• Title/Summary/Keyword: Intestinal bleeding

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Pre-Hospital and In-Hospital Management of an Abdominal Impalement Injury Caused by a Tree Branch

  • Ahn, So Ra;Lee, Joo Hyun;Kim, Keun Young;Park, Chan Yong
    • Journal of Trauma and Injury
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    • v.34 no.4
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    • pp.288-293
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    • 2021
  • In South Korea, most patients who visit trauma centers with abdominal injuries have blunt trauma, and penetrating injuries are relatively rare. In extremely rare cases, some patients are admitted with a long object penetrating their abdomen, and these injuries are referred to as abdominal impalement injuries. Most cases of impalement injuries lead to fatal bleeding, and patients often die at the scene of the accident. However, patients who survive until reaching the hospital can have a good prognosis with optimal treatment. A 68-year-old female patient was admitted to the trauma center with a 4-cm-thick tree branch impaling her abdomen. The patient was transported by a medical helicopter and had stable vital signs at admission. The branch sticking out of the abdomen was quite long; thus, we carefully cut the branch with an electric saw to perform computed tomography (CT). CT revealed no signs of major blood vessel injury, but intestinal perforation was observed. During laparotomy, the tree branch was removed after confirming that there were no vascular injuries, and enterostomy was performed because of extensive intestinal injury. After treating other injuries, the patient was discharged without any complications except colostomy. Abdominal impalement injuries are treated using various approaches depending on the injury mechanism and injured region. However, the most important consideration is that the impaled object should not be removed during transportation and resuscitation. Instead, it should only be removed after checking for injuries to blood vessels during laparotomy in an environment where injury control is possible.

Ascariasis Presenting as Hematoma in the Sigmoid Mesocolon: A Case Report (구불창자간막 혈종으로 발현한 회충증: 증례 보고)

  • Ji-Eun Kim;Kyung Eun Bae;Hyun-Jung Kim;Byung-Noe Bae;Ji Hae Lee;Mi-Jin Kang;Ji-Young Kim;Jae Hyung Kim
    • Journal of the Korean Society of Radiology
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    • v.81 no.4
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    • pp.1013-1018
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    • 2020
  • Ascariasis is an intestinal disease caused by Ascaris lumbricoides. Most patients with ascariasis are asymptomatic; however, the presence of many larvae in the bowel can cause gastrointestinal complications, such as intestinal obstruction, obstructive jaundice, cholangitis, cholecystitis, and pancreatitis. Herein, we report a case of ascariasis presenting as hematoma and active bleeding in the sigmoid mesocolon of a 74-year-old man on computed tomography (CT). Sigmoid colon perforation was also detected on follow-up CT. Laparoscopic low anterior resection was performed; there was a large hematoma in the sigmoid mesocolon. Roundworms were microscopically identified in the mesenteric adipose tissue. The clinical and CT findings of this unusual presentation of ascariasis revealed serial complications during parasite migration from the intestinal lumen to the peritoneal cavity.

Synergistic Effects of Carboxymethylchitosan Fabric and Low Molecular Weight Heparin in Reducing Adhesion Formation in the Rat Uterine Horn Model (Rat에서 Carboxymethylchitosan Fabric과 Low Molecular Weight Heparin의 자궁각 유착 형성 방지 상승효과)

  • Kwon, Young-Sam;Jang, Kwang-Ho
    • Journal of Veterinary Clinics
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    • v.25 no.4
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    • pp.263-267
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    • 2008
  • This study was performed to compare the efficacy of carboxymethylchitosan fabric (CMCF) with that of the combination of CMCF and low molecular weight heparin (LMWH) for the prevention of postoperative uterine adhesion in rats. Adhesions were induced by suturing both the uterine serosa and peritoneum abrased until petechial bleeding occurred. Fourteen days later, adhesions were evaluated clinically and histopathologically. The mean tensile strength was significantly decreased in the CMCF and CMCF+LMWH groups compared to that of control group, and the CMCF+LMWH group had the lowest tensile strength. The distance of adhesion site was highest in the CMCF group and slightly decreased in the CMCF+LMWH group comparing to that of control group. The inflammatory cell infiltration and neovascularization of the CMCF group were significantly lower than those of the control group. It was observed that the damage at intestinal serosa was significantly decreased in the CMCF+LMWH group comparing to that of control group. Therefore, it was concluded that CMCF and LMWH may be useful to prevent postoperative uterine adhesion in rats.

