• Journal of Trauma and Injury
• /
• 제28권4호
• /
• pp.262-265
• /
• 2015

An arteriovenous fistula (AVF) from the renal artery following a penetrating abdominal trauma is not common. We report the case of a 19-year-old male who presented with a knife stab wound in the right upper quadrant. Due to unstable vital signs and to the protrusion of the mesentery through the stab wound, providing definite evidence of peritoneal violation, an emergent exploratory laparotomy was carried out. There were injuries at the proximal transverse mesocolon and the second portion of the duodenum, with bile leakage. There was also a mild amount of retroperitoneal hematoma near the right kidney, without signs of expansion or pulsation. The mesocolon and the duodenum were repaired. After the operation, abdominal computerized tomography (CT) was performed, which revealed contrast from the right renal artery shunting directly into the vena cava. Transcatheter arterial embolization with a coil and vascular plug was performed, and the fistula was repaired. The patient recovered completely and was discharged without complication. For further and thorough evaluation of an abdominal trauma, especially one involving the retroperitoneum, a CT scan is recommended, when possible, either prior to surgery or after surgery when the patient is stabile. Furthermore, a lateral retroperitoneal hematoma and an AVF after a penetrating trauma may not always require exploration. Sometimes, it may be safely treated non-operatively or with embolization.

• Journal of Chest Surgery
• /
• 제38권10호
• /
• pp.710-713
• /
• 2005

급성복부대동맥 폐쇄는 드물지만, 응급을 요하며 높은 사망률과 이환율을 보이는 혈관질환이다. 늦은 진단은 예후에 심각한 영향을 미치게 된다. 승모판 협착, 심방세동, 관상동맥협착, 삼첨판 역류 및 심방중격결손으로 인한 개심슬을 받은 60세 여자가 술 후 13일에 하지의 감각이상, 마비, 심한 통증을 호소하였다. 배꼽 아래부터 발끝에 이르는 피부가 얼룩덜룩하였으며 하지의 맥박이 촉지되지 않았다. 저자들은 다중 검출 컴퓨터 단층 촬영을 이용하여 급성 복부 대동맥 폐쇄를 진단하고, 응급 혈색전 제거 및 대동맥-양측 대퇴동맥 우회로술로 성공적으로 치료하였다.

• Journal of Chest Surgery
• /
• 제47권5호
• /
• pp.473-477
• /
• 2014

Primary leiomyosarcoma of the inferior vena cava (IVC) is a rare malignant tumor. Herein, we report the case of a 52-year-old male patient who had postprandial abdominal distension and right upper quadrant abdominal pain. The abdominal computed tomography (CT) angiogram showed an IVC mass extending from the infrahepatic to the suprarenal inferior vena cava. The radiologic findings were suggestive of an IVC leiomyosarcoma. Surgical resection and reconstruction with a cryopreserved homograft were performed. The follow-up abdominal CT angiogram revealed the patient to be disease-free 6 months after surgery with patency of the IVC and renal vein.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• 제18권3호
• /
• pp.193-196
• /
• 2015

A fecaloma refers to a mass of accumulated feces that is much harder than a mass associated with fecal impaction. Fecalomas are usually found in the rectosigmoid area. A 10-year-old male with chronic constipation was admitted because of increasing abdominal pain. An abdominal computed tomography scan and a simple abdominal x-ray revealed rapidly evolving mechanical obstruction in the small intestine. Most of the fecalomas are successfully treated by conservative methods such as laxatives, enemas and rectal evacuation. When conservative treatments have failed, surgical intervention may be needed. In this case, an emergency operation was performed and a $4{\times}3{\times}2.5cm$ fecaloma was found in the distal ileum. We thus report a case of ileal fecaloma inducing small bowel obstruction in a patient with chronic constipation, who required surgical intervention. When symptoms of acute small intestinal obstruction develop in a patient with chronic constipation, a fecaloma should be considered in differential diagnosis.

• 한국임상수의학회지
• /
• 제22권4호
• /
• pp.424-427
• /
• 2005

A 5-year-old Pekingese bitch was presented with a history of vaginal bleeding and copulation before 4-week. Ovarian remnant syndrome was diagnosed on the clinical changes, vaginal cytology and exploratory laparotomy. An abdominal mass was diagnosed on radiography, ultrasonography and Computed Tomography. The remnant of ovarian tissue and an abdominal mass were removed surgically under general anesthesia. Ultrasonographic examination of the removed ovarian tissue (water bath scanning) revealed three corpora lutea. The condition resolved following surgical excision of the remaining ovarian tissue and an abdominal purulent mass.

