• Journal of Yeungnam Medical Science
• /
• v.14 no.2
• /
• pp.393-398
• /
• 1997

An accurate early diagnosis of congenital midgut malrotation is essential to prevention of catastrophic effects of volvulus. To evaluate the usefulness of radiologic examinations in diagnosing intestinal malrotation, we retrospectively analyzed radiologic findings and operation records of 17 intestinal malrotation patients, who were radiologically diagnosed. The age range of the patients studied were from 1day to 12years. The presenting symptoms were vomiting, vomiting with abdominal pain, abdominal distention, diarrhea and failure to thrive. The viewpoints of this analysis were the location of duodeno-jejunal flexure on barium meal and cecal location on barium enema. Sixteen of 17 patients, who were radiologically diagnosed, were surgically proven, but one patient with annular pancreas was false positive. In the case of 3 surgically proved patients, malrotation was suspected on barium meal prior to the barium enema, but final diagnosis was determined on barium enema examination. We concluded that a barium enema should be performed on all children with suspected malrotation where the initial upper gastro-intestinal study was normal or suspicious on account of the small incidence of false positive and false negative barium meals.

• Journal of Veterinary Clinics
• /
• v.38 no.5
• /
• pp.231-234
• /
• 2021

A 14-month-old, intact female Maltese (case 1) and a 26-month-old, spayed female Dachshund (case 2) had persistent regurgitation over 1 year and 2 years, respectively. In both cases, there were not specific findings in blood examination. Diagnostic imaging and fluoroscopy revealed that gastroesophageal reflux (GER) occurred when the patients ate a barium meal without abdominal contraction. They were treated with proton-pump inhibitor (esomeprazole), sucralfate and prokinetics (cisapride) while in a standing position for an hour after every meal, according to the gastroesophageal disease (GERD) suggested treatment. The case 1 dog was discharged with improved clinical signs, and the case 2 dog also had been improved clinical signs; however, aspiration pneumonia occurred in case 2, which was thought to be a complication from GERD. After receiving treatment for aspiration pneumonia, the case 2 dog was discharged from the hospital. Since there was no further improvement in symptoms after discharge, the case 1 dog was euthanized by owner's request, and the case 2 is alive, having only mild clinical signs upon the writing of this paper.

• Archives of Pharmacal Research
• /
• v.25 no.6
• /
• pp.978-983
• /
• 2002

Small intestinal transit (SIT) has often been regarded as an index of pathophysiological state of postoperative ileus (PI) in rats. The reliability of SIT as an index of PI was examined in the present study. PI was induced via abdominal surgery (i.e., laparotomy with evisceration and manipulation) in rats. For one group of PI-induced rats, SIT of a charcoal test meal was measured. When necessary, the physical state (i.e., severity and site of distension) of the gastrointestinal (GI) tract in each rat was visually examined. For another group of PI-induced rats, abdominal X-ray radiographs were obtained after introducing the barium sulfate suspension. The abdomen was then opened and the physical state of the GI tract was visually examined. The SIT was decreased in most of the PI-induced rats, and the GI distension was observed, with substantial intersubject variations, in all of the PI-induced rats. However, no linear relationship was evident between the SIT and the severity of GI distension (e.g., at 20 h after PI induction). Instead, the severity and site of GI distension could be monitored by the X-ray radiology. Therefore, the use of SIT as an index of PI should be substantially limited.

• Journal of Gastric Cancer
• /
• v.15 no.2
• /
• pp.147-150
• /
• 2015

Gastric volvulus is an uncommon clinical entity. There are three types of gastric volvulus; organoaxial, mesenteroaxial and combined type. This condition can lead to a closed-loop obstruction or strangulation. Traditional surgical therapy for gastric volvulus is based on an open approach. Here we report a successful case of a patient with chronic gastric volvulus with a laparoscopic treatment. A 79-year-old woman came to the emergency department with epigastric pain accompanied by nausea for 2 weeks. Abdominal computed tomography revealed markedly distended stomach with transposition of gastroesophageal Junction and gastric antrum. Barium meal study revealed presence of the antrum was folded over 180 degrees that was located above gastroesophageal junction. We attempted an endoscopic reduction, but it was unsuccessful. The patient got laparoscopic anterior gastropexy. Based on our result, laparoscopic gastropexy can be considered as a good choice of the treatment for gastric volvulus.

• Advances in pediatric surgery
• /
• v.20 no.2
• /
• pp.65-68
• /
• 2014

Congenital duodenal obstruction is a one of the emergent surgical conditions in neonates. Almost of them were diagnosed with double-bubble sign in prenatal ultrasonography. However, partial obstruction caused from duodenal web could be overlooked. We reported a duodenal web in early childhood. A three-year-old girl visited at our pediatric clinic for constipation. She had been showed non-bilious vomiting after weaning meal since 6 months old of her age, but her weight was relevant for 50-75 percentile of growth curve. Barium enema was initially checked, but any abnormal finding was not found. We noticed the severely distended stomach and 1st portion of duodenum. Upper gastrointestinal series revealed partial obstruction in 2nd portion of duodenum. After laparotomy, we found the transitional zone of duodenum and identified a duodenal web via duodenotomy. We performed duodeno-duodenostomy without any injury of ampulla of Vater. She was recovered uneventfully. During 6 months after operation, she does well without any gastrointestinal symptoms or signs, such as vomiting or constipation.

