• Title/Summary/Keyword: Retroperitoneal

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Candida Parapsilosis Spondylodiscitis after Lumbar Discectomy

  • Cho, Kyun-Gil;Lee, Sun-Ho;Kim, Eun-Sang;Eoh, Whan
    • Journal of Korean Neurosurgical Society
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    • v.47 no.4
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    • pp.295-297
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    • 2010
  • Candida is a relatively rare cause of spinal infections that commonly affects immunocompromised patients. A 70-year-old woman, who underwent a lumbar discectomy on L5-S1 two months earlier, was admitted to our department complaining of persistent back and leg pain. Magnetic resonance imaging showed irregular enhancing mass lesion in L5-S1 intervertebral space, suggest of pyogenic discitis with epidural abscess. The surgery was performed via retroperitoneal approach and the infected material at L5-S1 intervertebral space was removed. The histological examination of the specimen revealed chronic inflammation involving the bone and soft tissue, and a culture of the excised material was positive for Candida parapsilosis. The patient received intravenous fluconazole for 4 weeks after surgery and oral fluconazole 400 mg/day for 3 months after surgery. The patient made a full recovery with no symptoms 6 months after surgery. We present a rare case of spondylodiscitis after a lumbar discectomy due to Candida parapsilosis and discuss treatment option with a review of the literatures.

Ureteral Injury Caused By Blunt Trauma: A Case Report (둔상에 의한 요관 손상 1례)

  • Kwon, Oh Sang;Mun, Yun Su;Woo, Seung Hwo;Han, Hyun Young;Hwang, Jung Joo;Lee, Jang Young;Lee, Min Koo
    • Journal of Trauma and Injury
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    • v.25 no.4
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    • pp.291-295
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    • 2012
  • Ureteral trauma is rare, accounting for less than 1% of all urologic traumas. However, a missed ureteral injury can result in significant morbidity and mortality. The purpose of this case presentation is to suggest another method for early detection of ureteral injury in blunt traumatic patient. A 47-years-old man was injured in pedestrian traffic accident. He undergone 3-phase abdominal CT initially and had had a short-term follow-up simple. We suspected ureteral injury. Our final diagnosis of a ureteral injury was based on follow-up and antegrade pyeloureterography, he underwent emergency surgery. We detected the ureteral injury early and took a definitive action within 24 hours. In blunt trauma, if abnormal fluid collection in the perirenal retroperitoneal space is detect, the presence of a ureteral injury should be suspected, so a short-term simple X-ray or abdominal CT, within a few hours after initial abdominal CT, may be useful.

A Case of Malignant Fibrous Histiocytoma of the Larynx (후두에 발생한 악성 섬유성 조직구종)

  • Koo, Yong-Cheol;Hwang, Chi-Sang;Kim, Gi-Jeong;Choi, Hong-Shik
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.22 no.2
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    • pp.159-161
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    • 2011
  • Malignant fibrous histiocytoma is one of the rare types of larynx tumor. The most common sites of the tumor are limbs, trunk, and retroperitoneal space, but tumor localization within head and neck are very rare. It is built of histiocytes, fibroblasts and multinuclear giant cells. A diagnosis of the tumor includes microscopic and immunohistologic examination with identification of specific tissue markers and intermediate filaments of proteins. This disease has been treated by several methods combining radical surgery, radiotherapy, and chemotherapy, but the prognosis is poor. We present 74-year-old Asian man with dysphonia for 2 years. The tumor of the larynx was examined on laryngoscopy. The radical surgery rendered the final pathological diagnosis, confirmed histologically and immunohistochemically as malignant fibrous histiocytoma. This tumor was treated with laser cordectomy followed by radiotherapy. 3.5 year's observation of the patient didn't either show any signs of recurrence or dysphonia.

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Congenital Internal Hernia Presented with Life Threatening Extensive Small Bowel Strangulation

  • Lee, Narae;Kim, Su-Gon;Lee, Yeoun Joo;Park, Jae-Hong;Son, Seung-Kook;Kim, Soo-Hong;Hwang, Jae-Yeon
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.16 no.3
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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.

