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4 Cases of Chronic Abdominal Pain Children Treated by Sihogyeji-tanggagam with Acupuncture and Moxibustion Treatment (시호계지탕가감방과 침구치료로 호전된 만성 복통 환아 4례)

  • Lee, Shin Hee;Heo, Yu Jin;Cho, Yun Soo
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.35 no.6
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    • pp.261-266
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    • 2021
  • This study aim to report 4 cases with chronic abdominal pain whose symptoms are alleviated by Sihogyeji-tanggagam with Korean medicine treatments. The patients were decided to administer Sihogyeji-tanggagam through abdominal examination. The patients were treated by Korean medicine, including acupuncture, moxibustion, and herbal medicine (Sihogyeji-tanggagam). We used Gastrointestinal Symptom Rating Scale (GSRS), Abdominal examination, Visual Analog Scale (VAS), and Subjective Unit of Clinical Symptoms to evaluate the progress of treatments. The improvement of clinical symptoms appeared to be effective with out any remarkable side effects. The abdominal pain of all patients stared to improve as soon as treatment begin, and disappeared in 1-2 weeks. We also confirmed that the abdominal symptoms improved together with the improvement of clinical symptoms. This study suggests that Sihogyeji-tanggagam is effective on reducing symptoms of chronic abdominal pain, but further studies should be followed.

Massive traumatic abdominal wall hernia in pediatric multitrauma in Australia: a case report

  • Sarah Douglas-Seidl;Camille Wu
    • Journal of Trauma and Injury
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    • v.36 no.4
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    • pp.447-450
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    • 2023
  • Traumatic abdominal wall hernia is a rare presentation, most commonly reported in the context of motor vehicle accidents and associated with blunt abdominal injuries and handlebar injuries in the pediatric population. A 13-year-old boy presented with multiple traumatic injuries and hemodynamic instability after a high-speed motor vehicle accident. His injuries consisted of massive traumatic abdominal wall hernia (grade 4) with bowel injury and perforation, blunt aortic injury, a Chance fracture, hemopneumothorax, and a humeral shaft fracture. Initial surgical management included partial resection of the terminal ileum, sigmoid colon, and descending colon. Laparostomy was managed with negative pressure wound therapy. The patient underwent skin-only primary closure of the abdominal wall and required multiple returns to theatre for debridement, dressing changes, and repair of other injuries. Various surgical management options for abdominal wall closure were considered. In total, he underwent 36 procedures. The multiple injuries had competing management aims, which required close collaboration between specialist clinicians to form an individualized management plan. The severity and complexity of this injury was of a scale not previously experienced by many clinicians and benefited from intrahospital and interhospital specialist collaboration. The ideal aim of primary surgical repair was not possible in this case of a giant abdominal wall defect.

Effects of 4-week PNF Exercise Program on Activity, Posture, and Muscle Strength in a Patient with Abdominalis Weakness after Cesarean Section: A Single-Subject Study

  • Beom-Ryong Kim;Tae-Woo Kang;Seo-Yoon Park
    • The Journal of Korean Physical Therapy
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    • v.36 no.1
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    • pp.1-8
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    • 2024
  • Purpose: The purpose of this study was to determine the effect of proprioceptive neuromuscular facilitation (PNF) abdominal muscle strengthening exercise on the activity, posture, and body function of clients with abdominal muscle weakness after cesarean section. Methods: PNF abdominal muscle strengthening exercise was applied to one patient with abdominal muscle weakness after cesarean section. PNF abdominal muscle strengthening exercise was applied five times a week for four weeks. The 5-time supine-to-long sitting test (5-TSLST) and supine-to-stand test (SST) were used to measure activity, and the pelvis tilt angle test (PTAT) and anterior head translation test (AHTT) were used to measure posture. Body function was assessed using the transverse abdominis muscle strength test (TAMST), the internal oblique and external oblique muscle strength test (IOEOMST), and the rectus abdominis muscle strength test (RAMST). Results: Activity, posture, and body function were improved post-intervention. Conclusion: The study verified that PNF abdominal muscle strengthening exercises are effective when applied to patients with abdominal muscle weakness after cesarean section. The findings of this study provide useful data for future interventions in patients with abdominal muscle weakness after cesarean section.

