• Title/Summary/Keyword: Abdominal discomfort

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Clinical Practice Guideline for Soyangin Disease of Sasang Constitutional Medicine: Yin-Deficit Diurnal-Heat (Eumheo-oyeol) symptomatology (소양인체질병증 임상진료지침: 음허오열병)

  • Yu, Jun-Sang;Lee, Eui-Ju
    • Journal of Sasang Constitutional Medicine
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    • v.26 no.3
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    • pp.272-280
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    • 2014
  • Objectives This research was carried out to establish the clinical practice guideline(CPG) for Yin-Deficit Diurnal-Heat (Eumheo-oyeol) symptomatology of Soyangin disease. Methods Dongeuisusebowon(sinchuk edition) and several kinds of literatures including journal articles concerning this symptomatology of Soyangin disease were collected and classified. Sasang constitutional specialists' conference was held to make an agreement on the conflicting issues as well. Consensus was drawn as a result of the conference. Results & Conclusions 3 papers were selected as an inclusion and exclusion criteria for the relevant articles to Yin-Deficit Diurnal-Heat (Eumheo-oyeol) symptomatology of Soyangin disease. Yin-Deficit Diurnal-Heat (Eumheo-oyeol) symptomatology consists of two aspects : Yin-Deficit Diurnal-Heat (Eumheo-oyeol) severe pattern and Yin-Deficit Diurnal-Heat (Eumheo-oyeol) critical pattern. In Yin-Deficit Diurnal-Heat (Eumheo-oyeol) severe pattern contains 1 disease, namely, Clear Yang Depletion of Large Intestine (Daejang-cheongyang Moson) pattern (Lower wasting-thirst (Haso) pattern). In Yin-Deficit Diurnal-Heat (Eumheo-oyeol) critical pattern contains 2 diseases, Yin-Deficit Diurnal-Heat (Eumheo-oyeol) pattern and Yin-Deficit Diurnal-Heat (Eumheo-oyeol) advanced pattern. Yin-Deficit Diurnal-Heat (Eumheo-oyeol) symptomatology has several kinds of symptoms like dry mouth, disliking to drink much water, diurnal body fever, coldness on the back and nausea as well as body fever, chest discomfort, constipation or dry stool as a common symptoms of Interior Heat disease. Clear Yang Depletion of Large Intestine (Daejang-cheongyang Moson) pattern (Lower wasting-thirst (Haso) pattern) has above mentioned symptoms and much urine/turbid urine, thin thigh and knee joints and twinge of joint pain over the body. Yin-Deficit Diurnal-Heat (Eumheo-oyeol) pattern has symptoms like indigestion and epigastric discomfort, abdominal pain and vomiting in addition. Yin-Deficit Diurnal-Heat (Eumheo-oyeol) advanced pattern has symptoms like hematemesis as well.

Ultrasonographic Features of Intra-abdominal Abscess (복부내 농양의 초음파 소견)

  • Cho, Kil-Ho;Jung, Kyung-Hee;Hwang, Mi-Soo;Chang, Jae-Chun;Kwun, Koing-Bo;Min, Hyun-Sik
    • Journal of Yeungnam Medical Science
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    • v.2 no.1
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    • pp.87-93
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    • 1985
  • Intraabdommal abscess usually causes distress with fever, leukocytosis, pain and toxicity. Diagnosis of intraabdominal abscess is occasionally difficult and It has high morbidity. However radiologic method, such as ultrasonography, CT scan, or RI scan are helpful to early detection of intraabdominal abscess. Among these methods, ultrasonography is a non-invasive technique and performed without discomfort to patient. And also differential diagnosis between cystic and solid lesion is very easy and sequential ultrasonography in same patient is valuable for the evaluation of treatment effect. We analyzed the ultrasonic features of 48 cases with intra-abdominal abscesses and the results are as follows; 1. In total 48 cases, the intra-abdominal abscesses were 30 cases, the retroperitoneal abscesses, 5 cases, and the visceral abscesses, 13 cases. 2. The causes of the intra-abdominal abscesses were perforating appendicitis (25 cases), postoperative complications (5 cases), pyogenic and amebic hepatic abscesses (13 cases), and the others (5 cases). 3. Round or oval shaped lesions were 26 cases (54%), irregular shape, 18 cases (38%), and multiple abscess formation in 4 cases (8 %). 4. The size of the lesions were between 5 and 10cm in diameter in 54% of total 48 cases, and the most frequent feature of the echo-pattern of the lesions was cystic with or without internal echogenicity (69%).