Modified Approach through the Sacrococcygeal Junction to Block the Ganglion Impar (천미골 접합부를 이용한 외톨이 신경절 차단법)

  • Song, Sun-Ok;Kwon, Oh-Deuk;Kim, Seong-Ki
    • The Korean Journal of Pain
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    • v.10 no.2
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    • pp.254-257
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    • 1997
  • Ganglion impar lies immediately anterior to the sacrococcygeal junction and blockade of the ganglion is used to treat anorectal and perineal pain. Although the technique introduced by Plancarte et at is widely practised, the bent needle is sometimes difficult to position precisely and patients find the procedure painful. We modified this approach of block of ganglion impar by positioning the needle into the sacrococcygeal junction and using the loss of resistance technique. With the patient in the lateral position, a skin wheal was raised at 1-1.5cm below the sacral hiatus. Twenty-three gauge short needle was directly placed into the sacrococcygeal junction with aid of fluoroscopic guidance. From 1 cm behind the anterior margin of the vertebral body in lateral view, we used the loss of resistance technique to confirm the retroperitoneal space. We found this modified approach easier to perform during six blocks for three patients with anorectal or perineal pain. Our modified approach through the sacrococcygeal junction may provide opportunity for wider administration of this procedure because of its simple technique, reduced pain during procedure and decreased risk of infection.

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Two Cases of Pancreatoblastoma (췌모세포종 2예)

  • Huh, Young-Soo;Hah, Jeong-Ok;Jang, Seon-Mo;Lee, Jung-Hoon
    • Advances in pediatric surgery
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    • v.6 no.2
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    • pp.139-142
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    • 2000
  • Pancreatoblastoma is uncommon in children and is exceedingly rare in adults. Prognosis is good if the tumor is removed prior to metastasis. Complete tumor resection is the most important factor for long survival. We report two cases of pancreatoblastoma in 4 and 7 years old girls. Palpable abdominal mass was accidentally found by their parents. Abdominal CT scan showed a huge retroperitoneal mass of unknown origin in one case and a mass involving the pancreas in the other case. At laparotomy, well encapsulated tumor mass($10{\times}10$ cm in maximum dimension) was noted in the body of pancreas in one case, and in the tail of pancreas in the other case( $8{\times}7$ cm). We resected the tumor and preserved the spleen in both cases. Histological examination revealed that the tumors were pancreatoblastoma. Patients received postoperative chemotherapy with 6 cycles of cisplatinum, adriamycin, ifosfamide and etoposide and are alive in good condition 19 months and 17 months after operation.

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The effect of Taeumjowetang and Herba Ephedrae on the Obese mRNA and TNF-α mRNA in obesity-induced rats (태음조위탕(太陰調胃湯)과 마황(麻黃)이 비만(肥滿) 백서(白鼠)의 Leptin에 미치는 영향(影響))

  • Shin, Dong-jun;Kim, Dal-rae;Kim, Sun-hyung
    • Journal of Sasang Constitutional Medicine
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    • v.13 no.1
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    • pp.79-87
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    • 2001
  • In order to investigate the effect of Taeumjowetang and Herba Ephedrae on obesity-induced rats, after Taeumjowetang and Herba Ephedrae were administered by mouth, and then body-weight, serum triglyceride, total cholesterol, Obese mRNA and TNF-${\alpha}$/ mRNA were measured. The reselts were as follows ; 1. The body-weight was decresed with the statistical significance in both the Taeumjowetang and the Herba Ephedrae group as compared with the control group. 2. The quantitation of serum triglyceride was decresed with the statistical significance in both the Taeumjowetang and the Herba Ephedrae group as compared with the control group. 3. The total cholesterol was slightly decresed in both the Taeumjowetang and the Herba Ephedrae group as compared with the control group, but there was no statistical significance. 4. The manifestation of Obese mRNA and TNF-${\alpha}$/ mRNA in epidymal, retroperitoneal, mesenteric and skeletal muscle tissues were inhibited in Taeumjowetang and Herba Ephedrae group. According to the above results, Taeumjowerang and Herba Ephedrae were recognized to be helpful for the treatment of obesity.

