• Title/Summary/Keyword: 혈변

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A case of neonatal amoebiasis with after-birth vomiting and bloody stool (출생 직후 혈변과 구토 증상이 시작된 Amoebiasis 신생아 1례)

  • Kahng, Jimin;Kim, So-Young
    • Clinical and Experimental Pediatrics
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    • v.50 no.12
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    • pp.1257-1260
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    • 2007
  • E. histolytica has a simple life cycle with two stages: an infective cyst and an invasive trophozoite. It lives on humans as its host. Its infection occurs through the ingestion of the cyst form, and the disease begins when the trophozoite, converted at the small intestine, adheres to colonic epithelial cells with a latent period of two days to four months. In some instances, amoebic abscess formations can occur at the liver, lung, brain, or spleen via the lymphoid system. Rare cases of amoebiasis in neonates have been reported, much less any intrauterine infections in the world that may have occurred during the gestation period. We've recently experienced a case of neonatal amoebiasis that entailed after-birth vomiting and bloody stool. The infant seemed pre-infected with E. histolytica before birth.

Clinical Features of Dietary Protein Induced Proctocolitis (식이 단백 유발 직결장염의 임상적 고찰)

  • Im, Sun Ju;Kim, Seong Heon;Bae, Sang Nam;Park, Jae Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.8 no.2
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    • pp.157-163
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    • 2005
  • Purpose: Dietary protein induced proctocolitis (DPIPC) can be considered as a cause of rectal bleeding or blood streaked stool in otherwise healthy-looking infants in the first several months of life. Failure to appreciate this entity may lead to inappropriate diagnostic or therapeutic intervention. This study aimed to ascertain the clinical features, treatment and prognosis of DPIPC. Methods: We reviewed 13 infants retrospectively, presented with bloody stool in early infancy. They were diagnosed as DPIPC clinically in Pusan National University Hospital from May 2002 to June 2004. Results: Seven males and six females were included. The mean age at onset of bleeding was $96.8{\pm}58.8days$. The mean frequency of hematochezia was $2.6{\pm}2.5$ times a day. Duration from onset of symptom to diagnosis was $35.5{\pm}55.0days$ and duration from onset of symptom to resolution of bleeding was $58.7{\pm}67.0days$. Nine (69.2%) were exclusively breast-fed infants and two (15.4%) were formula-fed infants. All but one infant did not have family history of other allergic diseases. A dietary history of ingestion of cow's milk, nut or shellfish was present in three mothers. Peripheral eosinophil count was normal to slightly elevated (total WBC count $10,555{\pm}3,145/mm^3$, relative eosinophil count $6.3{\pm}3.0%$, absolute eosinophil count $659.0{\pm}532.2/mm^3$). Sigmoidoscopy revealed lymphonodular hyperplasia with surrounding hemorrhagic spots in the rectosigmoid colon in 6 infants. Histopathologic finding of colonic biopsies in 5 infants showed chronic inflammation with lymphoid follicular hyperplasia (5 infants), crypt abscess (3 infants), or mild infiltration of eosinophils (less than 20/high power field) in the lamina propria. Spontaneous resolution of rectal bleeding occurred in all infants without dietary change or medicine. Conclusion: Most infants with DPIPC experience a very benign course and have spontaneous resolution of rectal bleeding without changes in the mother's diet. In the case of strong evidence for DPIPC we suggest deferring further invasive investigation and continuing breast feeding.