• Journal of Trauma and Injury
• /
• 제26권1호
• /
• pp.22-25
• /
• 2013

Severe blunt abdominal trauma frequently involves the liver. The development of nonsurgical treatment of liver trauma has led to more frequent appearance of unusual complications. A hepatic arterioportal fistula (APF) is a rare complication of liver trauma. We present a case of traumatic APF in a patient with liver trauma. A 31-year-old male visited our emergency department with pain in the right upper abdomen following a traffic accident. Initial physical exam and abdominal computed tomography (CT) revealed liver laceration with hemoperitoneum. An abdominal CT obtained on day 11 revealed early opacification of the right portal vein on the arterial phase. After we had come to suspect an APF of the liver, its presence was confirmed on angiography. It was subsequently managed by using transcatheter coil embolization. In patients with portal hypertension and no evidence or history of cirrhosis, one should consider an APF as a potential etiology if history of liver biopsy or penetrating trauma exists. In a patient with liver trauma, serial abdominal CT is important for early detection and treatment of an APF.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• 제23권3호
• /
• pp.304-309
• /
• 2020

An 18-year-old woman with annular pancreas and duodenal duplication presented with recurrent acute pancreatitis and underwent a resection of duodenal duplication. However, the patient experienced recurrent abdominal pain after resection. Abdominal computed tomography and magnetic resonance imaging showed a dilatation of the peripheral pancreatic duct and stenosis and malformation of both the Wirsung's and Santorini's duct due to multiple stones. The modified puestow procedure was performed. The main pancreatic ducts in the body and tail were opened, and the intrapancreatic common bile duct was preserved. A Roux-en-Y pancreatico-jejunostomy was performed for reconstructing the pancreaticobiliary system after removing the ductal protein plug. The patient experienced no abdominal pain, no significant elevation of the serum amylase and lipase levels, and no stone formation during the 2 years of follow-up. This procedure is considered to be beneficial for pediatric patients with chronic pancreatitis due to annular pancreas and duodenal duplication.

• Journal of Chest Surgery
• /
• 제48권3호
• /
• pp.214-216
• /
• 2015

Blunt abdominal trauma may cause peripheral vascular injuries. However, blunt abdominal trauma rarely results in injuries to the external iliac and common femoral arteries, which often stem from regional bone fractures. Here, we present the case of a patient who had experienced trauma in the lower abdominal and groin area three months before presenting to the hospital, but these injuries did not involve bone fractures and had been managed conservatively. The patient came to the hospital because of left lower leg claudication that gradually became severe. Computed tomography angiography confirmed total occlusion of the external iliac and common femoral arteries. The patient underwent femorofemoral bypass grafting and was discharged uneventfully.

• Advances in pediatric surgery
• /
• 제11권2호
• /
• pp.186-191
• /
• 2005

A 10-year-old-girl was referred to our hospital due to abdominal pain. She underwent Roux-en-Y cystojejunostomy for a choledochal cyst at another hospital at the age of 3 months. Abdominal ultrasonography (USG) and computed tomography (CT) showed type I choledochal cyst and multiple gallbladder stones. Because of severe inflammation and adhesion, partial resection of the choledochal cyst and Roux-en-Y hepaticojejunostomy was performed. Two and one half years later, intermittent abdominal pain, fever, nausea and vomiting occured. Abdominal CT scan showed a polypoid nodular lesion in the remnant of the choledochal cyst and probable metastasis at segment 7 of the liver. The duodenum was obstructed by the mass. Liver biopsy revealed moderately differentiated adenocarcinoma. A palliative gastrojejunostomy was performed to relieve duodenal obstruction. She died of hepatic insufficiency 4 months later.

• Journal of Gastric Cancer
• /
• 제11권4호
• /
• pp.243-247
• /
• 2011

A 48 year old woman was diagnosed with a huge cystic mass in her abdominal cavity. She complained of significant abdominal discomfort due to the mass. The abdominal computed tomography revealed a giant multi-lobulated mass, measuring $26{\times}12$ cm in size, adjacent to the lesser curvature of the stomach. In the operation field, the mass was found to originate from the lesser omentum, including the right and left gastric vessels and the vagus nerves, and to invade the lesser curvature of the stomach. For curative resection, distal subtotal gastrectomy with mass excision followed by gastroduodenostomy were performed. This mass was pathologically diagnosed to be a mesenteric cystic lymphangioma; in fact, the largest ever reported. The patient had no complications during the postoperative period and was discharged from the hospital on the seventh day after surgery.