• Journal of information and communication convergence engineering
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• 제21권4호
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• pp.322-328
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• 2023

The number of senior citizens with large bowel obstruction is steadily growing in Korea. Plain radiography was used to examine the severity and treatment of this phenomenon. To avoid examiner subjectivity in radiography readings, we propose an automatic segmentation method to identify fluid-filled areas indicative of large bowel obstruction. Our proposed method applies the Hough transform to locate suspicious areas successfully and applies the possibilistic fuzzy c-means unsupervised learning algorithm to form the target area in a noisy environment. In an experiment with 104 real-world large-bowel obstruction radiographs, the proposed method successfully identified all suspicious areas in 73 of 104 input images and partially identified the target area in another 21 images. Additionally, the proposed method shows a true-positive rate of over 91% and false-positive rate of less than 3% for pixel-level area formation. These performance evaluation statistics are significantly better than those of the possibilistic c-means and fuzzy c-means-based strategies; thus, this hybrid strategy of automatic segmentation of large bowel suspicious areas is successful and might be feasible for real-world use.

• 한국정보통신학회논문지
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• 제24권12호
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• pp.1618-1624
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• 2020

X-ray를 기반으로 하는 장 폐색 진단 방법은 검사자의 주관적인 요소가 포함되기 때문에 객관적 진단에 영향을 미칠 수 있다. 따라서 본 논문에서는 허프 변환과 PCM 클러스터링 기법을 적용하여 장폐색 영역을 추출하는 방법을 제안한다. 제안된 방법은 X-ray 장폐색 영상에서 ROI 영역을 추출한 후, 허프 변환 기법을 이용하여 ROI 영역에서 직선을 검출하고, 검출된 직선을 이용하여 공기 액체층의 형태학적 특징을 이용하여 대장 폐색을 추출한다. 그리고 추출된 ROI 영역을 PCM 클러스터링을 적용하여 ROI 영역을 양자화 한다. 양자화된 ROI 영역 중에서 대장 폐색의 특징이 포함된 클러스터의 그룹을 선정하고, 선정된 클러스터의 그룹에서 객체를 탐색하여 소장 장폐색 영역을 추출한다. 장폐색 환자의 X-ray 영상 30개를 대상으로 PCM 클러스터링을 적용한 결과, PCM의 초기 클러스터의 수를 4개로 설정한 경우가 장폐색 검출 성능이 우수하였고 TPR은 81.47%로 나타났다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제16권3호
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• pp.190-194
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• 2013

Internal hernia (IH) is a rare cause of small bowel obstruction occurs when there is protrusion of an internal organ into a retroperitoneal fossa or a foramen in the abdominal cavity. IH can be presented with acute or chronic abdominal symptom and discovered by accident in operation field. However, various kinds of imaging modalities often do not provide the assistance to diagnose IH preoperatively, but computed tomography (CT) scan has a high diagnostic accuracy. We report a case of congenital IH in a 6-year-old boy who experienced life threatening shock. CT scan showed large amount of ascites, bowel wall thickening with poor or absent enhancement of the strangulated bowel segment. Surgical exploration was performed immediately and had to undergo over two meters excision of strangulated small bowel. To prevent the delay in the diagnosis of IH, we should early use of the CT scan and take urgent operation.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제38권
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• pp.10.1-10.5
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• 2016

Herniation after harvesting of deep circumflex iliac artery (DCIA) flap is a known but not a common complication. It occurs about 2.8 to 9 % according to the literatures and can proceed to a more severe complication such as bowel obstruction. There are several factors that exacerbate the risk: surgical factors, operator factor, and patient factors. Surgical factors include large anatomical defect and denervation of related muscles. Operator factor stands for unpunctual suture technique. Patient factors represent obesity, diabetes, pulmonary disease, smoking habits, and so on. Thus, herniation might occur regardless of meticulous suture. Herein, we would like to report two cases of herniation after DCIA flap harvesting and repaired by Lichtenstein tension-free hernioplasty with literature review.

