• Title/Summary/Keyword: Distension

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A Case of Midgut Volvulus with Gastric Perforation and Periveintricular Leukomalacia in a Term Infant

  • Park, Seul Gi;Hwang, Jong Hee
    • Neonatal Medicine
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    • v.28 no.1
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    • pp.53-58
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    • 2021
  • Intestinal malrotation with midgut volvulus (MV) is a life-threatening surgical emergency. Most events of MV occur in the neonatal period with bilious vomiting, abdominal distension, feeding intolerance, and bloody stools. Neonatal gastric perforation (GP) is a rare and life-threatening condition associated with high mortality. It occurs either in an idiopathic form or in association with gastrointestinal anomalies such as duodenal atresia and MV. The pathogenesis of both MV and GP is related to ischemic change and inflammatory response. MV and GP can lead to morbidities such as sepsis, intestinal ischemia, and organ failure, but not neurologic problems. We herein report the case of a term infant at 5 days after birth, with MV accompanied by GP, who developed periventricular leukomalacia.

Hematocolpos, pyocolpos, and pyocolpometra in intact female dogs with imperforate hymen

  • Kim, Hyejin
    • Journal of Animal Reproduction and Biotechnology
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    • v.37 no.2
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    • pp.144-148
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    • 2022
  • Imperforate hymen is a rare congenital disorder that may predispose to retention of fluid in the vagina and uterus, thereby resulting in conditions such as hematocolpos, pyocolpos, and pyocolpometra in female dogs. A 7-year-old intact female shih tzu exhibiting abdominal distension, depression, anorexia, dysuria, dyschezia, and tenesmus was diagnosed with pyocolpos; a 9-year-old intact female Yorkshire terrier with abdominal mass, dysuria, and tenesmus was diagnosed with hematocolpos; and a 7-year-old intact female shih tzu with dysuria, dyschezia, anorexia, and vomiting was diagnosed with pyocolpometra. Ovariohysterectomy and partial vaginectomy were performed, and the blind end of the vaginal stump was omentalized. This clinical report provide diagnostic process and surgical treatment option for congenital vaginal obstruction cases.

Computed tomographic findings of peritoneal lymphomatosis in a cat: a case report

  • Sung, Ah Won;Kim, Juyeong;Lee, Youngwon;Choi, Hojung
    • Korean Journal of Veterinary Research
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    • v.62 no.2
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    • pp.17.1-17.5
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    • 2022
  • A 12-year-old castrated male Persian cat presented with abdominal distension and anorexia. The radiography revealed ascites, pleural effusion, and a cranioventral mediastinal mass. Ultrasonography showed a well-defined mass lesion within a thickened ileal segment with a transmural loss of layering and multiple hyperechoic nodules arising from the peritoneum. Computed tomography showed peritoneal thickening with contrast enhancement, a bulky heterogeneous ileal mass, and mesenteric involvement with diffuse nodules. An alimentary lymphoma was confirmed by fine needle aspiration of the small intestinal mass. This report describes the imaging features of lymphoma with peritoneal lymphomatosis in a cat.

Appendiceal Mucinous Neoplasm Detected due to the Protrusion of Mucin, in the Absence of Appendiceal Distension: A Case Report

  • Park, Jin Woo;Park, Min Geun;Song, Ji-Sun;Cho, Hyeon Je;Kim, Yu Jin
    • Journal of Digestive Cancer Reports
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    • v.8 no.2
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    • pp.109-111
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    • 2020
  • A mucocele is a cystic dilatation of the vermiform appendix that contains mucous material. The symptoms associated with it are not specific and the diagnosis is seldom made prior to surgery. The reported prevalence in appendectomy specimens procured during surgery is 0.2-0.3%. Recently, we experienced a case of patient with appendiceal mucocele detected by colonoscopic examination. This case did not show typical colonoscopic features of a mucocele, demonstrating protrusion of mucin, in the absence of a smooth mound with normal overlying mucosa surrounding the appendiceal orifice. The case involved a 64-year-old woman who underwent a colonoscopy. An abdominopelvic computed tomography scan suggested a normal appendix. Subsequently, we performed an appendectomy. The pathologic finding was a low-grade appendiceal mucinous neoplasm.

