• Title/Summary/Keyword: Chronic abdominal pain

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Bowel Wall Thickening on Computed Tomography in Children: A Novel Method of Measurement and Its Clinical Significance

  • Lee, Do Kyung;Cho, Ky Young;Cho, Hyun-hae;Seo, Jeong Wan
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.24 no.3
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    • pp.279-287
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    • 2021
  • Purpose: The clinical implications of bowel wall thickening (BWT) on abdominal computed tomography (CT) among children are unknown. We aimed to suggest a new method for measuring BWT and determining its clinical significance in children. Methods: We retrospectively analyzed 423 patients with acute abdomen who underwent abdominal CT; 262 were classified into the BWT group. For this group, the pediatric radiologist described the maximal bowel wall thickness (MT), normal bowel wall thickness (mm) (NT), and their ratios for each segment of the bowel wall. Results: In the thickened bowel walls, the thickness differed significantly between the small bowel (6.83±2.14 mm; mean±standard deviation) and the colon (8.56±3.46 mm; p<0.001). The ratios of MT to NT in the small bowel (6.09±3.17) and the colon (7.58±3.70) were also significantly different (p<0.001). In the BWT group, 35 of 53 patients had positive fecal polymerase chain reaction results; 6 patients infected with viruses predominantly had BWT in the small intestine, while the terminal ileum and the colon were predominantly affected in 29 patients with bacterial infections. In the initially undiagnosed 158 patients with BWT, the symptoms improved spontaneously without progression to chronic gastrointestinal disease. Conclusion: This study provides a clinical reference value for BWT in the small intestine and colon using a new method in children. The BWT on abdominal CT in children might indicate nonspecific findings that can be observed and followed up without additional evaluation, unlike in adults.

A Case Report of Colonic Mucinous Adenocarcinoma in 27 Year Old Patient (27세 남자환자에서 발견된 대장의 점액선암종 1례)

  • Woo Sun Rou;Ju Seok Kim;Sun Hyung Kang;Hee Seok Moon;Jae Kyu Sung;Hyun Yong Jeong
    • Journal of Digestive Cancer Research
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    • v.6 no.2
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    • pp.69-72
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    • 2018
  • Mucinous adenocarcinoma occurs in 1.6-25.4% of patients with colorectal cancer. We report a case of a 27-year-old man with negative findings on initial colonoscopic biopsy, but finally diagnosed with mucinous adenocarcinoma of the colon. After undergoing an abdominal CT due to persistent abdominal pain, he was transferred to our hospital. The abdominal CT showed a diffuse and irregular wall thickening in the distal transverse colon. Due to the edema and stenosis of colonic wall, it was difficult to insert the colonoscope into the proximal region; a biopsy revealed chronic colitis with lymphofollicular hyperplasia. Transverse colectomy and lymph node dissection were performed. The diagnosis was mucinous adenocarcinoma of approximately 20×4.5 cm. Compared to adenocarcinoma, mucinous adenocarcinoma is found in a younger population with an advanced stage and is less responsive to palliative chemotherapy. Therefore, recalcitrant abdominal pain even in young people warrants early detection through appropriate examinations such as abdominal CT and colonoscopy.

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Co-Infection with Cytomegalovirus and Helicobacter pylori in a Child with $M\acute{e}n\acute{e}$trier's Disease

  • Yoo, Yangho;Lee, Yoon;Lee, Yoo Min;Choe, Yon Ho
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.16 no.2
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    • pp.123-126
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    • 2013
  • $M\acute{e}n\acute{e}$trier's disease is a rare protein-losing gastropathy characterized by hypertrophic gastric fold, foveolar hyperplasia, and hypoproteinemia with resulting peripheral edema. It is clinically evident as nonspecific gastrointestinal symptoms, including abdominal discomfort, nausea and vomiting, abdominal pain, weight loss, diarrhea, and edema. Pediatric $M\acute{e}n\acute{e}$trier's disease usually has an insidious onset and progressive, chronic clinical course and it spontaneously resolves in weeks or months. The pathogenesis of $M\acute{e}n\acute{e}$trier's disease is not clearly understood. $M\acute{e}n\acute{e}$trier's disease is thought to be associated with some gastric infections. But the cause of $M\acute{e}n\acute{e}$trier's disease is unknown, an association with cytomegalovirus (CMV) and Helicobacter pylori has been suggested. In Korea, We present the first a case of pediatric $M\acute{e}n\acute{e}$trier's disease with positive evidence of CMV and H. pylori.