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A Follow-Up Study of Hematochezia in Neonates and During Early Infancy (신생아와 조기 영아기에 혈변을 보였던 환아의 추적 관찰)

  • Bae, Su-Nam;Yoon, Jung-Min;Lim, Jae-Woo;Cheon, Eun-Jung;Ko, Kyoung-Og;Lee, Young-Hyuk;Mok, Woo-Kyun
    • Neonatal Medicine
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    • v.15 no.1
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    • pp.75-79
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    • 2008
  • Purpose : There are many causes of hematochezia in neonates and during early infancy. Cow's milk allergy is considered to be the most common cause of bloody stools in infants; however, cow's milk allergy is diagnosed in relatively few patients. In a significant proportion of case investigations, the etiology of hematochezia is not determined. The objectives of this study were to evaluate the clinical course and prognosis of patients with hematochezia of unknown etiology. Methods : The patients were <4-month-old infants with hematochezia in whom infectious and surgical etiologies had been excluded. We investigate retrospectively the clinical course and laboratory finding. We also perform 2-years follow-up study and evaluate prognosis of the patients. Results : In all study patients, RAST milk was negative. All patients had self-limited hematochezia. In 2-years of follow-up, the prognosis of patients was good. There were no differences at 2-year regarding allergic tendencies of the patients, as determined by the increase in total eosinophil count. Conclusion : Hematochezia in neonates and during early infancy is generally a benign and self-limiting symptom. Based on 2-years of follow-up, the prognosis of the patients is good.

화학물질의 독성 - 금속과 금속관련 화합물

  • No, Jae-Hun
    • 월간산업보건
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    • s.84
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    • pp.31-33
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    • 1995
  • 입에서 금속성 입맛을 동반하여 심한 위장관계 증상(예, 혈변, 복통, 오심, 구토)과 상부위장관출혈이 있으면 중금속 중독이 있음을 시사한다. 중금속은 유기형태와 무기형태 모두 유독함을 기역해야 한다. 혈액, 소변, 그리고 특히 모발내의 레벨이 급인성 중독을 정확하게 반영하지 않은 경우가 종종 있다. 중금속 중독이 된 많은 환자들이 킬레이션 치료(chelation therapy)에 효과가 있다.

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The Role of Colonoscopy in Children with Hematochezia (소아 선혈변에서 대장 내시경 검사의 역할)

  • We, Ju-Hee;Park, Hyun-Suk;Park, Jae-Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.14 no.2
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    • pp.155-160
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    • 2011
  • Purpose: This study was performed to evaluate the role of colonoscopy in children with hematochezia. Methods: We retrospectively reviewed the medical records of 277 children who underwent colonoscopy because of hematochezia between January, 2003 and July, 2010. Results: The mean age of the patients was $6.0{\pm}4.4$ (7 days~17.8 years) years. The male to female ratio was 2.2:1. The duration between the 1st episode of hematochezia and colonoscopy was $4.9{\pm}12.1$ months. Characteristics of hematochezia included red stool (65.1%), blood on wipe (12.8%), bloody toilet (11.9%), and blood dripping (10.2%). The most proximal region of colonoscopic approach was terminal ileum (84.5%), cecum (9.5%), hepatic flexure (2.8%), and splenic flexure (3.2%). Eighty five patients (30.6%) had no specific abnormal findings. Major causes of hematochezia were polyp (26.4%), food protein induced proctocolitis (6.9%), infectious colitis (5.4%), lymphofolliculitis (5.7%), non specific colitis (5.7%), and vascular ectasia (5.1%). The hemorrhagic sites included the rectum (24.0%), rectosigmoid junction (18.1%), sigmoid colon (13.5%), ascending colon (14.2%), transverse colon (11.3%), descending colon (7.8%), cecum (8.1%), and terminal ileum (3.1%). The recurrence rate of hematochezia after colonoscopy was 19.1%. Colonoscopy was performed in 262 patients (94.6%) with conscious sedation. Endoscopic hemostasis was performed in 5 patients. Complications of colonoscopy or sedation were not found. Conclusion: The causes and lesional localization of pediatric hematochezia were diverse. Colonoscopy has an important role in the diagnosis and treatment of hematochezia in children. Total colonoscopy is recommended to detect the cause of hematochezia.

