• 제목/요약/키워드: In-hospital Complication

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소아에서 수술을 요한 멕켈게실의 임상상 (Clinical Features of Complicated Meckel's Diverticulum Requiring Operation in Children)

  • 이성철;목우균;서정민;정성은;박귀원;김우기
    • Advances in pediatric surgery
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    • 제1권1호
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    • pp.33-39
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    • 1995
  • The incidence of Meckel's diverticulum(MD) in general population has been assessed as 2 percent. The major complications of MD are bleeding, perforation, and intestinal obstruction. In spite that the complication rate of Meckel's diverticulum is relatively high(about 4.2% during a lifetime), the preoperative diagnostic rate of complicated MD is very low. Authors investigated the clinical characteristics of complicated MD to improve the diagnostic rate. 16 patients with complicated Meckel's diverticulum who were operated upon at the Department of Pediatric Surgery, Seoul National University Children's Hospital from June 1985 to December 1993 were reviewed. Among the 16 patients with complicated MD, 12 patients(75%) were under 2 year-old and male were predominant(88%). The most common complication was bleeding patients with bleeding MD (8 cases) were diagnosed preoperatively as MD. 8 patients with other complications(perforation : 4 cases, obstruction : 4 cases) could not be suspected as complicated MD except one patient who had previous history of melena. These patients were diagnosed after exploratory laparotomy under the various impression other than MD. Among 12 patients with ulcer related complications such as bleeding and perforation, heterotopic gastric mucosa was found in 11 patients. In conclusion, in any children with unexplained acute abdomen, especially under 2 years old, complicated MD must be included in differential diagnosis. In children with obscure lower gastrointestinal bleeding, $^{99m}Tc$-pertechnetate scintigraphy is a useful diagnostic tool to rule out bleeding MD.

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한방병원에서 입원치료를 시행한 중증 아토피피부염 환자의 예후지표 탐색 (Prognostic Factors of Inpatients with Severe Atopic Dermatitis Treated in a Traditional Korean Medicine Hospital)

  • 곽재영;김민희;강민서;박소영;최인화
    • 한방안이비인후피부과학회지
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    • 제31권4호
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    • pp.13-21
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    • 2018
  • Objectives : This study was aimed to find significant prognostic factor of inpatients with severe atopic dermatitis (AD) who treated in a Traditional Korean Medicine (TKM) hospital. Methods : A retrospective review of medical records of 39 patients with severe AD who hospitalized for more than 7days was performed. All patients were treated with acupuncture, herbal decoction and herbal wet wrap dressing. Therapeutic effect was assessed by difference of objective SCORing of Atopic Dermatitis index (${\Delta}OSI$) at admission and at discharge. Patients were divided into two groups: improvement group (${\Delta}OSI{\leq}5$) and no-improvement group (${\Delta}OSI>5$), and clinical characteristics, severity, infectious complication, serum total IgE, eosinophil counts, adherence and concomitant treatment were investigated. Results : There were 7 cases in no-improvement group. There was no significant difference in OSI or infectious complication between the two groups. Also, there was no significant difference in total serum IgE and eosinophil counts, which are known to be related to severity of AD. However, the proportion of adherence group was significantly lower in no-improvement group than improvement group. Conclusions : This study suggest that treatment adherence is a significant prognostic factor for treatment outcome in inpatients with severe atopic dermatitis. If the adherence to treatment is improved, the therapeutic effect of hospitalization would increase in spite of severe AD or infectious complication.

식도기관루를 동반한 선천성 식도폐쇄 -20년간 51례 치료경험- (Esophageal Atresia with Tracheoesophageal Fistula : A 20 Year Experience of 51 Cases)

  • 한재현;정재희;송영택
    • Advances in pediatric surgery
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    • 제14권1호
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    • pp.1-11
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    • 2008
  • The aim of this study is to analyze the outcomes of the esophageal atresia with tracheoesophageal fistula over the last 2 decades. The records of 51 patients born between 1987 and 2006 were reviewed. Twenty-seven patients were male. Mean values of the age, gestational age and birth weight were 2.9 days, 296 days and 2.7kg, respectively. All patients had Gross type C anomalies. Thirty-one patients (60.7 %) had one or more associated congenital anomalies and the most common anomaly was cardiac malformation. In 48 cases, primary anastomosis was done and staged operation was done in one case. Circular myotomies in the proximal esophagus were performed in 9 cases. Postoperative complication developed in 26 cases (54 %): pulmonary complication in 12 cases, anastomotic leakage in 10 and anastomotic stricture in 10, recurrent trachoesophageal fistula in one and tracheomalasia in 2 cases. Reoperation was carried out in 2 patients with anastomotic leaks, the remaining leaks were managed non operatively. Three of the strictures were reoperated upon and the others were successfully managed by balloon dilatations. Overall mortality rate was 15.6 %. Mortality rate of the second 10 years (8 %) period decreased significantly compared to that of the first 10 years (23 %) period.

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마사지 시술 후 발생한 흉골골절 환자 증례보고 (Sternal Fracture occurred after Thai Massage : A Case Report)

  • 송영일;김동은
    • 척추신경추나의학회지
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    • 제10권2호
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    • pp.51-60
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    • 2015
  • Objectives: The purpose of this study is to investigate the safety, injury mechanism, complication and adverse reactions associated with Chuna manual theraphy(CMT), to report one case of adverse reaction with Thai Massage(TM). Methods: A 76-year-old woman presented with chest pain and dorsalgia. The patient undertook a TM. The patient's chest pain didn't improve by Korean medecine. In MRI study, sternal fracture was diagnosed. Results and Conclusions : It is supposed that this patient suffered chest pain and dorsalgia due to a TM. From this case, we can understand the etiology of sternal fracture to some extent and consider the complication of Chuna manual theraphy through TM. In addition, This study raises the awareness of the possibility of a sternal fracture caused by a low-energy CMT technique.