Clinical Characteristics of Celiac Disease and Dietary Adherence to Gluten-Free Diet among Saudi Children

  • Al Sarkhy, Ahmed;El Mouzan, Mohammad I.;Saeed, Elshazaly;Alanazi, Aziz;Alghamdi, Sharifa;Anil, Shirin;Assiri, Asaad
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.18 no.1
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    • pp.23-29
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    • 2015
  • Purpose: To describe the clinical characteristics of celiac disease (CD) among Saudi children and to determine the adherence rate to gluten free diet (GFD) and its determinant factors among them. Methods: A cross-sectional study was conducted, in which all the families registered in the Saudi Celiac Patients Support Group were sent an online survey. Only families with children 18 years of age and younger with biopsy-confirmed CD were included. Results: The median age of the 113 included children was 9.9 years, the median age at symptom onset was 5.5 years and the median age at diagnosis was 7 years, the median time between the presentation and the final diagnosis was 1 year. Sixty two of the involved children were females. Ninety two percent of the patients were symptomatic at the diagnosis while eight percent were asymptomatic. The commonest presenting symptoms included: chronic abdominal pain (59.3%), poor weight gain (54%), abdominal distention, gases, bloating (46.1%) and chronic diarrhea (41.6%). Sixty percent of the involved children were reported to be strictly adherent to GFD. Younger age at diagnosis and shorter duration since the diagnosis were associated with a better adherence rate. Conclusion: CD has similar clinical presentations among Saudi children compared to other parts of the ward; however, the adherence to GFD is relatively poor. Younger age at diagnosis and shorter duration since the diagnosis were associated with a better adherence rate.

Concurrent Torsion of the Caudate Liver Lobe and Spleen in a German Shepherd Dog

  • Seong-won An;Seung-Min Hwang;Il-Gwon Jung;Sang-Kwon Lee;Young-Sam Kwon
    • Journal of Veterinary Clinics
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    • v.41 no.1
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    • pp.30-36
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    • 2024
  • A 3-year-old, 20.6 kg, neutered male German Shepherd dog was referred to Kyungpook National University Veterinary Medicine Teaching Hospital. Clinical examination revealed chronic diarrhea for 6 weeks and a non-tender, distended abdomen without lethargy, anorexia, and vomiting. Diarrhea was watery and had a waxing and waning course despite symptomatic treatment. A complete blood count identified mild leukocytosis and mild anemia. Serum biochemistry analysis showed elevated alanine aminotransferase and aspartate aminotransferase levels, and mild hypoalbuminemia. Abdominal ultrasound examination revealed mixed echogenicity with absent blood flow at the caudate process of the caudate liver lobe and a small amount of ascites. Computed tomography revealed torsion of the caudate process of the caudate liver lobe and spleen and gas dilatation of the intestine. After establishing a diagnosis of organ torsion on imaging, we deemed the condition an emergency and immediately performed surgery. Given that laparotomy confirmed organ torsion, liver lobectomy, total splenectomy, and prophylactic gastropexy were conducted. The patient was discharged 11 days after surgery without complications. In general, liver lobe torsion and splenic torsion are uncommon in dogs and present with nonspecific clinical signs, such as abdominal pain, lethargy, anorexia, and vomiting. In the current case, torsion of the caudate liver lobe and spleen occurred without other clinical signs except for a distended abdomen. Moreover, no reports in dogs have demonstrated the simultaneous occurrence of both diseases.

