• Advances in pediatric surgery
• /
• v.7 no.1
• /
• pp.42-45
• /
• 2001

The major complications of Meckel's diverticulum (MD) are bleeding, intestinal obstruction, infection, umbilical fistula and perforation. Although the relative incidences vary between authors, bleeding is the most common complication in children. The aim of our study is to show the symptomatic guideline for the diagnosis of the bleeding MD. Eight cases with bleeding MD which were operated upon at the department of Pediatric Surgery, Yeungnam University Hospital from April 1985 to April 2001 were reviewed. Half of the patients were under 2 years of age and all patient s we re male. All patients were preoperatively diagnosed by previous history of intestinal bleeding (melena, hematochezia) and 99mTc pertechnetate MD scan. Segmental resection and end-to-end anastomosis was performed in 6 patients and diverticulectomy in 2 patients. Heterotropic gastric mucosa was found in 6 patients. Postoperative complication was not observed in any cases. In conclusion, in any male children with obscure intestinal bleeding, especially less than 2 years of age, bleeding MD must be suspected. It seems to us that 99mTc pertechnetate MD scan is a useful tool to diagnose bleeding MD.

• The Journal of Korean Medicine
• /
• v.21 no.3
• /
• pp.220-224
• /
• 2000

After stroke, there are many cases of gastro-intestinal bleeding in patients with dysphagia who are fed by Levin tubes. Ulcers in the stomach and duodenum are occasionally produced by psychiatric stress, irritation with the Levin tube and central nerve rusturbances. Because Dansambohyul-tang has been used to treat deficiency of blood, alleviate pain, tranquilize and to treat patients differentiated with an insufficiency of the heart and the spleen in oriental medicine, we treated a 62 year-old male patient who suffered from gastric ulcers with gastro-intestinal bleeding after stroke, and who was differentiated with an insufficiency of the heart and the spleen with Dansambohyul-tang, herb complex. After 20 days of treatment with Dansambohyul-tang, we observed improvement in the gastric ulcer through gastroscopy; serum hemoglobin increased by 5.1g/dl after 2 months; and symptoms (pale complexion.dysphagia.general weekness) were alleviated. So Dansambohyul-tang shows therapeutic effects on gastric ulcers with gastro-intestinal bleeding after stroke.

• Childhood Kidney Diseases
• /
• v.23 no.2
• /
• pp.128-133
• /
• 2019

Henoch-$Sch{\ddot{o}}nlein$ purpura (HSP) is a systemic vasculitis characterized by purpura, arthritis, abdominal pain, and nephritis. Gastrointestinal involvement can manifest as pain, intussusception, intestinal bleeding, and intestinal perforation. We report a case of fulminant HSP at an age of eight in 1994, with multiple complications of intra-thoracic bleeding, massive intestinal perforation, nephritis, and various skin rashes. The brisk bleeding findings of intestinal on Technetium-99m-labeled red blood cell scan ($^{99m}Tc$ RBC scan) were well matched to those of the emergency laparotomy and the resected intestine. The patient's abdominal conditions improved gradually but nodular skin eruptions developed newly apart from improving preexisting lower limb rashes and the urine findings continued abnormal, so skin and kidney biopsy were done for the diagnosis. After cyclosporine therapy, skin eruptions and urine findings returned to normal gradually. On a follow-up after 25 years in 2019, the patient is 33-year-old, healthy without any abnormality on blood chemistries and urine examination.

• Parasites, Hosts and Diseases
• /
• v.55 no.4
• /
• pp.417-420
• /
• 2017

Hookworm infections are rare causes of acute gastrointestinal bleeding. We report a middle aged man with primary nephrotic syndrome and pulmonary embolism. During the treatment with steroids and anticoagulants, the patient presented acute massive hemorrhage of the gastrointestinal tract. The results of gastroscopy showed red worms in the duodenum. Colonoscopy and CT angiogram of abdomen were unremarkable. Capsule endoscopy revealed fresh blood and multiple hookworms in the jejunum and ileum. Hookworms caused the acute intestinal bleeding. The patient responded well to albendazole. Hematochezia was markedly ameliorated after eliminating the parasites. Hence, hookworm infection should be considered in the differential diagnosis of a patient with obscure gastrointestinal bleeding. Capsule endoscopy may offer a better means of diagnosis for intestinal hookworm infections.

• The Korean Journal of Nuclear Medicine
• /
• v.32 no.2
• /
• pp.168-171
• /
• 1998

We present a case in which a patient with acute hemorrhagic gastritis demonstrated abnormal gastrointestinal accumulation of radiotracer during $^{99m}Tc$-methylene diphosphonate(MDP) skeletal scintigraphy. A hemorrhagic gastritis was subsequently demonstrated by endoscopy. The mechanism for the intestinal localization of $^{99m}Tc$-MDP in this patient is not clear, but we guess that the extravasated blood containing the radiopharmaceutical cannot recirculate and stays at the bleeding site, so we can see the intestinal activity.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.22 no.2
• /
• pp.193-200
• /
• 2019

A clinical suspicion of intestinal spirochetosis is required when patients have long lasting complaints of abdominal pain, diarrhea, rectal bleeding, weight loss, and nausea. An endoscopy with biopsies needs to be performed to confirm the diagnosis of intestinal spirochetosis. The diagnosis of intestinal spirochetosis is based on histological appearance. Intestinal spirochetosis can also be associated with other intestinal infections and juvenile polyps (JPs). JPs seem to be more frequent in patients with intestinal spirochetosis than in patients without intestinal spirochetosis. Intestinal spirochetosis in children should be treated with antibiotics. Metronidazole is the preferred option. In this article, we describe 4 cases of intestinal spirochetosis in a pediatric population and provide a review of the literature over the last 20 years. Intestinal spirochetosis is a rare infection that can cause a variety of severe symptom. It is diagnosed based on histological appearance.

