• Advances in pediatric surgery
• /
• 제15권2호
• /
• pp.132-140
• /
• 2009

The purpose of this study was to determine the success rate of air reduction as the primary treatment of intussusception and whether the success of air reduction could be predicted by plain x-ray. The authors reviewed the medical records of 54 consecutive patients diagnosed with intussusception from Jan 2005 to Dec 2007 at the Department of Surgery, Masan Samsung Hospital. The natures of symptoms and findings of plain abdominal radiography performed in the emergency department (ED) were reviewed. Air reduction failed more frequently (26.3 %) in patients who visited ED more than 24 hours after symptom onset (p=0.009). The mean duration of symptom for operated patients was longer than air reduction group (p=0.01). Also, 3/4 of patients having localized distension of small bowel in the left upper quadrant abdomen had unsuccessful air reduction (p=0.002). In conclusion, the time interval from symptom onset to arrival at ED and localized distension of small bowel in the left upper quadrant abdomen significantly increased the failure rate of air reduction.

• Clinical and Experimental Pediatrics
• /
• 제49권5호
• /
• pp.574-576
• /
• 2006

Bezoar는 흡수되지 않은 이물질이 음식물과 섞여 형성된 장내 결석으로 이 중에서도 모발에 의한 경우를 trichobezoar라고 한다. 모발석은 대부분 위 내에 존재하고 소장까지 이동하지는 않는다고 알려져 있으며 빈혈, 위장관 폐쇄 또는 천공, 복막염, 장중첩증, 췌장염 등을 유발할 수 있다. 저자들은 복통과 담즙성 구토를 주소로 내원한 8세 여아에서 공장내의 10 cm 길이의 모발석을 진단하였고, 이로 인해 유발되었을 것으로 추정되는 췌장 효소(아밀라제 및 리파제)의 증가를 관찰하였다. 환아는 모발석의 수술적 제거 후 증상의 호전을 보였고, 췌장효소는 정상화되었다. 드물게 보고되고 있는 공장내의 큰 모발석 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Advances in pediatric surgery
• /
• 제5권2호
• /
• pp.116-120
• /
• 1999

The surgical treatment of intussusception during two periods, 1975-1978 and 1995-1998 (Group B) were compared. There were 48 patients in Group A and 75 cases in Group B. Male were predominant in both group (2.7:1 vs 1.6:1). The mean age at operation was $6.7{\pm}5.0$ months (Group A) and $8.1{\pm}7.0$ months (Group B). The major signs and symptoms in both Groups included vomiting, hematochezia and irritability. There was a significantly higher bowel resection rate for group B (31.3 % vs 14.7 %, p=0.041). There were two operative deaths in group B but no deaths in group A. Hospitalization was significantly shorter in group B($7.5{\pm}2.7$ days vs $5.4{\pm}2.1$ days, p<0.001). We conclude that there were no differences in patient characteristics but surgical treatment in the 1990s results in more rapid recovery and reduced hospital stay.

• Advances in pediatric surgery
• /
• 제2권2호
• /
• pp.81-87
• /
• 1996

Although nonoperative reduction plays a major role in the management of uncomplicated intussusception in the pediatric age group, surgical treatment is still a necessary alternative when nonoperative reduction is unsuccessful. The author analyzed the clinical features of 68 patients requiring operation in order to identify factors which might influence the type of operative management. A nine-year experience at Ewha Womans University Hospital was reviewed, and the findings compared to previous reports. Barium was used for the initial reduction attempt in 33 cases, saline in 35. Manual reduction by milking at operation achieved success in 41 cases(60.3%). Fifteen cases(22.1%) required resection of bowel, and 12 patients(17.6%) were found to have spontaneous and complete reduction of the intussusception at operation. Two cases had pathologic leading points. There were no perforations due to nonoperative reduction. There were no significant differences in demographic data, clinical findings, laboratory data, and anatomic type of intussusception between barium and saline reduction groups. However, a significant number of cases with spontaneous reduction were in saline reduction group(p<0.05). There was a slight chance of spontaneous reduction in infants under 6 month of age(p<0.001). Age under 6 month. body temperature over $38^{\circ}C$, symptom over 24 hours, and ileo-colic and ileo-ileo-colic intussusception contributed significantly to the necessity for bowel resection(p<0.05-0.001). The author believes that the age, body temperature, duration of illness, and anatomic type of intussusception strongly influence operative management.

• Advances in pediatric surgery
• /
• 제6권1호
• /
• pp.50-55
• /
• 2000

Pathologic lead points are found in a few intussusception patients. To evaluate the pathologic lead points in childhood intussusception, a retrospective review of 227 operated cases of intussusception treated at the Yeungnam University Hospital from January 1986 to April 1999. The patients were divided into 2 groups; idiopathic group 209 cases, (92.1 % and lead points group 18 cases, 7.9 %). Intussusception developed between age two months and six months in both groups. Enteroenteric type of intussusception was relatively more frequent in the lead point group than in idiopathic group. The lead points were veil (10 cases, 52.6 %), Meckel's diverticulum(3 cases, 15.8 %), lymphoma(3 cases, 15.8 %), ectopic pancreas(2 cases, 10.5 %), Henoch-Sch$\ddot{o}$nlein purpura(1 cases, 5.3 %). The bowel resection rate was 44.4 % in the lead point group and 8.6% in idiopathic group. The recurrence rate was 5.56 % in lead points group and 1.44 % in idiopathic group.