The Clinical Evaluation of Hepatic Disease (간장질환의 임상에 대한 관찰)

  • Yang, Il-Sun;Cho, Chong-Sook
    • Journal of Nutrition and Health
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    • v.6 no.2
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    • pp.17-24
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    • 1973
  • The function of the liver is so complicated and important that various Hepatic diseases are occured due to functional retardation of liver. Above all, the incidence of Hepatitis and liver cirrhosis among Koreans has shown an increasing tendency recently. 113 cases of Hepatitis and 125 cases of liver cirrhosis which had been admitted, more than 10 days, to KOREA Hospital between November, 1968 and July,1972, were studied through clinic charts. (A) Hepatitis 1) of the 113 cases; 54 cases (47.7%) were Infectious hepatitis; 40 cases (35.4%) were chronic hepatitis 2) of the 113 cases ; 80 cases (70.8%) were male and 33 cases (29.2%) were female; the sex ratio was 2.4 : 1 The ages of the onset of the disease was as follows; 34 cases (30.1%) were among $30{\sim}40$. 3) Patients had abdominal pain (77.9%) anorexia (66.4 %) and general weakness(82.3%) as symptom and jaundice (94.7%) hepatomegaly (76.1%) as sign 4) 57 cases of all had complication 26 cases (45.6%) were parasite, 12 cases (21.1%) were diabeties mellitus. 5) 99 casea (87.6%) of all were improved and recovered. (B) Liver Cirrhosis 1) Etiologic factors are hepatitis (56cases) and alcoholics (28 cases). 2) of the 125 cases, 84 cases (67.2%) were male and 41 cases (32.8%) were female; the sex ratio was 2 : 1 The age of the onset of the disease was as follows; 47 cases (37.6%) were among 41-50. 3) Patients had symptoms: indigestion (64.8%), Abdominal pain (60%), general wenkness (35.2%) and signs; Hepatomegaly (61.6%) Ascites (59.2%), Jaundice(56.8%). 4) 107 cases of all had complications; Hepatic coma was 20 cases (18.7 %), Ascites was 16 cases (15.0%). 5) 69 cases (55.2%) were improved. (c) Treatment of Hepatitis and cirrhosis. 1) Absolutely (bed) rest. 2) A well-balanced diet adequate in calorie value, showed be given (High Carbohydrate, High Protein, High vitamin diet) if the patient's appetite is good and easily digested. 3) Drugs; (1) Vitamins (2) Digestants (3) Tranquize

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A Case of Tuberculous Enteritis with Active Pulmonary Tuberculosis in a 12-Year-Old Girl (12세 여아에게서 활동성 폐결핵에 동반된 장결핵 1례)

  • Park, Ga Young;Park, Jae Young;Kim, Chang Hwi;Kwak, Jeong Ja;Park, Jae Ock
    • Pediatric Infection and Vaccine
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    • v.20 no.3
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    • pp.190-196
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    • 2013
  • Intestinal tuberculosis (TB) is presented with nonspecific and variable clinical manifestations such as abdominal pain, diarrhea, fever and weight loss. Diagnosis of tuberculous enteritis may be missed or confused with many other chronic gastrointestinal disorders such as the Crohn disease and intestinal neoplasms. The diagnosis should be based on careful clinical evaluations, such as extra-intestinal signs and colonoscopic and histologic findings. Newer techniques such as PCR tests from the specimens through colonoscopic biopsy may be helpful to confirm diagnosis of tuberculous enteritis. The treatment regimens for pulmonary tuberculosis are generally effective for tuberculous enteritis as well. If not treated early, the prognosis of intestinal tuberculosis is poor. We report a case of tuberculous enteritis diagnosed by colonoscopic biopsy and TB PCR which was presented with diarrhea, abdominal pain, intermittent fever and weight loss in a 12-year-old girl with active pulmonary tuberculosis. The patient was treated successfully with antituberculosis agents for 11 months without any complications.

