• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.22 no.5
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• pp.487-492
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• 2019

Waardenburg syndrome (WS) type IV is characterized by pigmentary abnormalities, deafness and Hirschsprung's disease. This syndrome can be triggered by dysregulation of the SOX10 gene, which belongs to the SOX (SRY-related high-mobility group-box) family of genes. We discuss the first known case of a SOX10 frameshift mutation variant defined as c.895delC causing WS type IV without Hirschsprung's disease. This female patient of unrelated Kuwaiti parents, who tested negative for cystic fibrosis and Hirschsprung's disease, was born with meconium ileus and malrotation and had multiple surgical complications likely due to chronic intestinal pseudo-obstruction. These complications included small intestinal necrosis requiring resection, development of a spontaneous fistula between the duodenum and jejunum after being left in discontinuity, and short gut syndrome. This case and previously reported cases demonstrate that SOX10 gene sequencing is a consideration in WS patients without aganglionosis but with intestinal dysfunction.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.13
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• pp.5427-5431
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• 2014

Aim: To evaluate the outcome of stapled versus sutured colo-rectal anastomosis after low anterior resection of mid-rectal carcinoma. Patients and Methods: A prospective study of fifty patients who underwent colo-rectal anastomosis following low anterior resection (LAR) of T2 mid-rectal cancers at the Egyptian National Cancer Institute during the time period from June 2010 to June 2013 was conducted. Classification was into two groups; a stapled anastomosis group I (25 patients) and a hand-sewn anastomosis group II (25 patients). All operations are evaluated regarding intra-operative complications such as anastomotic line bleeding, visceral injuries or major blood loss. The anastomotic time and operative time are documented for each operation. All patients are evaluated post-operatively for anastomotic leakage (AL), wound infection and ileus. Results: The distance of the tumor from the anal verge was $9.6{\pm}2.0cm$ in group I and $9.9{pm}2.4cm$ in group II. The mean operative time was $191.5{\pm}16.2min$ in the stapled group and $208{\pm}18.6min$ in the sutured group (p=0.002). The mean anastomotic times were $9.0{\pm}1.9min$ and $19.7{pm}12.2min$ (p=0.001). Anastomotic leakage developed in three (12.0%) patients in the stapled group and in four (16.0%) patients in the sutured group (p=1.000). Post-operative ileus was observed in 3 patients in group I and one patient in group II. Wound infection developed in three (12.0%) patients in the stapled group and four (16.0%) patients in the sutured group (p=1.000). Conclusion: Colo-rectal anastomosis after low anterior resection for mid rectal carcinoma can be conducted safely either by stapling or hand-sewn techniques; however the stapling technique showed shorter anastomotic and operative times with no significant advantages regarding intra- or post-operative complications or hospital stay.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.22 no.6
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• pp.518-526
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• 2019

Purpose: Limited means exist to assess gastrointestinal activity in pediatric patients postoperatively. Recently, myoelectric gastrointestinal activity recorded by cutaneous patches has been shown in adult patients to be predictive of clinical return of gastrointestinal function postoperatively. The aim of this case series is to demonstrate the feasibility of this system in pediatric patients and to correlate myoelectric signals with return of bowel function clinically. Methods: Pediatric patients undergoing abdominal surgery were recruited to have wireless patches placed on the abdomen within two hours postoperatively. Myoelectric data were transmitted wirelessly to a mobile device with a user-interface and forwarded to a cloud server where processing algorithms identified episodes of motor activity, quantified their parameters and nominally assigned them to specific gastrointestinal organs based on their frequencies. Results: Three patients (ages 5 months, 4 year, 16 year) were recruited for this study. Multiple patches were placed on the older subjects, while the youngest had a single patch due to space limitations. Rhythmic signals of the stomach, small intestine, and colon could be identified in all three subjects. Patients showed gradual increase in myoelectric intestinal and colonic activity leading up to the first recorded bowel movement. Conclusion: Measuring myoelectric intestinal activity continuously using a wireless patch system is feasible in a wide age range of pediatric patients. The increase in activity over time correlated well with the patients' return of bowel function. More studies are planned to determine if this technology can predict return of bowel function or differentiate between physiologic ileus and pathologic conditions.

• Clinical and Experimental Pediatrics
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• v.51 no.2
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• pp.219-221
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• 2008

Intestinal obstruction is not uncommon in infants. The common causes of intestinal obstruction in the neonatal period are Hirschsprung disease, intestinal atresia, meconium ileus, and intussusception. However, small bowel obstruction caused by a congenital band is very rare. We report a 27-day-old baby who was admitted with abdominal distension and fever. The abdominal X-ray revealed massive bowel dilatation and the contrast gastrografin enema suggested a distal small bowel obstruction. The explolaparotomy showed small bowel entrapment due to an unusual anomalous congenital band.

• Advances in pediatric surgery
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• v.1 no.2
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• pp.186-189
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• 1995

Neonatal intestinal perforation is mainly caused by necrotizing enterocolitis, intestinal atresia, meconium ileus or unknown etiology. Occasionally, Hirschsprung's disease presents with neonatal intestinal perforation, of which, it is known that total colonic aganglionosis is common. Therefore, Hirschsprung's disease should be considered as a cause of neonatal intestinal perforation. The authors have experienced 3 cases of neonatal Hirschsprung's disease associated with colonic perforations. Cecal perforations were noted in 2 cases with aganglionosis from descending colon and sigmoid perforation in a case with aganglionosis in rectum. These cases will be discussed with literature review.