• Clinical and Experimental Pediatrics
• /
• 제48권4호
• /
• pp.433-437
• /
• 2005

위석은 비교적 흔하지 않은 질환이지만, 진단을 못할 경우 위궤양과 출혈, 장천공, 장중첩증, 장폐쇄, 복막염 등의 심각한 합병증을 동반할 수 있는 만성적 복통의 한 원인이며, 모발석 환아의 대부분은 발모벽과 식모증의 과거력이 있다. 저자들은 내원 4년 전까지 자기 머리카락을 뽑아서 먹는 습관이 있었고, 이후 간헐적 복통과 오심, 구토를 일으킨 11세 여아에서 모발석을 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Journal of Yeungnam Medical Science
• /
• 제22권1호
• /
• pp.113-118
• /
• 2005

Diverticulosis of the small intestine is a rare entity, compared with that of duodenum or colon, and is found in only 1% of autopsied patients. The main complications are diverticulitis with or without a perforation, obstruction and hemorrhage, which are associated with a high mortality. Intussusception is primarily a disease of childhood; with only 5 to 10% of cases occurring in adults. In contrast to childhood intussusception, 90% of adult intussusception cases are had an associated pathologic processes. An inflammatory fibroid polyp is an uncommonly localized non-neoplastic lesion of the gastrointestinal tract. It occurs most often in the stomach and secondly in the ileum. It rarely occurs in other organs such as the colon, jejunum, duodenum and esophagus. We report a case of jejunal diverticulitis with a perforation combined with intussusception caused by an inflammatory fibroid polyp. A 78-year-old female presented with abdominal pain, fever and chill. Contrast CT scan showed intussusception of the ileum. The patient was treated with a small bowel segmental resection. After surgery, the specimen showed jejunal diverticulitis with perforation.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• 제1권1호
• /
• pp.133-137
• /
• 1998

Although midgut volvulus is clinically characterized by bilous vomiting and abdominal distention, plain abdominal X-ray is usually non-specific and therefore it can be misdiagnosed to other diseases. Upper gastrointestinal contrast study and computed tomography have been used as a routine diagnostic tool but it takes cost and time. Abdominal ultrasonography is a relatively good alternatives in diagnosing midgut volvulus and it relatively saves cost and time. But case presentation of midgut volvulus diagnosed with abdominal ultrasonography are rarely found in literature. We experienced a 6 month old girl who had come to our hospital with bilous vomiting and was diagnosed as midgut volvulus with ultrasonography. Thus we report this case with the presentation of typical ultrasonographic findings of midgut volvulus.

• Tuberculosis and Respiratory Diseases
• /
• 제69권3호
• /
• pp.196-200
• /
• 2010

Intussusception primarily occurs in children and is uncommon in adults. Moreover, intussusception caused by intestinal tuberculosis is very rare. We report a case of intussusception induced by intestinal tuberculosis. A 53-year-old man presented to our hospital with complaints of cough and sputum for 2 weeks. We started anti-tuberculosis medication as the patient's sputum acid-fast staining was positive. After 4 days of treatment, the patient developed abdominal cramping pain. Imaging studies showed ileo-ileal type intussusception. The patient underwent segmental resection of the small bowel and intestinal tuberculosis was confirmed on histological examination. He recovered after surgery and was discharged on anti-tuberculosis medication.

• Advances in pediatric surgery
• /
• 제7권2호
• /
• pp.126-129
• /
• 2001

Childhood intussusception is usually idiopathic, and pathological lesions as the leading point are found in limited cases. Sixteen operative cases with leadpoints among 2,889 cases of childhood intussusecption treated at the surgical departments of the affiliated hospitals of Catholic University over 19 years are reviewed. The approximate incidence of pathological lesions as the leading point was 0.6%. The male to female ratio was 2:1. The mean age was 3.5 years. There was not an age preponderance. The symptoms were vomiting(63%), abdominal pain(38%), irritability(38%), bloody stools(25%), fever(25%) and abdominal mass(6%). The average duration of the symptoms was 2.4 days(1-10days). The most common lesion was Meckel's diverticulum, followed by malignant lymphomas, polyps, ectopic pancreas, and cecal duplication. An ileocolic type was most frequent, followed by ileoileocolic and ileoileal. Segmental resection or wedge resection of the ileum was done in 10 cases, ileocecectomy in 3, and right hemicolectomy in 3. Surgical reduction was done only in an ectopic pancreas, with no later recurrence. The average hospital stay was 10 days. Postoperative adhesive ileus occurred in two cases, and in one of them adhesiolysis was performed. One case of malignant lymphoma died at 28 days after surgery due to chemotherapy related complication.