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Clinical Study on 1 Case of Soyangyin Patient Diagnosed as Crohn's Disease (크론씨병으로 진단된 소양인 환자 치험 1 례)

  • Lee, Seung-Hyun;Park, Darn-Seo
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.21 no.5
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    • pp.1346-1351
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    • 2007
  • Crohn' disease is an auto-immune disease characterized by intermittent chronic diarrhea, high fever, weight loss, abdominal spastic pain or abdominal discomfort which is followed by granulomatous necrosis and cicatrical inflammation. It is also called segmental enteritis or granulomatous enteritis. In western medicine the exact cause is undefined, however it is presumed as an immunological unbalance in alimentary tract commoonly occured in ileum portion of small intestitine or ascending colon and therefore immuno suppressive agents(usually steroids) and anti-inflammatory drugs are prescribed. In case of emergency such as ileus, perforation of intestinal wall surgical methods are considered. In oriental medicine this falls under the category of diarrhea(泄瀉), dysentery(痢疾), splenic diarrhea(脾泄). As to the pathological mechanism the abnormal ascending and descending circulation of stomach and splenic energy(脾不升淸, 胃不下降) the hepatic stagnation(肝鬱氣滯) and dysfunction of small intestine in expelling urine and feces(小陽淸獨不利) all together causes such condition. Main treatments are inducing diuresis(利小便), warming kindey to reinforce yang(溫賢助陽), nourishing the middle energy to invigorate spleen(補中健脾), elimination of the dampness by cooling(淸熱燥濕). In this case the patient was diagnosed as soyangyin(少陽人) constitution and herb medicine soyangyin Hyongbangjihwan-tang(少陽人 荊防地黃湯), Sa-am acupuncture Sojangjeonggyeok(小腸政格) was applied. There was an significant improve in chief complaints and general conditions.

A Clinical Case Report of a Lung Cancer Patient with Shoulder Pain after Lobectomy (폐엽절제술 후 견배부 통증을 호소한 폐암환자 치험 1례)

  • Choi, Kyu-Hee;Bang, Ji-Hyun;Kim, Jae-Hwan;Jung, Sung-Ki;Jung, Hee-Jae
    • Journal of Korean Traditional Oncology
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    • v.15 no.1
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    • pp.79-87
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    • 2010
  • Objectives : Quality of life(QoL) in patients with lung cancer usually goes down after pneumoectomy, and the pain is the most common cause. Uncontrolled postoperative pain can restrict the movements of shoulders resulting in frozen shoulder. This case report is to report the effect of herb medicine, Ohjuksan on a 49-year-old female lung cancer patient with shoulder pain after lobectomy. Methods : The patient was treated with Ohjuksan for 10 days. The patient's symptoms were assessed by range of motion(ROM) of shoulder, Visual analogue scale(VAS) of shoulder pain and abdominal diagnosis. Results & Conclusions : The patient showed improvement of ROM, VAS and abdominal diagnosis. As the shoulder pain is relieved from VAS6 to VAS3, ROM of abduction, adduction and internal rotation were increased. Also discomfort of abdomen was disapeared to a certain degree. This suggests that herb medicine, Ohjuksan is effective for treating postoperative pain of shoulder for a Lung cancer patient.

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A case of gastric trichobezoar causing psychiatric problems (정신적 문제로 인한 털위석 1례)

  • Seo, Ji Young;Kim, Min Young;Noh, Jae Ho;Kim, Chun Dong;Park, Jae Ock;Choi, Gyo Chang
    • Clinical and Experimental Pediatrics
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    • v.52 no.10
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    • pp.1167-1170
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    • 2009
  • Trichobezoar is characterized by the accumulation of hair in the gastrointestinal tract and usually occurs in those who have trichotillomania, other psychiatric disorders, or neurologic problems. Trichobezoar typically presents as gastric obstruction, including abdominal pain, vomiting, anorexia, and weight loss. A 9-year-old girl visited our clinic with the complaint of abdominal discomfort and vomiting. A review of her medical history revealed that she had trichophagia since the age of 5, and she felt that her parents had been strict with her. She underwent gastrotomy, during which a large trichobezoar was removed. This case highlights the importance of psychiatric and comprehensive approaches in patients with trichobezoar.