A case report of stroke patient with ileus treated with Crotonis Fructus(巴豆) (파두 투여 후 호전된 뇌경색 환자의 장마비 치험 1례)

  • Yang, Na-rae;Kwon, Young-joo;Jo, Woo-keun;Choi, Dong-jun;Han, Chang-ho
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.11 no.1
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    • pp.99-104
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    • 2010
  • Paralytic ileus is one of the common complications in stroke patients. In western medical treatment, surgery or conservative care is used for treating ileus. In this case, patient diagnosed as paralytic ileus had problems of constipation, or abdominal distension. Therefore the patient were treated with Crotonis Fructus(巴豆), and the patient showed improvement in X-ray findings and these symptoms. So we report this case.

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Deprivation of Esophageal Boluses and Dry Forage Intake in Large-type Goats

  • Van Thang, Tran;Sunagawa, Katsunori;Nagamine, Itsuki;Kato, Seiyu
    • Asian-Australasian Journal of Animal Sciences
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    • v.23 no.9
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    • pp.1174-1183
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    • 2010
  • In goats fed on dry forage twice a day, an esophageal fistula was used to investigate the physiological factors present in the marked suppression of dry forage intake that occurs after 40 min of feeding. The animals used in this study were five large-type male esophageal- and ruminal-fistulated goats. Roughly crushed alfalfa hay cubes with any large remaining chunks removed were used as feed for this research. The study was conducted under both normal feeding conditions (NFC) and sham feeding conditions (SFC). In the NFC control, the esophageal fistulae were closed by plugs and the animals ate dry forage in the normal manner. In the SFC treatment, before starting the experiment the plugs for closing the esophageal fistula were removed and the cannulae for collecting boluses were fitted into the fistulae. Therefore, the esophageal boluses were removed via an esophageal fistula before they entered the rumen. In the NFC control, eating rates sharply decreased in the first 40 min of feeding and were subsequently maintained at low levels. However, eating rates in the SFC treatment remained high after 40 min of the feeding period had elapsed and the goats ate continuously during the 2 h feeding period. In comparison with the NFC control ($1,794{\pm}203.80\;g$/2 h), cumulative dry forage intake in the SFC treatment ($3,182{\pm}381.69\;g$/2 h) was 77.4% greater (p<0.05) upon conclusion of the 2 h feeding period. In the SFC treatment, cumulative bolus output ($6,804{\pm}469.92\;g$/2 h) was about twofold the cumulative dry forage intake due to cumulative salivary secretion volume ($3,622{\pm}104.13\;g$/2 h) upon conclusion of the 2 h feeding period. The result indicates that large amounts of secreted saliva during dry forage feeding act in conjunction with consumed feed to form the ruminal load responsible for ruminal distension. The increased plasma total protein concentrations were higher in the SFC treatment than in the NFC control. However, plasma and ruminal fluid osmolalities increased in the NFC control during and after feeding but were mostly unchanged in the SFC treatment. In comparison with the NFC control ($3,440{\pm}548.04\;g$/30 min), thirst level in the SFC treatment ($1,360{\pm}467.02\;g$/30 min) was 60.5% significantly less (p<0.05) upon conclusion of the 30 min drinking period. The results of the present study indicate that In the second hour of the 2 h feeding period, dry forage intake is regulated by factors produced when boluses enter the rumen.