The Management of Pancreatic Fistula Complicated by Gastric Fistulation Following Emergency Splenectomy

  • Huei, Tan Jih;Lip, Henry Tan Chor;Thou, Chow Sing;Mohamad, Yuzaidi;Alwi, Rizal Imran
    • Journal of Trauma and Injury
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    • 제33권1호
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    • pp.43-47
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    • 2020
  • Pancreatic and gastric fistulas are rare complications of emergency splenectomy, and it is extremely rare for a pancreatic fistula to be further complicated by a fistulation into the stomach. Here, we present a case of pancreatogastric fistula in a 60-year-old man who experienced polytrauma due to a blunt mechanism. He underwent emergency splenectomy for splenic injury and developed a pancreatic fistula as a complication. A percutaneous endoscopic procedure was performed to drain the fistula, after which he developed a pancreatogastric fistula as a further complication. A double-pigtail stent was inserted via gastroscopy into the fistula tract to allow internal drainage of the pancreatic collection into the stomach cavity. When a pancreatic fistula is complicated by gastric fistulation, endoscopic stenting of the pancreatogastric fistula tract for internal drainage is an effective treatment option.

허혈성뇌졸중의 수술치료시 동반되는 합병증과 관리 (Surgical Complication and Its Management in Ischemic Stroke)

  • 김달수;유도성;허필우;조경석;강준기
    • Journal of Korean Neurosurgical Society
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    • 제29권8호
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    • pp.1107-1112
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    • 2000
  • Recently various operative procedures including microsurgery or endovascular surgery have been increasing for the management of ischemic cerebrovascular diseases. Carotid endarterectomy(CEA), extracranial-intracranial(EC-IC) arterial bypass, embolectomy, decompressive craniectomy, arterial transposition, intravascular thrombolysis, and percutaneous transarterial angioplasty and stenting (PTAS) are available surgical modalities for ischemic stroke. This article focuses the complications and perioperative management of patients treated with CEA and carotid PTAS among various surgical managements for ischemic stroke.

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Intraparenchymal Pericatheter Cyst as a Complication of a Ventriculo-Peritoneal Shunt in a Premature Infant

  • Rim, Hae-Ri;Hwang, Sung-Kyoo;Kwon, Soon-Hak;Kim, Heng-Mi
    • Journal of Korean Neurosurgical Society
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    • 제50권2호
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    • pp.143-146
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    • 2011
  • A ventriculo-peritoneal shunt is a standard surgical management for hydrocephalus, but complications may impede the management of this disease. Obstruction of the catheter is one of the most common complications and manifests clinically in various ways. Intraparenchymal cyst development after shunt malfunction has been reported by several authors, but the underlying mechanism and optimal treatment methods are debatable. The authors report a case of intraparenchymal cyst formation around a proximal catheter in a premature infant after a ventriculo-peritoneal shunt and discuss its pathogenesis and management.

정신질환 동반 입원 환자의 치료결과와 조기합병증에 영향을 미치는 요인 (Factors Influencing Treatment Result and Early Complication in Inpatients with Psychiatric Comorbidity)

  • 김상미;이현숙
    • 한국병원경영학회지
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    • 제22권4호
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    • pp.113-122
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    • 2017
  • The purpose of the study was to investigate the patient, disease and hospital characteristics which affect treatment result and early complication for inpatients with psychiatric comorbidity. We analyzed data on 19,806 patients of the Korea Centers for Disease Control and Prevention from 2012 to 2014, Korea National Hospital discharge in-depth data. Frequency, chi-square and logistic regression analysis was performed, using STATA 12.0. According to logistic regression analysis, gender(Odds ratio(OR)=0.776, 95% confidence interval(CI)=0.686-0.878), insurance type(OR=0.853, CI=0.731-0.995), operation(OR=0.424, CI=0.350-0.513), disposition(OR= 39.307, CI=34.394-44.923), beds(300-499, OR=0.470, CI=0.377-0.585; 500-999, OR=0.462, CI=0.395-0.541; 1000 over, OR=0.598, CI=0.480-0.745) were significant predictors of treatment result. And insurance type(OR=1.527, CI=1.241-1.879), CCI(3 over, OR=1.865, CI=1.534-2.266), operation(OR=5.399, CI=4.562-6.389), disposition(OR=1.279, CI=1.013-1.614), district(Metropolitan city, OR=0.519, CI=0.407-0.661; Non-metropolitan OR=0.469, CI=0.383-0.574), beds(500-999, OR=2.799, CI=1.986-3.944; 1000 over, OR=2.109, CI=1.429-3.113) were significant predictors of early complication. This research would be used as a basic data of high quality of medical care and efficient resource utilization in order to detect and minimize the negative medical treatment results of inpatients with psychiatric comorbidity.

폐절제술을 시행받은 환자의 수술 전후 관리 (Perioperative Management of Lung Resection Patients)

  • 이장훈
    • Journal of Yeungnam Medical Science
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    • 제29권1호
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    • pp.9-13
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    • 2012
  • Lung resection has various and commonly occurring postoperative complications. Pulmonary complication is well known as one of the most important among them, exerting a negative influence on the postoperative course and resulting in mortality. Thus, the prevention of pulmonary complication after lung resection is very important. To prevent postoperative pulmonary complication, the perioperative management must be optimal. Perioperative management begins long before the surgery and does not end until the patient leaves the hospital. The goal of perioperative management is to identify the high-risk patients, to provide appropriate intervention, to prevent postoperative complications, and to obtain the best outcomes.

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