Peutz-Jeghers Syndrome: A Case Report and Review of Literature (Peutz-Jeghers 증후군: 증례보고와 문헌고찰)

  • Kim, Hyun Soo;Kim, Soung Min;Choi, Jin Young;Myoung, Hoon;Lee, Suk Keun;Lee, Jong Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.34 no.5
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    • pp.363-366
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    • 2012
  • Peutz-Jeghers syndrome is a rare syndrome with characteristic features of multiple hamartomatous polyps and mucocutaneous pigmentation. This syndrome is an autosomal dominant disease, and has complications related with polyps of the gastrointestinal tract, such as small bowel obstruction, iron deficiency anemia associated with bleeding, and intussusceptions. Many studies have reported about higher cancer risk of patients with this syndrome than those with no syndrome in the gastrointestinal tract, including gastric, duodenal, jejunal and the extragastrointestinal organs, such as gallbladder, breast and reproductive system. There are guidelines for periodic test for early detection and treatment for higher risk organs. We report a case of Peutz-Jeghers syndrome patient in the emphasis of Oral and Maxillofacial surgeon's role with review of the literature.

Non-Surgical Management of Gastroduodenal Fistula Caused by Ingested Neodymium Magnets

  • Phen, Claudia;Wilsey, Alexander;Swan, Emily;Falconer, Victoria;Summers, Lisa;Wilsey, Michael
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.21 no.4
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    • pp.336-340
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    • 2018
  • Foreign body ingestions pose a significant health risk in children. Neodymium magnets are high-powered, rare-earth magnets that is a serious issue in the pediatric population due to their strong magnetic force and high rate of complications. When multiple magnets are ingested, there is potential for morbidity and mortality, including gastrointestinal fistula formation, obstruction, bleeding, perforation, and death. Many cases require surgical intervention for removal of the magnets and management of subsequent complications. However, we report a case of multiple magnet ingestion in a 19-month-old child complicated by gastroduodenal fistula that was successfully treated by endoscopic removal and supportive care avoiding the need for surgical intervention. At two-week follow-up, the child was asymptomatic and upper gastrointestinal series obtained six months later demonstrated resolution of the fistula.

An Unusual Cause of Gastrointestinal Hemorrhage: Gastrocolic Fistula Caused by Colon Cancer Invasion (위장관 출혈의 증상으로 진단된 대장암에 의한 위대장루)

  • Cho, Jeong Hyeon;Kim, In Tae;Choi, Jin Yi;Chun, Song Wook;Kang, Beo Deul;Bae, Sang Kyun;Kim, Hee Man;Song, Ji Sun
    • Journal of Yeungnam Medical Science
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    • v.30 no.1
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    • pp.43-46
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    • 2013
  • Gastrocolic fistula is a fistulous communication between the stomach and the colon. It is a passage between the gastric epithelium and the colonic epithelium. This uncommon complication is caused by benign and malignant diseases of the stomach or the colon. Its clinical manifestations include weight loss, diarrhea and fecal vomiting; occasionally, anemia, poor oral intake, fatigue and dizziness; and very rarely, gastrointestinal bleeding. In this paper, an unusual case of gastrocolic fistula accompanied by hematochezia, which was revealed to have been caused by colon cancer invasion, is described.

The Effect of Thalidomide on Entero-Behcet's Disease (장관 베체트병 환자에서 Thalidomide의 치료 효과)

  • Kim, Jung Hak;Nam, Voki;Moon, Ho Sik;Kim, Jin Ook;Sung, Choon Ho
    • The Korean Journal of Pain
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    • v.22 no.1
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    • pp.104-106
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    • 2009
  • Behcet's disease is a chronic relapsing vasculitis characterized by recurrent aphthous oral and genital ulcers with uveitis. Multiple organs can be involved. Entero-Behcet's disease is often uncontrollable, relapsing, and can cause acute intestinal bleeding, fistula formation, or perforation. Corticosteroids, immunosuppressors, and colchicines are used to treat Entero-Behcet's disease with varying degree of success. Thalidomide may also be feasible. We present a 29-year-old male Entero-Behcet's patient suffering from abdominal pain, diarrhea, and back pain. He did not respond to prior treatments, but responded to thalidomide.