Acupuncture, ST-36 Electroacupuncture and Moxa Treatment of Abdominal Pain due to Bowel Obstruction in Cancer Patients : Case Report (말기 암 환자의 장폐색성 복통에 대한 침구 및 족삼리 전침 치험 2례)

  • Kim, So Yeon;Choi, Jun Yong;Park, Seong Ha;Kwon, Jung Nam;Lee, In;Hong, Jin Woo;Han, Chang Woo
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.28 no.2
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    • pp.238-242
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    • 2014
  • Here we described 2 cancer patients treated by acupuncture for abdominal pain as a complication of bowel obstruction. The patient 1, 43-year-old man was treated with surgery, radiotherapy and chemotherapy for rectal cancer. Two years after surgery, he complained of acute abdominal pain due to small bowel adhesion band. Bowel obstruction and symptoms were not improved by conservative therapy like as fasting, keeping Levin tube, and fluid therapy. 4 months later, he could eat a little rice water, but ileus and abdominal pain persisted despite of applying opiod drug and patch. Got started on acupuncture, electroacupuncture(ST-36) and moxa treatment, pain was relived gradually. He could stop opioids 1 month later and ileus was improved after acupuncture therapy for 2 months. The patient 2, 65-year-old woman got hepatectomy, cholecystectomy, and chemotherapy with cholangiocarcinoma. 6 months after surgery, she got laparotomy again for biopsy of new mass around ascending colon. She started eating after gas passing, but felt abdominal distension. Diffuse paralytic ileus was diagnosed by abdominal X-ray, and she got started conservative therapy. During ST-36 electroacupuncture therapy, symptoms like abdominal pain and distension were improved and could stop opiod patch. But eating aggravated ileus again and clinical finding of mechanical bowel obstruction was appeared. Based on these cases, acupuncture and moxa therapy could be helpful for improving abdominal pain and ileus, but possibility of malignant bowel obstruction should be considered especially in cancer patients.

Degree of Enteral Tube Feeding in the Intensive Care Unit and Change in Nutritional Status (병원 중환자의 경관유동식 공급 현황 및 영양상태 변화)

  • Im, Hyeon-Suk;Park, Eun-Gyeong;Lee, Jong-Ho
    • Journal of the Korean Dietetic Association
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    • v.7 no.3
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    • pp.217-226
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    • 2001
  • It is important to supply adequate nutrition to critically ill patients, whose gastrointestinal system is properly functioning, through the enteral tube feeding if oral intake is impossible. In this study we investigated the changes in nutritional status with enteral tube feeding according to the volume required. We investigated the volume ordered according to the patient's requirements, volume infused according to the volume ordered in 41 enteral tube feeding patients in intensive care unit from Jannuary to July, 2000. Body weight, serum albumin level, and total lymphocyte count were evaluated to assess nutritional status. The mean fasting period was 5 days before the enteral feeding and patients whose fasting period over 3 days were 51%. The mean enteral tube feeding period was 29 days and method of feeding was nasogastric, bolus feeding 6 times per day. The volume ordered was 69.7% of the patients' recommended calorie and volume infused was 86.6% of their volume prescribed. Accordingly, the volume infused was estimated 61.7% of their volume required. Only 44.6% of their reqiured volume was infused within 3 days after enteral tube feeding was started. It took 16 days in average to meet the patients' recommended calorie; 56% of subjects still did not fully met their requirements by the end point. Among the impeding factors in supplying enteral tube feeding, factors related to the number of feeding were high residual volume in stomach, vomiting, gastrointestinal bleeding, abdominal distension and surgery. Factors related to the acctual infused volume were diarrhea, gastrointestinal bleeding, abdominal distension, airway management and tube reinsertion. Significant correlations were shown between the volume infused and changes in both the patients' weight and serum albumin level. Deviding the subjects into two groups by their infused volume, less than 70% and more than that, we compared the two to come up with a significant difference in their serum albumin level, -0.23 vs 0.21, and their body weight, -4.52 vs 0.12. In enteral tube feeding, the volume delivered in sufficient to the pateints' energy requirement can affect their nutriitional status in critically ill patient; adequate nutritional management plan is essential. It is necessary to make every effort to educate clinical staff and to set up a unified management program to prescribe adequate ammount of energy for the patient's nutritional requirement.