A Case of Primary Mucinous Cystadenocarcinoma (원발성 후복막 점액낭샘암종 1예)

  • Ji, Jun-Ho;Lee, Hwa-Jung;Park, Seung-Chan;Park, Jung-Chul;Choi, Eun-Jung;Seo, Hye-Jin;Lee, Won-Sik;Lee, Jung-Lim;Bae, Byung-Jo;Shon, Kyung-Rak;Lee, Kyung-Hee
    • Journal of Yeungnam Medical Science
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    • v.25 no.2
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    • pp.134-138
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    • 2008
  • Primary retroperitoneal mucinous cystadenocarcinoma is a very rare malignancy, and little is known concerning its pathogenesis, optimal treatment, and prognosis. A 29-year-old pregnant woman (21 weeks) presented with abdominal discomfort. CA 19-9, CA 125, and CEA were normal. Abdominal CT scanning revealed a $19{\times}15{\times}13cm$ retroperitoneal tumor. Exploratory laparotomy and tumor excision were performed. Mucinous retroperitoneal implants were removed as completely as possible. Histologically, the tumor showed focal areas of capsular invasion, but free resection margins. The uterus and both ovaries were normal in appearance. No adjuvant therapy was pursued. Six months later, peritoneal and bilateral ovarian metastases were discovered. Hence, we report the details of this case of primary retroperitoneal mucinous cystadenocarcinoma and present a review of the literature.

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Calcifying Aponeurotic Fibroma Occurring on the Chin: A Case Report (턱에 발생한 석회화건막섬유종 : 증례보고)

  • Jung, Yun Joo;Choi, Young Woong;Shin, Eun Ah
    • Archives of Plastic Surgery
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    • v.35 no.1
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    • pp.104-106
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    • 2008
  • Purpose: Fewer than 100 cases of calcifying aponeurotic fibroma have been reported in the literature since this entity was initially described by Keasbey in 1953 who called it calcifying juvenile aponeurotic fibroma. The tumor is a slowly growing, painless mass. In most cases the mass is poorly circumscribed and causes neither discomfort nor limitation of movement. Most lesions occur in children, with a peak incidence ages of 8-14 years. There is no evidence of any increased familial prevalence. Predilection sites are palm, finger, toe, but it also occurs in the wrist, forearm, elbow, upper arm, neck, abdominal wall, lumbar paravertebral area, leg and ankle. We herein describe a rare case of calcifying aponeurotic fibroma occurring on the chin with review of the literature. Methods: A 14-year-old male had painless, slowly growing mass(${\phi}2.5cm$) on a chin for a year. The tumor was excised elliptically under local anesthesia and the excisional site was repaired directly. Due pathological examination was processed. Results: Histological examination revealed an illdefined fibrous growth that extends with multiple processes into the surrounding tissue with centrally located foci of calcification. The tumor is composed of short spindled plump fibroblasts with round or ovoid nuclei separated by collagenous stroma, showing vaguely palisading pattern. Diagnosis of calcifying aponeurotic fibroma was conferred. Postoperatively, the patient did well, and the lesion had not recurred. Conclusion: Fewer than 100 cases of calcifying aponeurotic fibroma have been reported in the literature. The most common occurring sites are palm, finger & toe, but it has been reported in the wrist, forearm, elbow, upper arm, neck, abdominal wall, lumbar paravertebral area, leg and ankle. Two cases of calcifying aponeurotic fibroma occurring on the neck have been reported in the literature. To the authors knowledge, our case of calcifying aponeurotic fibroma occurring on the chin is the first to be reported.

