• Title/Summary/Keyword: Hollow viscus

Search Result 7, Processing Time 0.022 seconds

Current Research Status of Irreversible Electroporation for Hollow Viscus Organ of Gastrointestinal Tract (위장관 비가역적 전기천공법의 연구 현황)

  • Keum, Bora;Choi, Hyuk Soon;Jeon, Han Jo
    • Journal of Digestive Cancer Reports
    • /
    • v.8 no.1
    • /
    • pp.61-64
    • /
    • 2020
  • Ablative therapy has drawn attention for cancer treatment as minimally invasive therapy. Recently, irreversible electroporation which has a different concept from the existing ablation method has emerged. Although gastrointestinal tract cancer is commonly managed by ablation such as liver, pancreas cancer, hollow viscus cancer is extremely challenging for applying ablative therapy because of its high perforation risk. Therefore, several studies about hollow viscus irreversible electroporation will be introduced in this review regarding its pre-clinical relevance.

Impact of Initial Helical Abdominal Computed Tomography on the Diagnosis of Hollow Viscus Injury and Blunt Abdominal Traumare (복부 둔상 및 유강장기 손상에 있어서 초기 나선형 복부전산화 단층촬영의 진단적 가치)

  • Cho, Young-Duck;Hong, Yun-Sik;Lee, Sung-Woo;Choi, Sung-Hyuk;Yoon, Young-Hoon;Lim, Sung-Ik;Jang, Ik-Jin;Baek, Seung-Won
    • Journal of Trauma and Injury
    • /
    • v.21 no.1
    • /
    • pp.28-35
    • /
    • 2008
  • Purpose: This study was conducted to examine the clinical significance IV-contrasted helical abdomen computed tomography (CT) as a diagnostic screening tool to evaluate hollow viscus injury in blunt abdominal trauma patients. Methods: This is a retrospective study encompassing 108 patients, presenting to Korea University Medical Center (KUMC) Emergency Department (ED) from January 2007 to December 2007, with an initial CT finding suggestive of intra-abdominal injury. An initial non-enhanced abdomen CT was taken, followed by an enhanced CT with intravenous contrast. Patients' demographic data, as well as the mechanisms of injury, were inquired upon and obtained, initial diagnosis, as dictated by specialized radiologists, were added to post-operational (post-OP) findings and to additional CT findings acquired during their hospital stays, and all were combined to arrive at final diagnosis. Initial CT findings were further compared with the final diagnosis, yielding values for sensitivity, specificity, and accuracy, as well as positive and negative predictive values. Patients were further divided into two groups, namely, those that underwent operational intervention and those that did not. The initial CT findings of each group were subsequently compared and analyzed. Results: Initial CT scans revealed abnormal findings in a total of 212 cases - solid organ injuries being the most common finding, as was observed in 97 cases. Free fluid accumulation was evident in another 69 cases. Based on the CT findings, 77 cases (71.3%) were initially diagnosed as having a solid organ injury, 20 cases (18.5%) as having a combined (solid organ + hollow viscus) injury, and 11 cases (10.2%), as having an isolated hollow viscus injury. The final diagnosis however, were somewhat different, with only 67 cases (62.0%) attributed to solid organ injury, 31 cases (28.7%) to combined injury (solid + hollow), and 10 cases (9.3%) to hollow viscus injury. The sensitivity (CI 95%) of the initial helical CT in diagnosing hollow viscus injury was 75.6%, and its specificity was 100%. The accuracy in diagnosing hollow viscus injury was also meaningfully lower compared to that in diagnosis of solid organ injury. Among patients initially diagnosed with solid organ injuries, 10 patients (2 from follow-up CT and 8 from post-OP finding) turned out to have combined injuries. A total of 38 patients underwent an operation, and the proportion of initial CT findings suggesting free air, mesenteric hematoma or bowel wall thickening turned out to be significantly higher in the operation group. Conclusion: Abdominal CT was a meaningful screening test for hollow viscus injury, but the sensitivity of abdominal CT was significantly lower in detecting hollow viscus injury as compared to solid organ injury. This calls for special consideration and careful observation by the ED physicians when dealing with cases of blunt abdominal trauma.

Natural Orifice Transluminal Endoscopic Surgery (NOTES) (자연개구부 내시경수술)

  • Kim, Kwang-Taik
    • Korean Journal of Bronchoesophagology
    • /
    • v.16 no.1
    • /
    • pp.16-19
    • /
    • 2010
  • NOTES (Natural orifice transluminal endoscopic surgery) is a new technique in minimally invasive procedure, surgeon use normal orifice and hollow viscus for procedurs as approaching route, Currently the NOTES are performed for diagnostic and therapeutic purpose by some investigators in research setting. NOTES has potential benefit in terms of sear, pain, post op recovery. Rut Bacterial contamination, deal with major complication are needed more stud) and development.

