• Childhood Kidney Diseases
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• 제2권1호
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• pp.90-94
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• 1998

Hinman syndrome is a condition representing urinary voiding dysfunction in the neurologically intact child. The syndrome is probably caused by acquired behavioral and psychosocial disorders manifested by bladder and/or bowel dysfunction mimicking neurologic disease. Clinically, the symptom complex may include day and night time enuresis, encopresis, constipation, and recurrent urinary tract infections. Cystoscopy frequently demonstrates normal vesicourethral anatomy. Voiding films usually demonstarate a carrot-shaped proximal urethra with a persistent narrowing at the external sphincter. The bladder is large and often appears trabeculated with a thickened wall and significant postvoid residual. A 13-year-old male child was admitted due to fever, urinary tract infection, enuresis and flank pain. His neurologic examination was normal. Renal sonograms showed moderate hydronephrosis. Voiding cystourethrograms showed a huge, trabeculated bladder without vesicourethral reflux and urethral valves. No abnormal findings was found in spinal MRI.

• 사상체질의학회지
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• 제20권3호
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• pp.142-150
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• 2008

1. Objective The purpose of this study is to examine the characteristics and the improvement in the symptoms of the patients who administrated Hyungbangjihwang-tang. 2. Methods We examined 793 case report forms(CRFs) from six oriental medical hospitals and three regional oriental medicine clinics. These CRFs are recorded from november 2007 to july 2008. All constitutions of cases were diagnosed not only by Sasang constitution experts but also through clinical experiences. The traits of the patients and the effects of their treatment were examined. 3. Results and Conclusion 1. The chief complaints in which the patients showed improvement were Headache, fatigue, lumbago, dyspepsia. 2. The ordinary symptoms in which the patients showed improvement were insomnia, fatigue, constipation, dyspepsia, headache. 3. The average food intake of the patients was normal(65.2%) and their feces had intermediate hardness (semi-soft). The color of their urine was either clear or yellow. 4. The amount of the patients' sweat was appropriate (39.1%) Their water intake was approximately normal, and they preferred drinking the cold water. 5. Among the diseases that the patients previously had chronic gastritis(19.6%) had the highest frequencies. 4. Conclusion: The above results show that Hyungbangjihwang-tang can be considered beneficial to headache, fatigue, lumbargo, insomnia, constipation, dyspepsia patients whose food intake is normal, whose sweat level is either appropriate, who prefer to drink cold water, and who are suffering from chronic gastritis.

• Advances in pediatric surgery
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• 제1권1호
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• pp.68-72
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• 1995

Segmental dilatation of the colon is a very rare disease entity of unknown etiology and may mimic Hirschsprung's disease. It is characterized by dilatation of a segment of the colon of variable length with obstruction due to lack of peristalsis in a normally innervated intestine. Recently authors experienced a case of segmental dilatation of the sigmoid colon in a 6 month-old male, who presented with severe constipation, abdominal distention, and abdominal mass since 2 months of age. Down's syndrome and congenital nystagmus were associated. Barium enema demonstrated focal dilatation of the sigmoid colon, but the rectum and descending colon proximal t o the affected colon were of normal caliber. Rectal suction biopsy with acetylcholinesterase staining was normal and anorectal manometry showed normal rectosphincteric reflex. At operation, there was a massively dilated and hypertrophied sigmoid colon with increased tortuous serosal vessels, measuring 15 cm in length and 10 cm in width. Teniae coli were identifiable in the affected segment. Frozen section biopsies at the proximal, affected, and distal colon showed ganglion cells. Descending loop colostomy was constructed initially and segmental resection and end to end colocolostomy were carried out 3 months later. Final histologic examination showed 1) normal colonic mucosa with ganglion cells, 2) prominent submucosal fibrosis and marked muscular hypertrophy, 3) unremarkable acetylcholinesterase activity and immunohistochemical findings against S-100 protein. On 8 months follow-up, he has been doing well and moves bowels 1-2 times daily.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제23권1호
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• pp.26-34
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• 2020