• Advances in pediatric surgery
• /
• v.18 no.1
• /
• pp.24-29
• /
• 2012

Although hemangiomas are common vascular tumors that can occur anywhere in the body, they seldom involve the gastrointestinal tract. Hemangiomas of the gastrointestinal tract in infants and children are rare benign vascular tumors that most commonly present with gastrointestinal bleeding. We describe here the case of 2-year-old boy with intestinal bleeding caused by a large jejunal cavernous hemangioma, which was treated by laparoscopy-assisted resection of the affected portion of the jejunum.

• Clinical Endoscopy
• /
• v.56 no.3
• /
• pp.283-289
• /
• 2023

Gastrointestinal (GI) bleeding is one of the most common conditions among patients visiting emergency departments in Korea. GI bleeding is divided into upper and lower GI bleeding, according to the bleeding site. GI bleeding is also divided into overt and occult GI bleeding based on bleeding characteristics. In addition, obscure GI bleeding refers to recurrent or persistent GI bleeding from a source that cannot be identified after esophagogastroduodenoscopy or colonoscopy. The small intestine is the largest part of the alimentary tract. It extends from the pylorus to the cecum. The small intestine is difficult to access owing to its long length. Moreover, it is not fixed to the abdominal cavity. When hemorrhage occurs in the small intestine, the source cannot be found in many cases because of the characteristics of the small intestine. In practice, small-intestinal bleeding accounts for most of the obscure GI bleeding. Therefore, in this review, we introduce and describe systemic approaches and examination methods, including video capsule endoscopy and balloon enteroscopy, that can be performed in patients with suspected small bowel bleeding in clinical practice.

• The Korean Journal of Physiology
• /
• v.7 no.2
• /
• pp.39-47
• /
• 1973

The influences of the acute hemorrhage on the intestinal functions were studied in the rabbits subjected to acute bleeding, amounting 1.5-2% of the body weight. The motility and the absorptive capacity of the ileum were compared before and after the bleeding. Transfusion of shed blood was also performed in order to see whether the deteriorations were reversible or not. The tension developed in the direction of the longitudinal axis of the ileum was recorded through an appropriate transducer, and the frequency of the rhythmic contraction was counted throughout the procedure. Test solution, 10ml in amount, was placed in the loop of the ileum, and the samples were drawn at zero time and at 20 minutes. Triplicated procedures were repeated on the same loop;namely, before and after bleeding and after transfusion. The test solution was composed of 200 mg% urea, 218 mEq/l of NaCl and 150 mg% of polyethylene glycol (PEG) No. 4,000 in distilled water. The latter substance was used as a marker substance for the volume change of the loop. The results obtained were as follows; 1. The motility of the ileum suffered little effects by acute hemorrhage. However, minor fluctuations were seen in the frequency of the rhythm, showing a slight tendency of decreasing rhythmicity, and it was reversed by transfusion. 2. Diminution of absorptive capacity of urea was noticed in acute hemorrhage and it was interpreted as the consequence of the secondary effect of the retardation of the active transport mechanism governing the sodium transport 3. Absorption rate of the sodium ion was dropped in the hemorrhage, suggesting the indispensable need of the blood supply. 4. Osmolarity of the luminal fluid remained higher in the case of acute hemorrhage. 5. There was a tendency of retaining more fluid in the intestinal lumen in acute hemorrhage, comparing with that observed prior to the bleeding. 6. The deteriorations in the absorptive capacity were restored by transfusion of shed blood.

• Journal of The Korean Society of Clinical Toxicology
• /
• v.7 no.2
• /
• pp.164-171
• /
• 2009

Purpose: The number of patients who take warfarin is growing and so is the number of complications. Hemorrhage is the major complication, but the clinical characteristics and outcomes have not been determined for Korean patients. Therefore, we tried to evaluate the characteristics of the patients with hemorrhagic complications after taking warfarin as anticoagulation therapy. Methods: We retrospectively reviewed the medical records of the patients who visited the emergency room with bleeding complications after taking warfarin anticoagulation at the out-patient clinic for 1 year from 1 st January 2008. We compared between two groups (the major hemorrhage group vs. the minor hemorrhage group) according to the clinical criteria, the unstable vital signs that required blood transfusion, transfusion more than 2 units of blood, the need for further laboratory follow-up, the need for interventional treatment and the development of critical complications or death due to bleeding. Results: There were 150 patients who met the criteria and had acute hemorrhagic complications (the major group: 90 patients and the minor group: 60 patients). In the major hemorrhage group, the frequent sites of bleeding were the gastro-intestinal system (40 patients), lung (14 patients) and intracranium (7 patients). At the emergency room, the major group showed a higher initial INR of the activated prothrombin time than did the minor group (p=0.02). The bleeding sites of the fatal cases were the gastro-intestinal system (3 patients), lung (3 patients) and intracranium (3 patients), but the percentage of fatality was the highest for intracranium bleeding. Conclusion: In the major hemorrhage group, gastrointestinal bleeding was the most frequent complication and fatality was the highest for intracranium bleeding. An initially higher INR showed a greater risk of major bleeding, but not more fatalities.