A Case of Gastrointestinal Stromal Tumor in a Child (소아에서 발생한 위장관 간질 종양 1예)

  • Yun, Kyung-Bin;Kim, Jae-Young;Ryu, Jae-Hong;Sul, Ji-Young;Kang, Dae-Young
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.10 no.1
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    • pp.71-75
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    • 2007
  • Gastrointestinal stromal tumors (GISTs) are the most common primary mesenchymal tumors of the digestive tract. They have been commonly observed in adults but have been rarely described in children. They arise typically from the intestinal wall and rarely in the mesentery, omentum, or retroperitoneum. GISTs originate from the interstitial cell of Cajal and are characterized by overexpression of the receptor tyrosine kinase c-kit. Up to 94% of these tumors express the CD117 on immunohistochemical stain. Surgery is the main modality of treatment for primary resectable GIST. Completely resectable GIST with low risk has excellent prognosis after primary surgical intervention, with over 90% of the 5-year survival. We report a case of 10-year-old girl presenting with an upper gastrointestinal bleeding caused by gastrointestinal stromal tumor.

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Henoch-Sch$\ddot{o}$nlein Purpura in Pediatric Surgery (소아외과에서의 Henoch-Sch$\ddot{o}$nlein 자반증)

  • Kim, Dae-Yeon;Kim, Seong-Chul;Kim, In-Koo
    • Advances in pediatric surgery
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    • v.6 no.1
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    • pp.45-49
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    • 2000
  • Henoch-Sch$\ddot{o}$nlein purpura is a systemic vasculitis of unknown etiology that is probably related to an autoimmune phenomenon. Henoch-Sch$\ddot{o}$nlein purpura is characterized by a purpuric rash, arthralgia, nephritis, and gastrointestinal manifestations. We reviewed 169 children hospitalized with a diagnosis of Henoch-Sch$\ddot{o}$nlein purpura between 1989 and 1998. One-hundred thirty-nine (82.2 %) had gastrointestinal findings including abdominal pain, nausea, vomiting and gastrointestinal bleeding. Surgical consultations were obtained for ten children, and laparotomy was performed in five. Three children suspected of having appendicitis underwent appendectomy. None had appendicitis. One child thought to have been intestinal strangulation was found to have hemorrhagic edema of the proximal jejunum and of the distal ileum. Another child underwent resection for an hemorrhagic infarct of the distal ileum. A high index of suspicion of this disease entity in the differential diagnosis of abdominal pain in children can avoid unnecessary laparotomy in most cases. However, life-threatening gastrointestinal complications may occur in low percentage of cases. Prompt recognition and adequate radiologic evaluation of the abdominal manifestation of this entity is necessary for early surgical intervention.

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The Improving Effect of Gastrodia elata Blume on DSS-induced Colitis in Mice

  • Ahn, Eun-Mi;Kim, Su-Jin
    • Biomedical Science Letters
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    • v.24 no.3
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    • pp.168-174
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    • 2018
  • Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized by abdominal pain, rectal bleeding and diarrhea. Gastrodia elata Blume (GE) has been used for the treatment of various diseases including neurodegenerative diseases and inflammatory disease. However, there has been no information on whether GE regulates intestinal inflammation. The aim of this study is to elucidate whether GE can protect against dextran sulfate sodium (DSS)-induced colitis in a mouse model. The colitis mice were induced by drinking water containing 5% DSS for 7 days. Body weight, colon length and clinical score were assessed to determine the effects on colitis. The levels of inflammatory cytokines, tumor necrosis factor $(TNF)-{\alpha}$ and interleukin (IL)-6 in colitis tissue were also measured. The results showed that mice administrated with DSS showed clinical signs including weight loss and reduced colon length. GE inhibited the DSS-induced loss of body weight and shortening of colon and increased Disease activity index score. Additionally, we observed that GE suppressed the levels of $TNF-{\alpha}$ and IL-6 in DSS-treated colon tissues. Collectively, these findings provide experimental evidence that GE might be a useful therapeutic agent for patients with UC.