• Journal of Chest Surgery
• /
• v.7 no.2
• /
• pp.163-168
• /
• 1974

Five cases of traumatic diaphragmatic hernia were repaired in the Department of Thoracic Surgery, Seoul National University Hospital, during the period from 1967 to 1974. The first case, a 14-year aid girl, was diagnosed as diaphragmatic hernia during laparotomy because of jejunal perforation 3 days after traffic accident. Herniated stomach, transverse colon, spleen and left lobe of the liver were repositioned and the diaphragmatic rupture on left posterolateral portion was repaired with two layers of nonabsorbable sutures by transthoracic approach. The second case, a 26-year old man,was diagnosed immediately after traffic accident at a local clinic and transferred to this hospital 24 hours later. Herniated stomach, transverse colon and jejunum were repositioned amd diaphragmatic rupture,about 9 cm in length,from the posterolat.edge to the base of pericardium was sutured in two layers. The third case, a 26-year old man who had stab wound on the left lower lateral chest two years ago,was admitted with sudden abdominal pain and vomiting. Upper gastrointestinal series with barium meal revealed diaphragmatic hernia. The herniated stomach and transverse colon through the defect,about 3.5cm in diameter, at anterolateral portion on the left side,were repositioned and repaired with two layers of nonabsorbable sutures. The forth case, a 26-year old man, sustained blunt trauma to the chest by a roller and was transferred to the emergency room complaining of dyspnea 40 minutes after the accident. The diaphragmatic rupture extended from left midaxillary line to contralateral anterior axillary line,about 20cm long, at anterior portion of diaphragm, which was repaired with two layers, of nonabsorbable sutures. The fifth case, a 4-year old girl, had two separate diaphragmatic ruptures on both sides, which were caused by traffic accident. Immediate upper gastrointestinal series after injury showed herniated stomach, colon and spleen into left Chest cavity. Another small rupture with anterior edge of right lobe of the liver in chest cavity was noted. These were repaired with non-absorbable sutures via thoracotomy.

• Journal of the Korean Society of Radiology
• /
• v.4 no.3
• /
• pp.19-25
• /
• 2010

Dysphagia is common and serious problems in post-stroke patients. The post-stroke dysphagia with aspiration is associated with dehydration, malnutrition, pneumonia, sepsis and death. Up to date, gag reflex and choking history used to decide the aspiration in clinical. The purpose of this study was to evaluate the aspiration and to choice the proper meal formation using by video fluoroscpic swallowing study(VFSS) with post-stroke dysphagia patients. 58 post-stroke patients and ten normal person participated to perform the VFSS with liquid type, puding, yoplait, rice mixed with barium(Ba). Two rehabilitation medicine doctors and a radiological technologist analysed the phase(oral, pharyngeal, esophageal phase)with video film, and checked the pharyngeal transition time(PTT). 38 patients showed abnormality in pharyngeal phase, 13 patients in oral and pharyngeal phase, 3 patients in oral phase, and 2 patients in pharyngeal and esophageal phase. 43 patients(65.2%) occured the aspiration, but 23 of 43 patients improved by the chin tuck position. Aspiration occured 34 patients in liquid type, 2patients in rice gruel and nothing in boiled rice. After VFSS, 13 of 23 patients change the intaking pathway from nasogastric tube(NGT) to oral, On the contrary with 3 of 42 patients from oral to NGT. Consequently VFSS is clearly effective to evaluate the aspiration with post-stroke dysphagia patients.

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.9
• /
• pp.5023-5029
• /
• 2013

Background: To evaluate knowledge about screening tests and tests without proven screening value in a Greek Breast Unit population undergoing benign vacuum-assisted breast biopsy (VABB). Materials and Methods: This study included 81 patients. Three knowledge-oriented items (recommended or not, screening frequency, age of onset) were assessed. Regarding screening tests two levels of knowledge were evaluated: i). crude knowledge (CK), i.e. knowledge that the test is recommended and ii). advanced knowledge (AK), i.e. correct response to all three knowledge-oriented items. Solely CK was evaluated for tests without proven screening value. Risk factors for lack of knowledge were assessed with multivariate logistic regression. A second questionnaire was administered 18 months after VABB to assess its impact on the performance of tests. Results: Concerning screening tests considerable lack of AK was noted (mammogram, 60.5%; Pap smear, 59.3%; fecal occult blood testing, 93.8%; sigmoidoscopy, 95.1%). Similarly lack of CK was documented regarding tests without proven screening value (breast self-examination, 92.6%; breast MRI, 60.5%; abdominal ultrasound, 71.6%; barium meal, 48.1%; urine analysis, 90.1%; chest X-Ray, 69.1%; electrocardiogram, 74.1%; cardiac ultrasound, 75.3%). Risk factors for lack of AK were: place of residence (mammogram), age (Pap smear), personal income (sigmoidoscopy); risk factors for lack of CK included number of offspring (breast MRI, chest X-Ray), BMI (abdominal ultrasound), marital status (urine analysis), current smoking status (electrocardiogram). VABB's only effect was improvement in mammogram rates. Conclusions: A considerable lack of knowledge concerning screening tests and misperceptions regarding those without proven value was documented.