• Clinical Endoscopy
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• 제55권2호
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• pp.310-312
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• 2022

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권6호
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• pp.571-575
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• 2019

We report a case of a 13-year-old girl who presented with a 2-month history of intermittent abdominal pain. Laboratory examination showed hepatitis and pancreatitis. Because of persistent vomiting, computed tomography (CT) was performed, which revealed a circumferential soft tissue density in the duodenal wall, causing partial obstruction. Supportive therapy failed. Repeat CT showed no significant change from the initial study. The patient underwent upper endoscopy, which revealed a mass in the second portion of the duodenum, which occluded most parts of the lumen. The histopathological finding was consistent with an anaplastic large cell lymphoma, a rare form of small bowel neoplasm. After the third course of chemotherapy, complete resolution of the mass was noted, and her symptoms were relieved.

• Advances in pediatric surgery
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• 제1권2호
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• pp.177-180
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• 1995

A 2-day-old male (Premie, Large for gestational age(LGA), Intrauterine period(IUP) 33 weeks, birth weight 2,955 gram) was transferred with marked abdominal distention, bilious return via the orogastric tube, respiratory difficulty, and generalized edema (hydrops fetalis). He was born by cesarean section to a 36 year-old mother. Antenatal ultrasonogram at IUP 31 weeks demonstrated multiple dilated bowel loops suggestive of intestinal obstruction. There was no family history of cystic fibrosis. Simple abdominal films disclosed diffuse haziness and suspicious fine calcifications in the right lower quadrant. Barium enema demonstrated a microcolon. Sweat chloride test was not available in our institution. At laparotomy, there noted 1) a segmental volvulus of the small bowel with gangrenous change, associated with meconium peritonitis, 2) an atresia of the ileum at the base of the volvulus, and 3) the terminal ileum distal to the volvulus was narrow and impacted with rabbit pellets-like thick meconium. These findings appeared to be very similar to those of a complicated meconium ileus. In summary, the ileal atresia and meconium peritonitis seemed to be caused by antenatal segmental volvulus of the small intestine in a patient with probable meconeum ileus.

• Journal of Trauma and Injury
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• 제26권4호
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• pp.300-303
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• 2013

Blunt abdominal trauma is commonly encountered in the emergency department. The lack of historical data and the presence of distracting injuries or altered mental status, from head injury or intoxication, can make these injuries difficult to diagnose and manage. We experienced a case of traumatic organized hematoma misdiagnosed as intra-peritoneal tumor with intestinal obstruction. A 52-year-old homeless male patient who have chronic alcoholism was admitted via emergency room with infra-umbilical abdominal pain. At admission, he was drunken status and so we could not be aware of blows to the abdomen. He had a unknown large operation scar on mid abdomen. A computed tomography (CT) scan showed the intestinal obstruction of the ileum level with 5.5cm sized mesenteric tumor. We performed adhesiolysis and widely segmental resection of small bowel including tumor with side-to-side anastomosis due to great discrepancy in size. He stated later that he was a victim of the violence before 3 weeks. A final pathologic report revealed well encapsulated, traumatic mesenteric hematoma with organizing thrombi, ischemia and abscess formation with multiple adhesion bands. Finally, the patient was discharged without complications on postoperative day 14.

• 대한영상의학회지
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• 제81권4호
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• pp.1013-1018
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• 2020

회충증은 Ascaris lumbricoides에 의하여 유발되는 장 질환이다. 대부분의 회충증 환자는 무증상이지만 장내 유충이 많은 경우에는 장 폐색, 폐쇄성 황달, 담관염, 담낭염, 췌장염과 같은 합병증이 생길 수 있다. 저자들은 컴퓨터단층촬영(이하 CT)에서 구불창자간막에 혈종과 활동성 출혈이 발생하여 회충증으로 진단된 74세 남자의 사례를 경험하였다. 이후에 환자가 시행한 CT에서는 이와 더불어 구불창자의 천공 발생이 확인되었다. 복강경을 통한 저위전방절제술이 시행되었고 구불창자간막에 큰 혈종이 있었으며 장간막 지방 조직에서 현미경적으로 회충이 확인되었다. 이러한 회충증의 드문 임상적, 영상의학적 소견은 기생충이 장관의 내강 안에서 복강 내로 이동하는 과정에서 발생한 순차적인 합병증들을 보여준다.