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A clinical study of peripheral vascular surgery using prosthetic or autogenous vein grafts -34 cases- (인조혈관 및 자가혈관을 이용한 말초혈관 수술 34예에 대한 임상적 고찰)

  • 이정렬
    • Journal of Chest Surgery
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    • v.19 no.3
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    • pp.412-420
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    • 1986
  • From 1968 through September 1986, the authors have experienced 34 cases of peripheral arterial surgery using various vascular grafts. Almost all patients [32] were men, and age distribution was variable according to the disease entities. There were twenty eight cases of chronic occlusive peripheral vascular disease including ASO [21], Buerger`s disease [6], Aortoenteric fistula complicating infrarenal abdominal aortic aneurysm [1], four cases of vascular trauma, one case of acute arterial embolism [1] and one case of unknown etiology. The indications of operations for chronic vascular disease was intermittent claudication in 48%, rest pain in 45%, ischemic pregangrene or gangrene in 28%, and sensory change in 10% of patients. Types of operation used were arterial bypass in 28 cases [Aortobifemoral in 5, Aortoiliac in 3, Aortofemoral in 4, Aortoiliac with Aortofemoral in 1, Femorofemoral in 1, Femoropopliteal in 8, Femoroperoneal in 2, Axillofemoral in 3 cases of patients], graft interposition in four and patch angioplasty in three cases. Thirty four prosthetic vascular grafts including Dacron, Gore-Tex, Nylon and two autogenous saphenous vein graft and patch were used for vascular reconstruction in thirty four patients. Unfortunately recently performed one vein bypass was failed immediate postoperatively due to severity of disease and poor case selection. The authors experienced five post operative complications: wound infection [1], graft infection [1], bleeding [1], great saphenous neuralgia [1], pseudoaneurysm [1]. Twenty two of thirty four patients were followed up for more than one month and their cumulative patency rate was 81% [17/22] at 1 month and, 31% [7/22] at 5 month.

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Chronic Gastric Volvulus with Laparoscopic Gastropexy after Endoscopic Reduction: A Case Report

  • Lee, Hye Yeon;Park, Jung Hyun;Kim, Sung Geun
    • Journal of Gastric Cancer
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    • v.15 no.2
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    • pp.147-150
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    • 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.

The Study about Relationship between Treatment of Ulcerative Colitis and Intestinal Bacteria According to Characteristic of Herbal Medicine (한약재 특성에 따른 궤양성 대장염 치료과 장내세균 상관관계 연구)

  • Yong-Deok Jeon
    • Proceedings of the Plant Resources Society of Korea Conference
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    • 2020.08a
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    • pp.9-9
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    • 2020
  • Many modern people are exposed to chronic inflammatory diseases, such as inflammatory bowel disease (IBD), atopic dermatitis and immune disorder. Among those chronic diseases, the incidence ratio of IBD has been increased. IBD, including Crohn's disease and ulcerative colitis (UC), is known to cause abnormal inflammation in intestinal tissue. UC is accompanied by abdominal pain, bloody stool and diarrhea. Many therapeutic agents, such as sulfasalazine, corticosteroids, immunosuppressive agents, have been used for treating UC. However, those agents have side-effects and temporary effects on UC. The aim of this study was to investigate the effect of herbal medicine on UC and relationship between UC and intestinal bacteria according characteristic of herbal medicine. To determine the effect of herbal medicine on UC, various herbal medicine were chosen within oriental medicine category such as cheongyeol and onyeol medicine. In this study, we found carthami fructus, included in cheongyeol medicine, had stronger effect than onyeol medicine. Also, we determined influence of carthami fructus against lactic acid bacteria. Catthami fructus and lingon berry extracts affected the composition of mice intestinal bacteria in mice fecal. The symptoms of UC could be regulate by using herbal medicine, according to characteristic of herbal medicine. Also, herbal medicine might be change body condition to healthy by controlling intestinal bacteria composition. Herbal medicine characteristic could be a therapeutic agent by revealing relationship between intestinal bacteria and UC.

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