultrasonography showed that the mean diameter of the lesions and mean thickness of the outer rims were 1.6${\pm}$0.7 and 1.7${\pm}$1.8 mm, respectively. Eleven lesions were located in the left abdominal or paraumbilical regions. Children who underwent surgical management were older than children with transient small bowel intussusception (mean age, 51 vs. 109 months). The mean diameter of the lesions and mean thickness of the outer rims were greater in the surgically-managed group. The location of intussusception was not significantly different between the two groups. Conclusion: Small bowel intussusception was spontaneously reduced in a large number of pediatric patients. However, sonographic demonstration of larger size, older age, and pathologic lead point warrant surgical intervention.

Clinical Significance of Repeated Delayed Air Reduction in Unsuccessful Initial Reduction of Intussusception (초기 정복에 실패한 장중첩증 환자에서 반복 지연 정복술의 임상적 의의)

  • Shin, Song-Heui;Rho, Young-Il;Park, Young-Bong;Moon, Kyung-Rye
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.4 no.2
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    • pp.175-180
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    • 2001
  • Purpose: The advantages of air reduction are the ease of performing the procedure, reduced radiation time and lower morbidity rate if perforation occurs. But, patients who fail air reduction undergo a laparotomy at which 10% have spontaneously reduced. The first enema decreases the edema and venous congestion of bowel wall, thus repeated reduction may succeed. The aim of this study is to evaluate the efficacy of delayed repeated pneumatic reduction of intussusception in patients with failure of an initial attempt. Methods: Between January 1998 and December 1999, 21 patients with proven intussusception received repeated delayed reduction 1 to 3 hours following the first failed attempt. These patients were in stable condition and did not have peritonitis, shock or toxic sign. Results: Before reduction, the patients had symptoms and signs for 6 to 48 hours (median 24 hr). The interval from the first reduction to the repeated was 1 to 3 hours (median 2.2 hr). The success rate of repeated reductions was 76.2% (16 of 21 patients), and 23.8% (5 of 21 patients) required surgery. Four of 5 patients requiring surgery were manually reduced and 1 spontaneously reduced in the operating room. Conclusion: We recommended a repeated reduction in patients with intussusception who are in stable clinical condition after an unsuccessful initial reduction attempt.

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A Case of Intussusception Arising from Heterotopic Pancreas in Ileum (회장에 발생한 이소성 췌장에 의한 장중첩증 1례)

  • Rhim, Jung Woo;Koh, Eun Suk;Park, Jae Ock
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.2
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    • pp.274-277
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    • 2004
  • The heterotopic pancreas is defined as the presence of pancreatic tissue lacking anatomical and vascular continuity from the main body of pancreas. Its incidence has been reported as widely ranging from 0.55~13.7% in autopsy studies and 0.2% in upper abdominal laparotomies. The most common sites are the antrum of stomach, duodenum and proximal jejunum. But, lesions have also been found in the ileum, Meckel diverticulum, common bile duct and the esophagus. Most cases are incidentally encountered during surgery, and on rare occasions, epigastric pain, hemorrhage, gastric outlet obstruction and intussusception have been directly attributable to the presence of the heterotopic pancreas. A 3-month-old boy presented with 1-day history of vomiting and irritability. Intussusception was confirmed on ultrasound scan. At laparotomy there was an irreducible ileoileal intussusception, the intussuscepted portion of ileum was resected and end to end anastomosis was performed. Histologically, the mass was found to be composed of pancreatic tissue.

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Risk Factors for the Failure of Non-operative Reduction of Intussusceptions (장중첩증에서 비수술적 정복의 실패 위험인자)

  • Ko, Kwang-Min;Song, Young-Wooh;Je, Bo-Kyung;Han, Jae-Joon;Woo, Chan-Wook;Choi, Byung-Min;Lee, Jung-Hwa
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.11 no.2
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    • pp.110-115
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    • 2008
  • Purpose: Intussusceptions are one of the most common causes of intestinal obstruction in infants and young children. Although it is easily treated by non-operative reduction using barium, water or air, this treatment is very stressful for young patients and may cause bowel perforation, peritonitis and shock. In this study, we identified the risk factors associated with the failure of non-operative reduction, to identify a group of children that would benefit from the procedure and those who would not. Methods: We reviewed the medical records of patients with intussusception who were treated at the Korea University Medical Center Ansan hospital from March 1998 to July 2006. Three hundred fourteen children with intussusception were identified. Among them, non-operative reductions were performed in three hundred. Clinical and radiological variables were compared according to the failure or success of the non-operative reduction. Results: Non-operative reductions were successful in 243 (81%) and failed in 57 (19%). The group that had failed procedures had a younger age (12.3${\pm}$17.2 months vs. 18.0${\pm}$15.8 months, p=0.03), longer symptom duration before reduction (33.6${\pm}$29.0 hr vs. 21.5${\pm}$20.3 hr, p<0.01), more vomiting and lethargy (p<0.01), but less abdominal pain and irritability (p<0.01), compared with the group that had a successful procedure. Logistic regression analysis showed that the factors associated with the failure of non-operative reductions were a younger age, less than 6 months of age (odds ratio: 2.5, 95% confidence interval: 1.2~5.2, p=0.01), duration of symptoms, longer than 24 hrs before reduction (odds ratio: 2.1, 95% confidence interval: 1.2~4.2, p=0.03), bloody stool (odds ratio: 4.8, 95% confidence interval: 1.9~12.2, p<0.01), lethargy (odds ratio: 3.4, 95% confidence interval: 1.1~10.4, p=0.04), and abdominal pain or irritability (odds ratio: 0.2, 95% confidence interval: 0.1~0.4, p<0.01). Conclusion: For children with intussusception, an age younger than 6 months, and duration of symptoms more than 24 hrs before reduction, as well as the presence of bloody stools, lethargy and abdominal pain or irritability were variables associated with failure of a non-operative reduction. Knowledge of these variables should be considered in making clinical decisions for therapeutic interventions.

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A Case of Intestinal Duplication Cyst Identified as Pathological Lead Point in a Child with Recurrent Intussusception (재발성 장중첩증 환아에서 병적 선두로 확인된 장중복 낭종 1예)

  • Lee, Kun-Song;Park, Ji-Yun;Oh, Jong-Seok;Seong, In-Chang;Han, Kang-Min;Lee, Young-Seok
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.13 no.1
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    • pp.75-80
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    • 2010
  • Intestinal duplication cysts are characterized by the attachment to some part of the gastrointestinal tract with which a blood supply is shared, and have an epithelial lining resembling some part of the alimentary tract. A 15-month-old female was admitted to our hospital with cyclic irritability, vomiting, and blood-tinged stool. The results of an ultrasound showed an ileocolic intussusception and a 1.3 cm cystic mass had double-wall sign and a Y-configuration with an adjacent ileal loop. She had a past history of two ileocolic intussusceptions. The cystic mass was considered to be a pathologic lead point, so resection and end-to-end anastomosis was performed. The gross and histologic evaluation of the specimen demonstrated a $2.4{\times}2.4$ cm cystic mass containing yellow mucoid fluid and the cyst wall was lined with intestinal and gastric mucosa and enclosed by a layer of muscle, which was shared with the adjacent ileum.