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Clinical Experience of Currarino Syndrome (큐라리노 증후군의 임상 경험)

  • Kim, Tae-Hoon;Cho, Min-Jeong;Kim, Dae-Yeon;Kim, Seong-Chul;Kim, In-Koo
    • Advances in pediatric surgery
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    • v.17 no.1
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    • pp.65-71
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    • 2011
  • Currarino syndrome is a hereditary syndrome characterized by the triad of a sacral bony defect, presacral mass and anorectal malformation. We retrospectively reviewed 13 Currarino syndrome patients who were treated in our center between 1997 and 2010. Demographic data, initial symptoms, initial diagnosis. pathologic diagnosis of presacral mass, associated anomalies and managements were analyzed. There were 8 boys and 5 girls. Four patients were diagnosed as Currarino syndrome immediately after birth with failure of passage of meconium and abdominal distension. Four patients underwent surgery for imperforate anus immediately after birth and W8re diagnosed as Currarino syndrome later and underwent reoperation. Three patients were diagnosed during work-up and management with of the tentative diagnosis of Hirschsprung's disease. Diagnosis of the remaining two patients was at the age of 26 months and 9 years and anorectal malformation was not associated. Twelve patients showed hemi-sacrum and one patient showed bilateral sacral subtotal agenesis. Two patients without anorectal malformation underwent presacral mass excision, untethering of spinal cord and repair of myelomeningocele. Six out of 8 patients, excluding 3 that expired or were lost to follow up, with anorectal malformation underwent colostomy, presacral mass excision, untethering of spinal cord, repair of myelomeningocele, posterior sagittal anorectoplasty and colostomy repair. One patient underwent only posterior sagittal anorectoplasty after colostomy. One waits the scheduled operation only with Hegar dilatation. Pathologic examation of presacral masses showed myelomeningoceles in 4 patients, lipomyelomeningoceles in 3 patients and dermoid Cyst in one patient. Teratoma was combined in 2 patients. Eight patients needed neurosurgical operation for spinal cord problems. Seven patients had urologic anomalies and two of them underwent operation. Currarino syndrome should be considered as a differential diagnosis in pediatric patients with abdominal distension, constipation and anorectal malforlnation. For proper evaluation and treatment, a multi-disciplinary approach is recommended.

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Congenital Ileal Atresia in Newborn (신생아 선천성 회장 폐쇄증)

  • Huh, Young-Soo;Kim, Chang-Sig;Shin, Son-Moon
    • Journal of Yeungnam Medical Science
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    • v.11 no.1
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    • pp.35-41
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    • 1994
  • Newborns with ileal atresia freqently present with abdominal distension, bilious vomiting. and failure to pass meconium. Diagnosis is usually established on plain x-ray of the abdomen by the findings of distended small bowel loops and air-fluid levels. In the period of October 1988 to February 1994, 8 patients with congenital ileal atresia were operated and the following results were obtained. 1. Eight patients were comprised of 4 males and 4 females, the ratio of male and female was 1 : 1. 2. Six patients(75%) had been admittted to our hospital during three days of life. 3. Congenital ileal atresia was in 8 cases : Type I in two(25%), Type II in two(25%), Type IIIa in three(37.5%), Type IIIb in one(12.5%). 4. There was one premature patient who was small for gestational age. 5. Overall, abdominal distension and bilious vomiting occurring in seven patients, were frequent presenting complaints. 6. Diagnosis was possible with clinical symptom and simple abdomen. 7. Operative treatment was undertaken as soon as the diagnosis was made. In seven cases a primary end-to-end anastomosis was performed after resection of dilated proximal loop. 8. A total of four associated congenital anomalies were found in one patient. 9. Postoperative complications occurred in three cases(37.5%).

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