Gastro-Cavenous Fistula Developed after Esophagectomy(Ivor Lewis Operation) Due to Active Gastric Ulcer in Esophageal Cancer (식도암 환자에서 식도암적출술후 활동성 위궤양에 의해 발생한 위-공동 누공)

  • 김성철;심영목;김관민;김진국
    • Journal of Chest Surgery
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    • v.32 no.1
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    • pp.49-52
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    • 1999
  • A 58-year-old male patient visited our hospital for epigastric discomfort and dysphagia which had developed 5 months earlier. He was diagnosed with esophageal cancer at the mid-thoracic level based on radiologic, endoscopic, and histologic examinations. An esophagectomy(Ivor Lewis technique) was done to treat the esophageal cancer. He was doing well until the 20th postoperative day when he began to complain of cough, sputum, fever and chills, Subsequently, thereafter, abdominal pain and generalized abdominal tenderness developed on the 22nd postoperative day. Upon gastrofiberscopy and esophagographic examinations, he was diagnosed with gastrobronchial fistula and an emergency operation was performed. On operative findings, the gastric fundus was perforated and directly connected to the abscessed cavity of the right upper lobe due to a gastric ulcer. We, herewith, report this case after review of the literature.

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Nutritional Status and Dietary Change after Gastrectomy of Gastric Cancer Patients (위암환자의 위절제술 후 영양상태 및 섭취량 변화)

  • Park, Young-Ok;Yoon, So-Yoon;Kang, Shin-Sook;Han, Sang-Mi;Kang, Eun-Hee
    • Korean Journal of Community Nutrition
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    • v.17 no.1
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    • pp.101-108
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    • 2012
  • The purpose of this survey is to investigate the nutritional status and dietary intake of gastrectomized cancer patients in Asan Medical Center. The subjects were 98 patients, who underwent a gastrectomy due to gastric cancer and were admitted to the General Surgery Department during March 2007 to December 2007. We examined general characteristics (sex, age, clinicopathological stage, type of operation), anthropometric data (height, weight change), biochemical data (red blood cell RBC, hemoglobin HGB, hematocrit HCT, mean corpuscular volume MCV, total lymphocyte count TLC, albumin, total cholesterol), dietary intake and dietary intake related symptoms. Weight loss of gastrectomized patients was $9.0{\pm}4.3$% from preillness weight to visiting out-patient department (OPD) weight. Biochemical data (RBC, HGB, HCT, MCV, TLC, albumin, total cholesterol) significantly deteriorated after gastrectomy. However, outpatient visits were all restored to the normal range. Postoperative energy intake was $785.0{\pm}164.2$ kcal, which corresponds to $41.6{\pm}9.6$% of daily energy requirement. The cause of poor oral intake is mostly fear, abdominal pain and abdominal discomfort. Therefore, to control pre-or post-operative weight change in the future requires, focusing on the body weight to maintain a normal or usual nutrition by interventions and increased caloric intake during hospitalization for the development of nutrient-dense meals. In addition, as the main reason of the lack of intake of meals after the gastrectomy was fear, the patients should be actively encouraged to consider the importance of eating proper meals.

Nonoperative management of colon and mesocolon injuries caused by blunt trauma: three case reports

  • Naa, Lee;Euisung, Jeong;Hyunseok, Jang;Yunchul, Park;Younggoun, Jo;Jungchul, Kim
    • Journal of Trauma and Injury
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    • v.35 no.4
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    • pp.291-296
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    • 2022
  • The therapeutic approach for colon injury has changed continuously with the evolution of management strategies for trauma patients. In general, immediate laparotomy can be considered in hemodynamically unstable patients with positive findings on extended focused assessment with sonography for trauma. However, in the case of hemodynamically stable patients, an additional evaluation like computed tomography (CT) is required. Surgical treatment is often required if prominent mesenteric extravasation, free fluid, bowel infarction, and/or colon wall perforation are observed. However, immediate intervention in hemodynamically stable patients without indications for surgical treatment remains questionable. Three patients with colon and mesocolon injuries caused by blunt trauma were treated by nonoperative management. At the time of admission, they were alert and their vital signs were stable. Colon and mesocolon injuries, large hematoma, colon wall edema, and/or ischemia were revealed on CT. However, no prominent mesenteric extravasation, free fluid, bowel infarction, and/or colon wall perforation were observed. In two cases, conservative treatment was performed without worsening abdominal pain or laboratory tests. Follow-up CT showed improvement without additional treatment. In the third case, follow-up CT and percutaneous drainage were performed in considering the persistent left abdominal discomfort, fever, and elevated inflammatory markers of the patient. After that, outpatient CT showed improvement of the hematoma. In conclusion, nonoperative management can be considered as a therapeutic option for mesocolon and colon injuries caused by blunt trauma of selected cases, despite the presence of large hematoma and ischemia, if there are no clear indications for immediate intervention.