  • PDF

Endoscopic Ultrasound Staging of Upper Gastrointestinal Malignancies

  • Saadany, Sherif El;Mayah, Wael;Kalla, Ferial El;Atta, Tawfik
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.17 no.5
    • /
    • pp.2361-2367
    • /
    • 2016
  • Since 1980, endoscopic ultrasound (EUS) has been used as an important tool for the evaluation of malignant diseases in hollow viscus and bilio-pancreas, as well as sub-epithelial tumors. The high-resolution capacity and low penetration depth of EUS make it possible to obtain highly detailed images of the gastrointestinal wall and immediate surroundings to a depth of 4-5 cm. Thus, over the past 35 years, EUS succeeded to modify management in significant number of cases and is now considered a gold standard tool for many gastrointestinal diseases, especially in the pancreatico-biliary tract, and adjuvant needle insertion now allows access to remote lesions that were difficult to reach in the past. With the growing spectrum of indications, tissue sampling for diagnostic purposes has become common. In this review, we aim to highlight the expanding spectrum of EUS indications and uses in staging of upper gastrointestinal malignancies, especially esophageal, gastric and ampullary tumors.

A Case of Trichosporon beigelii Esophagitis Presenting Hematemesis with a Large Amorphous Material (토혈과 원통 모양의 토물을 주소로 내원한 Trichosporon beigelii 식도염 1례)

  • Park, Eun-Jung;Hwang, Jin-Bok;Ahn, Wook-Su;Jun, Chang-Ho;Kim, Yong-Jin
    • Pediatric Gastroenterology, Hepatology & Nutrition
    • /
    • v.2 no.1
    • /
    • pp.74-79
    • /
    • 1999
  • We experienced a case of Trichosporon beigelii esophagitis in a 16-month-old boy who was presented with hematemesis with a large amorphous material. A spit-out material was silky, $10{\times}1.2\;cm$ in size and like a part of hollow viscus organ. Emergent gastrofiberscopy revealed that this silky material was teared up from upper and to lower esophagus and was threw with hematemesis. It was suggested that pseudomembrane on esophagus was peeled off followed by mucosal bleeding. Pathologic study revealed this material was pseudomembrane with esophageal mucosa of T. beigelii esophagitis and was teared at lamina propria level from submucosa.

  • PDF

Clinical predictors of therapeutic laparotomy in anterior abdominal stab injuries: a multicenter study from low-income institutions in Ethiopia

  • Segni Kejela;Abel Hedato;Yeabsera Mekonnen Duguma;Meklit Solomon Gebremariam
    • Journal of Trauma and Injury
    • /
    • v.37 no.2
    • /
    • pp.140-146
    • /
    • 2024
  • Purpose: Despite the high incidence of abdominal stab injuries, the rate of nontherapeutic laparotomies and the predictors of therapeutic laparotomies have rarely been studied in low-income settings. Methods: This multicenter retrospective study involved three of the largest academic medical centers in central Ethiopia. All patients who sustained an anterior abdominal stab injury and underwent exploratory laparotomy, regardless of the intraoperative findings, were included over the 3-year course of the study. Results: Of the 117 patients who underwent exploratory laparotomy, 35 patients (29.9%) underwent nontherapeutic laparotomies. Three factors predicted therapeutic laparotomy: hollow viscus evisceration (adjusted odds ratio [AOR], 5.77; 95% confidence interval [CI], 1.16-28.64; P=0.032), localized and generalized peritonitis (AOR, 4.77; 95% CI, 1.90-11.93; P=0.001), and white blood cell count ≥11,500/mm3 (AOR, 2.77; 95% CI, 1.002-7.650; P=0.049). The overall positive predictive value of the therapeutic predictors was 80.2%, while the negative predictive value of all predictor-negative patients was 58.1%. The predictors would have prevented 51.4% of the nontherapeutic laparotomies. Conclusions: Close to one-third of the patients had a nontherapeutic laparotomy. The clinical predictors of therapeutic laparotomy were shown to have a high positive predictive value despite a lower negative predictive value. Further prospective studies that involve all patients who sustain anterior abdominal stab injuries are needed to potentially improve on the negative predictive value of the predictors suggested by our study.

Emergency angioembolization performed in a hemodynamically unstable patient with grade V liver injury: The benefit of emergency angioembolization without computed tomography (혈역학적으로 불안정한 grade V 간손상에서 시행한 응급 혈관색전술: 전산화단층 촬영 없이 시행한 응급 혈관색전술의 이점)

  • Kang, Wu Seong;Park, Chan Yong
    • Journal of the Korea Academia-Industrial cooperation Society
    • /
    • v.20 no.2
    • /
    • pp.235-239
    • /
    • 2019
  • High-grade liver injury is associated with high morbidity and mortality rates. We report successful emergency angioembolization and early interventional radiology support to manage a high-grade liver injury in a 29-year-old man who presented following a fall during parachute training. Upon arrival, his blood pressure was 80/40 mmHg, and emergency ultrasonography showed a liver injury with perihepatic fluid collection. The patient's blood pressure reduced to 60/40 mmHg, and emergency angiography was performed without computed tomography (CT) (door to puncture time 36 min). After angioembolization, his blood pressure returned to 120/77 mmHg. Subsequent CT revealed no additional bleeding or hollow viscus injury. He was admitted to the Intensive Care Unit and discharged without complications 30 days after admission. In this case, emergency angioembolization (without performing CT) could successfully and safely treat a hemodynamically unstable patient with a high-grade liver injury.