• Journal of Yeungnam Medical Science
• /
• v.35 no.2
• /
• pp.222-226
• /
• 2018

Recurrent pericarditis is rare in children and is considered idiopathic in most cases. Its course is chronic, and preventing recurrences is important for the patient's quality of life. Although a treatment strategy in pediatric recurrent pericarditis has not yet been established, non-steroidal anti-inflammatory drugs (NSAIDs) are the most common treatment for management of this condition, followed by corticosteroids, colchicine, immunosuppressive agents, immunoglobulins, and interleukin-$1{\beta}$ receptor antagonists (e.g. anakinra). Herein, we report a case of recurrent pericarditis with pericardial effusion in a 5-year-old child who presented with fever and epigastric pain. He responded poorly to NSAIDs and corticosteroid therapy, but was successfully treated with colchicine.

• Journal of Chest Surgery
• /
• v.28 no.2
• /
• pp.143-149
• /
• 1995

From January, 1983, to August, 1993, 23 cases of pericardiectomy for chronic constrictive pericarditis were carried out. The 15 male and 8 female patients ranged in age from 7 to 68 years[mean 39.1 years . All patients underwent pericardiectomy through a median sternotomy. Postoperative complications were low cardiac output[2 patients , wound infection[2 patients , pneumonia[2 patients , and unilateral phrenic nerve palsy[2 patients . One patient died of low cardiac output 1 day after pericardiectomy due to the associated transposition of great artery and hypoplastic right lung. Clinical and pathological findings showed that the cause of constrictive pericarditis was tuberculous in 8 cases[34.8% , idiopathic in 12 cases[52.2% and pyogenic in 3 cases[13.0% . Central venous pressure fell below 10cmH2O by immediate in 6 cases, fell below 10cmH2O by 24hrs in 5 cases and continued above 10cmH2O after 24hrs in 12 cases. Preoperative NYHA functional class of patients showed class I-1, classII-4, class III-14, and class IV-3. Postoperativly NYHA functional class was improved to class I-15, classII-6, class III-1.

• Journal of Chest Surgery
• /
• v.22 no.1
• /
• pp.67-73
• /
• 1989

Forty two patients with chronic constrictive pericarditis, who were admitted to the Yonsei University College of medicine over a period of 18 years from January, 1970 to August, 1988, were analyzed retrospectively. Mean age of the patient was 33.5 year ranging from 6.8 to 60 years old. Male to female ratio was 1.3 to 1. Twenty-one cases [50%] were tuberculous origin [based on either associated pulmonary tuberculosis and/or caseous necrosis in thickened pericardial specimen] and 17 cases [40.5%] were idiopathic [non specific chronic inflammatory change was considered to be idiopathic]. Dyspnea on exertion was evident in 30 cases [71.4%] and abdominal distention in 21 cases [50%]. On physical examination, hepatomegaly [83.3%], neck vein distention [54.8%], distant heart sound [47.6%] and ascites were found. Thirty-nine patients showed low voltage of QRS and/or T wave flattening or inversion on EKG. Thirty-one cases had undergone cardiac catheterization which showed data compatible with chronic constrictive pericarditis. Midsternostomy group [n=15] had shown the most remarkable CVP decline [12.20 mmHg] as compared with bilateral submammary incision group [n=25, 8.96 mmHg] and left thoracotomy group [n=2, 7.75 mmHg] but difference was not significant statistically There was four early death among 42 patients [9.5%] including 3 cases of left ventricular failure and one cardiac tamponade. Main postoperative complications were wound infection [6 cases] and arrhythmia [3 cases]. Follow-up of 24 patients [mean; 55.3 months, ranging from 2 months to 155 months] revealed good functional status.

• Journal of Chest Surgery
• /
• v.16 no.2
• /
• pp.184-189
• /
• 1983

Between 1958 and 1982, 70 patients have undergone pericardiectomy for constrictive pericarditis at the Thoracic Department of Seoul National University Hosp. 58 males and 12 females, with an average age of 27 years [ranging 3 to 60 years], of which 55% were between 10 and 30 years old, were treated. Eight patients died, of whom 4 were in the immediate postoperative period, less that 24 hours after operation. The cause of death was myocardial failure in 3 patients and hypotension during operation in one patient. The remaining four deaths occurred between the fifth and eighteenth postoperative day, and the causes of death varied: bilateral phrenic nerves injury, congestive heart failure, dissemination of tuberculosis, and cardiac arrest. Two patients suffered from congestive heart failure pre-and postoperatively due to the associated valvular heart disease. There were 8 wound infections on which resulted in perichondritis of costal cartilages requiring segmental resection 2 months later. There was one postoperative bleeding requiring immediate reopening for bleeding control. Tuberculosis was confirmed as the cause of constrictive carditis in 27 patients [39%]. Acute pyogenic pericarditis was precursor in 8 patients [11%]. In 2 patients [2.9%], the constrictive pericarditis developed following OHS. Both suffered from congestive heart failure postoperatively due to the residual valvular heart disease. In the others, the cause of the constrictive pericarditis was considered idiopathic or non-specific inflammation.

• Journal of Chest Surgery
• /
• v.24 no.10
• /
• pp.973-978
• /
• 1991

From January, 1982, to December, 1990, 15 patients underwent pericardiectomy for chronic constrictive pericarditis on Department Of Thoracic and Cardiovascular Surgery, School of Medicine, Pusan National University. There were 9 male and 6 female patients [male to female ratio was 1.5: 1] ranging from 15 years to 63 years old [mean age 35.0]. All patients underwent pericardiectomy through a median sternotomy, partial cardiopulmonary bypass was performed on two patients. There were 3 postoperative death [20%]. Six cases [40%] were tuberculous origin 5 cases [34%] were Idiopathic [nonspecific chronic inflammatory change was considered to idiopathic], 2 cases [13%] were malignant origin, 2 cases [13Yo] were pyogenic origin. Dyspnea on exertion was evident in all patients and abdominal distention, general weakness, palpitation, peripheral edema were found. Eleven patients showed low voltage of QRS wave, 7 patients showed diffuse ST-T wave change, 2 patients showed atrial fibrillation on EKG. There were 6 patient showed pericardial thickening, 5 patients showed evidence of restriction, 5 patients showed pericardial effusion, 4 patients showed low cardiac output on preoperative echocardiogram. Hemodynamic response to pericardiectomy were observed; preoperative CVP 26.8 cmH2O declined to 15.0 cmH2O. Preoperative NYHA Functional class showed class II - 1, class III - 10, class IV - 4, postoperative NYHA functional class showed class I - 7, class II - 4, class Ill - l.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.18 no.4
• /
• pp.286-291
• /
• 2015

Ulcerative colitis (UC) is a chronic idiopathic inflammatory bowel disease. Mesalizine for the first-line therapy of UC has adverse effects include pancreatitis, pneumonia and pericarditis. UC complicated by two coexisting conditions, however, is very rare. Moreover, drug-related pulmonary toxicity is particularly rare. An 11-year-old male patient was hospitalized for recurring upper abdominal pain after meals with vomiting, hematochezia and exertional dyspnea developing at 2 weeks of mesalizine therapy for UC. The serum level of lipase was elevated. Chest X-ray and thorax computed tomography showed interstitial pneumonitis. Mesalizine was discontinued and steroid therapy was initiated. Five days after admission, symptoms were resolved and mesalizine was resumed after a drop in amylase and lipase level. Symptoms returned the following day, however, accompanied by increased the serum levels of amylase and lipase. Mesalizine was discontinued again and recurring symptoms rapidly improved.