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A Case of Myxoid Liposarcoma of the Cheek (협부에 발생한 점액양 지방육종의 치험례)

  • Yoo, Jun-Ho;Roh, Si-Gyun;Lee, Nae-Ho;Yang, Kyoung-Moo;Cha, Eun-Jung
    • Archives of Plastic Surgery
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    • v.38 no.4
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    • pp.505-507
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    • 2011
  • Purpose: Liposarcoma is the most common soft tissue sarcoma, and usually occurs on the thigh or in the retroperitoneal space, but rarely in the oral region. This report presents a case of liposarcoma of the cheek and includes a review of the literatures. Methods: A 21-year-old woman was admitted with a palpable mass in her cheek of about two years duration, which increased in size gradually initially, but had increased rapidly over the three months. There was no particular pain or tenderness. MRI showed a well-enhanced, well-defined mass, which suspected to be hemangioma. Results: The spherical, well-encapsulated mass was surgically excised. Biopsy results revealed myxoid liposarcoma. FDG PET-CT on the seventh postoperative day, revealed a minimal to mild FDG-uptake soft tissue lesion around the mass defect area without evidence of distant metastasis. The patient is being observed and undergoing radiation therapy. Conclusion: Liposarcoma in the head and neck region is a rare disease, and can be overlooked as a benign tumor without a pathologic diagnosis. Therefore, proper treatment and follow-up are required based on an understanding of this disease.

Aortoenteric Fistula - A Report of a Case - (대동맥장루 -1예 보고-)

  • 김성수
    • Journal of Chest Surgery
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    • v.22 no.5
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    • pp.823-828
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    • 1989
  • Aortoenteric fistula is an uncommon important complication of aortic reconstruction with a prosthetic graft. The complication often is difficult to diagnose and is associated with poor prognosis. Aortoenteric fistula could be divided into true aortoenteric fistula and paraprosthetic-enteric fistula. In case of true aortoenteric fistula, an actual communication between the gastrointestinal tract and the aortic lumen is present. So, massive gastrointestinal hemorrhage is the presenting manifestation. In paraprosthetic-enteric fistula, characterized by communication between the gastrointestinal tract and the external surface of synthetic vascular prosthesis without actual fistularization into the vascular lumen, the predominant clinical manifestation were sepsis, fever and anemia. We experienced one case of paraprosthetic-enteric fistula in a 16 years old male after abdominal aortic reconstruction with a prosthetic graft. The interval from the operation to onset of symptoms was 40 months. The initial clinical manifestation was sepsis, fever and anemia without massive gastrointestinal hemorrhage. Surgical treatment consists of complete excision of infected graft, two layers closure of jejunal wall defect and pledgets suture of aortic stump with surrounding health tissue. Anatomic revascularization was not able to be done: because of extensive retroperitoneal inflammation and extraanatomic revascularization did not performed due to adequate distal blood supply through rich collateral circulation. After operation, he complained numbness on left foot on moderate exertion and felt coldness on left leg compared with right leg but not showed skin color change. 43 days after operation, he discharged without gait disturbance except numbness on left foot on moderate exertion.

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A Sphaghetti Sign in the Abdominal Radiograph Consistent with Spleno-Systemic Shunts in a Cat

  • Oh, Donghyun;Hwang, Jaewoo;Yoon, Junghee;Choi, Mincheol
    • Journal of Veterinary Clinics
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    • v.37 no.4
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    • pp.227-230
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    • 2020
  • A 8-year-old spayed female Korean short-haired cat was presented with respiratory distress. CBC, serum chemistry analysis, plain radiography, and abdominal ultrasonography were performed. Besides hypertrophic cardiomyopathy (HCM) suspected by the thoracic radiograph, a tubular, tortuous soft tissue structure was detected at the region of the left retroperitoneal cavity on the abdominal radiograph. On the abdominal ultrasonography, a shunt vessel is identified caudo-lateral to the left kidney region. These findings are consistent with spleno-systemic shunts in cats. Furthermore, portal hypertension and diffuse hepatic lesion were also identified. Although the cause of a shunt vessel is not easy to diagnose, it is important to include spleno-systemic shunt into differential diagnosis list, when convoluted, tubular soft tissue opacity is seen on the digital radiography (DR). This report will allow clinicians to raise awareness of complications of portosystemic shunt (PSS) and better treat PSS suspected feline patients when the advanced modalities such as computed tomography and magnetic resonance imaging are not available.