• Journal of Chest Surgery
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• v.23 no.1
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• pp.107-114
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• 1990

During a ten-year period from August, 1978 to September, 1989 45 patients with benign esophageal stricture were surgically evaluated. The results are as follows; l. Out of 45 patients, there were 26 males and 19 females ranging from 2 to 70 years of age with a mean of 31.9 years. 2. The most common cause of benign esophageal stricture was corrosive burn due to caustic agents[40 cases, 88.9 %]. Corrosive agents were 15 cases of lye, 22 cases of acid and 3 cases of other agents. Other causes were two cases of esophageal web and each one case of previous surgical result, inflammation and idiopathic mediastinal fibrosis respectively. 3. The most frequent stricture site was whole esophagus as 21 cases[46.7 %] and the next was lower a third thoracic esophagus[10 cases, 25.0%]. 4. In 33 of total 45 cases, colon interposition with right colon was performed without resection of the strictured esophagus except one case which was complicated esophageal cancer. Other procedures were 4 cases esophagogastrostomy with segmental resection, 2 cases of plastic repair and so on. 5. Major postoperative complications which were needed for secondary operation were 5 cases[11.1 %]. [2 cases of stenosis, ileus and ulcer bleeding respectively] Overall mortality rate was 4.4 %.

• Journal of Korean Neurosurgical Society
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• v.53 no.4
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• pp.245-248
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• 2013

Guillain-Barr$\acute{e}$ syndrome (GBS) is an acute inflammatory demyelinating polyneuropathy. In typical cases, the first symptoms of GBS are pain, numbness, paresthesia, weakness in the limbs. Autonomic involvement is common and causes urinary retention and ileus. Much of these symptoms overlap with those of lumbar spinal stenosis. Therefore, correct diagnosis of GBS in a patient with symptomatic lumbar spinal stenosis or in a patient with atypical manifestations of GBS can be difficult, especially early in the course of GBS. Here, we report on a case of atypical GBS in a 74-year-old previously healthy patient with lumbar spinal stenosis and discuss the differential diagnosis of the GBS and lumbar spinal stenosis.

• Journal of Chest Surgery
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• v.23 no.6
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• pp.1213-1220
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• 1990

During the period of January 1979 to December 1988, 220 patients with empyema thoracis were treated in the department of Thoracic and Cardiovascular Surgery, Chonnam National University Medical School Hospital. There were 167 males[75.9%] and 53 females[24.1%] ranging from 18 days to 76 years of age. Occurrence ratio of left and right empyema was 1 : 1.9. The underlying pathologic lesions of empyema were pneumonia[30.9%], pulmonary tuberculosis[22.7%], chest trauma[8.6%] and postoperative complications. In bacteriologic study, staphylococcus, pseudomonas and streptococcus accounted for 26.4%, 11.8% and 9% respectively, and 25% were not identified. Surgical treatment modalities were thoracentesis[10 patients, 4.5%], closed thoracostomy[132, 60%], closed rib resection drainage[4.2, 6%], modified Eloesser’s operation[37, 16.8%], decortication[27, 12.3%], decortication with pulmonary resection[6, 2.7%], thoracoplasty[2, 0.9%], muscle flap closure [1, 0.5%], and staged pneumonectomy[1, 0.5%], The mortality rate was 2.3% and the complications were sepsis[9 patients]. acute renal failure[4], and paralytic ileus[3].

• Journal of Chest Surgery
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• v.23 no.5
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• pp.976-986
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• 1990

We experienced 12 patients with the abdominal aortic aneurysm during last 31 years [Dec. 1958 \ulcornerSep. 1989]. Among them, 10 patients were reviewed. They were all male. The age ranged from 34 to 80 years with the mean age of 59.4 years. The etiology of the aneurysm was atherosclerotic in 8, mycotic in 1, and aortitis in 1. The location of the aneurysm was infrarenal in 8, and suprarenal in 2 cases. Aneurysmectomy and Dacron Y-graft interposition in 8 cases, and lease with Teflon Y-graft were made. In another 1 case, long thoracoabdominal bypass surgery was made. The operative mortality was 30%[3cases]. The postoperative complications were respiratory complications[3cases], acute renal failure[2cases], bleeding[lease], mechanical ileus[ lease], and peritonitis[lease].

• Journal of Veterinary Clinics
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• v.7 no.1
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• pp.403-406
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• 1990

The effects of enternal feeding on wound healing and intestinal movement in 30 gastrotomized dogs were investigated. The dogs were divided into enteral and parenteral feeding groups. Wound healing was evaluated with tensile strengh on the suture line 4 days after surgery and intestinal movement with the auscultation of borborygmus sound in the abdomen. There was no difference of the tensile strengh on the suture line between enternal and parenteral feeding groups. Borborygmus was auscultated in all dogs of the enteral feeding groups from day2 after surgery. It was thought that enteral feeding had no detrimental effect on wound healing as compared with the parenteral feeding and had good effect on the prevention of ileus in gastrotomized dogs.