Histopathological Study of Carcinoma of the Colorectum in the Taegu Area (대구지방의 장암에 대한 병리조직학적 검색)

  • Nam, Hae-Joo;Choi, Won-Hee;Lee, Tae-Sook;Hong, Suk-Jae
    • Journal of Yeungnam Medical Science
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    • v.3 no.1
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    • pp.33-39
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    • 1986
  • A clinical and statistical study was done for 123 patients with histologically proven colorectal malignant tumor from 1983 to 1986 at the department of anatomical pathology. Yeung Nam University Hospital. The results were as follows: 1. Ratio between male and female was 1.6:1 and incidence was most prevalent in 7th decades comprising 29.3%. 2. Location of tumor was the most frequent in rectum(65%). 3. Frequent symptoms and signs in case of right colon were pain, abdominal mass and bowel habit change. In left colon, they were pain, bowel habit change and bloody stool or melena. In rectum, they were bloody stool or melena, bowel habit change and pain. 4. Duration of symptom was 1 to 3 months(33.3%). 5. The most frequent histological type was adenocarcinoma(82.9%). 6. According to Dukes's classification, 32.9% of the tumor were stage $C_2$. 7. Operative procedures were Mile's operation(47.0%), right hemicolectomy(19.8%) and lower anterior resection(11.7%). 8. Polyps were the most frequent associated disease. 9. The most common complication was wound infection(11.1%).

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A Randomized Controlled Trial To Motivate Worksite Fecal Occult Blood Testing (암위험사정이 직장인의 혈변검사에 미친 영향에 관한 실험연구)

  • 이정렬
    • Journal of Korean Academy of Nursing
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    • v.20 no.3
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    • pp.300-306
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    • 1990
  • Colorectal cancer is second only to lung cancer as a cause of death due to cancer in the united States. Studies have shown that fecal occult blood(FOB) tests are effective in detecting colorectal cancer in its early stages. To motivate worksite FOB testing, a randomized controlled trial was conducted. Employees 40 years or older from three federal agencies in Washington State were randomized to a control group(n=139) which received a letter stating the availability of the FOB test at the worksite clinic or to an intervention group(n=139) which received the letter about facts on colorectal cancer and a Colorectal Cancer Risk Appraisal. The Colorectal Cancer Risk Appraisal included a feedback on an individual's risk of developing colorectal cancer compared to his / her peers in terms of ‘normal’, ‘moderate’, or ‘high’ risk status. After 3 months, a follow-up questionnaire was sent to all participants to measure the effectiveness of the intervention. In the analysis of the three major outcomes, two possible confounding factors(dietary fat and family history of colorectal cancer) were controlled by logistic regression. Based on a review of the worksite clinic records, the Intervention group had 4.3% higher compliance rate with the FOB test during the follow-up period compared to the control group(p=.10). The largest effect of the intervention was on the employees' intention to get a FOB test within the next year(62.6% in the intervention group vs. 36.2% in the control group, OR=3.18, p<.001). In the final Multivariate logistic model, the employees who were more likely to intend to get a FOB test within the next year were in the intervention group ; were at ‘moderate’ or ‘high’ risk of colorectal cancer ; knew more about the availability of the FOB test at the worksite clinic ; and had a FOB test during the last three years.

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A Case of Segmental Nectotizing Jejunitis (분절성 괴사성 공장염(Segmental necrotizing jejunitis) 1례)

  • Yoo, Jee-Hyung;Kim, Hyo-Shin;Kim, Je-Woo;Chung, Ki-Sup;Han, Suk-Joo;Kim, Ho-Kun
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.2 no.2
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    • pp.222-226
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    • 1999
  • Segmental necrotizing jejunitis is characterized by severe abdominal pain of acute onset, bilious vomitings and foul smelling loose stools containing blood. Pathologic features include circumferential intestinal wall inflammation ranging from edema with minimal congestion to severe congestion, hemorrhage with necrosis, ulceration, and gangrene with perforation. Early diagnosis and suitable supportive measures prevent unnecessary laparatomy and complications. There was no report of this disease entity in children in Korea. We experienced a case of segmental necrotizing jejunitis with fever, abdominal pain and bloody stools, which was diagnosed by exploration and was treated successfully by antibiotics and supportive measures.

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