Purpose: To compare the clinical features, diagnostic findings, and medications of children with infrequent bowel movements or fecal soiling. Methods: This study enrolled 333 children (189 male; age range, 1 month to 18 years) diagnosed with functional constipation by Rome III or IV criteria. We classified them into 3 groups (infrequent bowel movement without fecal soiling [G3-a], infrequent bowel movement with fecal soiling [G3-b], and fecal soiling only [G3-c]) and into 2 subgroups of fecal soiling (G2-b) or not (G2-a). Retrospective data on clinical characteristics, colon transit time (CTT) test results, and medications were collected. The Wilcoxon rank-sum test, Kruskal-Wallis test, Chi-square test, and Fisher's exact test were used for the statistical analysis. Results: The median age (months) and interquartile range (IQR) was 33 (45) in G3-a, 54 (40) in G3-b, and 73 (48) in G3-c (p<0.0001). G3-c had the latest onset (median, 18; IQR, 18; p=0.0219) and longest symptom duration (24 [24], p=0.0148). PEG 4000 was used in 60.6% (G3-a), 96.8% (G3-b), and 83.2% (G3-c) of patients (p<0.0001). The median age (months) and IQR were 33.0 (45.0) in G2-a and 63.5 (52.5) in G2-b (p<0.0001). G2-b had later onset (median, 12; IQR, 19.5; p=0.0062) and longer symptom duration than G2-a (24 [12], p=0.0070). PEG 4000 was used in 60.6% (G2-a) and 88.3% (G2-b) of children (p<0.0001). No statistically significant intergroup differences were seen in maintenance laxative dose, CTT, or CTT type. Conclusion: Infrequent bowel movement and fecal soiling represent the advanced stage of chronic functional constipation.

• Journal of Yeungnam Medical Science
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• 제23권2호
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• pp.227-231
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• 2006

기도가 닫힌 상태에서 강하게 숨을 뿜어내는 발살바법은 망막의 정맥압을 상승시키고 이에 따라 망막 출혈을 유발시킬 수 있다. 힘든 배변을 경험한 55세 남자가 우안의 중심시력 감소로 인해 본원을 방문하였다. 전신적인 질환으로 고혈압, 만성 변비를 앓고 있었고 동공을 산대하여 정밀 안저검사를 한 결과 유두 한 개 정도 크기의 망막전 출혈과 황반와주위로 작은 크기의 망막내 출혈이 관찰되었다. 특별한 치료없이 망막 출혈은 자연 흡수되어 시력은 정상으로 회복되었다. 배변으로 인해 급작스런 시력감퇴를 나타낸 발살바 망막증을 경험하였기에 보고하는 바이다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제16권3호
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• pp.200-205
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• 2013

We present a case of a 47-month-old female suffering from acute urinary bladder neck obstruction and bilateral hydronephrosis secondary to a fecaloma. Fecaloma is defined as an accumulation of inspissated feces in the colon or rectum giving the appearance of an abdominal mass. A fecaloma can be developed by diverse causes and the causes of the fecaloma in this case were septum reformation after the Duhamel procedure and long-term constipation. Chronic constipation is very common at outpatient clinic. However, acute urinary retention and voiding difficulty caused by fecaloma in the giant Duhamel pouch has never been reported in Korea. We would like to present our case with acute urinary retention due to a fecaloma and suggest that fecaloma might be considered as one of the causes for acute urinary retention, especially in cases with previous Duhamel operation for repair of Hischsprung disease.

• Advances in pediatric surgery
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• 제8권1호
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• pp.54-61
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• 2002

Hirschsprung's disease (HD) is usually diagnosed in the newborn period and early infancy. The common presentation of HD in newborns consists of a history of delayed passage of meconium within the first 48 hours of life. The differential diagnosis in newborns is one of the clinical challenges of this disorder. A number of medical conditions which cause functional obstruction of the intestines are easily excluded. Neonates with meconium ileus, meconium plug syndrome, distal ileal atresia and low imperforate anus often present in a manner similar to those with HD in the first few days of life. Abdominal radiographs may help to diagnose complete obstruction such as intestinal atresia. Microcolon on contrast enema can be shown in cases with total colonic aganglionosis, ileal atresia or meconium ileus. Suction rectal biopsy or frozen section biopsy at operation is essential for differential diagnosis in such cases. HD is also considered in any child who has a history of constipation regardless of age. Older children with functional constipation may have symptoms that resemble those of HD and contrast enema is usually diagnostic. However, children with other motility disorders generally referred to as chronic idiopathic intestinal pseudoobstruction present with very similar symptoms and radiographic findings. These disorders are classified according to their histologic characteristics.; visceral myopathy, visceral neuropathy, intestinal neuronal dysplasia (IND), hypoganglionosis, immature ganglia, internal sphincter achalasia. Therefore, the workup for motility disorders should include rectal biopsy not only to confirm the presence of ganglion cells but also evaluate the other pathologic conditions.

• Archives of Reconstructive Microsurgery
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• 제26권1호
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• pp.18-22
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• 2017

Inevitable immobilization after surgery on lower extremities can induce chronic constipation. Elderly diabetic women usually express ambiguous gastrointestinal symptoms and signs. We present here a case of panperitonitis developed from severe fecal impaction in an elderly diabetic woman after hand reconstruction using material harvested from the lower extremities. A 68-year-old diabetic female underwent anterolateral thigh free flap and wound revision twice on the left thumb. Three weeks after surgery, she complained about mild abdominal pain though she had daily defecation. Despite encouraging ambulation, her compliance was low. Resection of the sigmoid colon and colostomy were performed after diagnosis with bowel perforation. However, the patient went into septic shock and died with multiorgan failure after the guardians issued a DNR (do not resuscitate) order. For preventing bowel perforation, increased uptake of dietary fiber and early ambulation postoperatively should be encouraged, after even hand surgeries.

• 한국의사학회지
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• 제35권1호
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• pp.69-86
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• 2022

This study examined guange (關格) in Yixuerumen (醫學入門) from a new perspective and evaluated its value in terms of emergency medicine. We compared and analyzed the definition, symptoms, and treatment methods of guange in Yixuerumen with related clinical presentations in modern medicine. Guange includes nausea and vomiting, dysphagia, dysuria, and constipation without diarrhea. A representative disease related to dysuria is uremia, while one related to constipation, nausea, and vomiting is enterocleisis, and and a third related to dysphagia is chronic esophagitis and esophagus cancer. Li Chan, the author of Yixuerumen, recognized guange as an emergency of serious eating and elimination disorder as various symptoms of diseases (病症) gradually get worse from the perspective of external diseases (外感病) and miscellaneous diseases (雜病) and handled it in various ways including yin-tonifying medicinals (補陰藥), qi-tonifying medicinals (補氣藥), qi-regulating formulas (理氣劑), phlegm-dispelling formulas (去痰劑), and "water rising, fire falling" formulas (水升火降) in addition to emetic formulas (催吐劑), diuretic formulas (滲利劑), and interior-attacking formula (攻裏劑). Concepts like guange in Yixuerumen were somewhat useful when handling the applicable emergencies at the level of then medical treatment.

• 대한한방내과학회지
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• 제28권2호
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• pp.391-398
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• 2007

Objectives and Methods : Chronic pancreatitis is an inflammative disease characterized by both persistent and irreversible progression of pancreatic lesions that accompanies complications and pain which hinders everyday life activities. As the alcohol consuming population increases, chronic pancreatitis is increasing consequently. We retrospectively analyzed the medical record of a chronic pancreatitis patient who had been treated with oriental herbal medicine, acupuncture and moxibustion for 40 days. He complained of anorexia, fatigue, indigestion, weight loss, constipation, abdominal discomfort and pain. We prescribed him Daekumeumja, Bojungikgi-tang and other oriental herbal medicines in order to cure these symptoms. Results and Conclusion : For 40 days he was treated with oriental medicine and the symptoms mostly disappeared. When it comes to the therapeutic effects, it could be suggested that oriental medicine has significant effects on improving symptoms and qualities of lives.