The Effects of Back Muscle Stretching and Abdominal Muscle Strengthening Exercises on the Flexibility of Spinal Column of Normal Adults (정상 성인에 있어 배부근 스트레칭 운동과 복부근력강화 운동이 척주 유연성에 미치는 영향)

  • Gong, Won-Tae
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.12 no.1
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    • pp.1-15
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    • 2006
  • Purpose: The purpose of this study was to evaluate the effects of abdominal muscle strengthening exercises and back muscle stretching on the flexibility of spinal column. Methods: The subjects were consisted of healthy adults ( 28 of females, 32 males; mean aged 21.6) from 18 to 29. All subjects randomly assigned to the control group, back muscle stretching group, abdominal muscle strengthening exercises group. back muscle stretching group received back muscles stretching for 20 minutes, abdominal muscle strengthening exercises group received abdominal muscle strengthening exercises for 30 minutes per day and 3 times a week during 3 week period. Spine motion analyzer (Spinal Mouse) was used to measure the flexibility of spinal column. All measurement of each subjects were measured at pre-experiment, after 10 days, and after 21 days. Results: The results of this study were summarized below 1. The sacral tilt angle of the hip joint of control group, back muscle stretching group, abdominal strengthening exercises group was no significantly differences at pre-experiment and after 10 days(p>0.5), but differency of each group occurred at after 21 days(p<0.5). the sacral tilt angle significantly increased at the back muscle stretching group, abdominal muscle strengthening exercises group, rather than the control group. 2. The thoracic vertebral tilt angle of the control group, back muscle stretching group, abdominal muscle strengthening exercises group was no significantly differences at pre-experiment, after 10 days, after 21 days(p>0.5). 3. The lumbar vertebral tilt angle of the control group, back muscle stretching group, abdominal muscle strengthening exercises group was no significantly differences at pre-experiment, after 10 days, after 21 days(p>0.5). 4. The spinal tilt angle of control group, back muscle stretching group, abdominal muscle strengthening exercises group was no significantly differences at pre-experiment and after 10 days(p>0.5), but differency of each group occurred at after 21 days(p<0.5). the spinal tilt angle significantly increased at the back muscle stretching group, abdominal muscle strengthening exercises group, rather than the control group(p<0.5). 5. The length of the spinal column of control group, back muscle stretching group, abdominal muscle strengthening exercises group was no significantly differences at pre-experiment and after 10 days (p>0.5), but differency of each group occurred at after 21 days(p<0.5). the length of the spinal column significantly increased at the back muscle stretching group, abdominal muscle strengthening exercises group, rather than the control group(p<0.5). Conclusion: these data suggests that 3-week abdominal muscle strengthening exercises and back muscle stretching improved the flexibility of sacrum, spinal column, and also improved spinal column lengthening. Additional randomized controlled trials to more fully investigate treatment effects and factors that may mediate these effects are needed.

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Case of Abdominal Compartment Syndrome Treated by using a Bedside Open Linea Alba Fasciotomy (외상에 의한 후복막 출혈환자에서 발생한 복부구획증후군을 침상 옆 백선 근막 절개술로 치료한 증례)

  • Kim, Ji-Hoon T.;Han, Myung-Sik;Choi, Gun-Moo;Jang, Hyuck-Jae;Kwak, Jin-Ho;Kim, Ji-Hoon S.
    • Journal of Trauma and Injury
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    • v.24 no.1
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    • pp.56-59
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    • 2011
  • Abdominal compartment syndrome (ACS) is a life-threatening disorder caused by rapidly increasing intra-abdominal pressure. ACS can result in multiorgan failure and carries a mortality of 60~70%. The treatment of choice in ACS is surgical decompression. There are very few reports of ACS and experience in Korea. We report 12-year-old male patient who developed an abdominal compartment syndrome due to traffic-accident-induced retroperitoneal hematomas, Which was successfully treated by performing a bedside emergency surgical decompression with open linea alba fasciotomy with intact peritoneum. When patients do not respond to medical therapy, a decompressive laparotomy is the last surgical resort. In patients with severe abdominal compartment syndrome, the use of a linea alba fasciotomy is an effective intervention to lower intra-abdominal hypertension (IAH) without the morbidity of a laparotomy. Use of a linea alba fasciotomy as a first-line intervention before committing to full abdominal decompression in patients with abdominal compartment syndrome improves physiological variables without mortality. Consideration for a linea alba fasciotomy as a bridge before full abdominal decompression needs further evaluation in patients with polytrauma abdominal compartment syndrome.

The Study on Association between Abdominal Visceral Fat and Obesity Indices in Obese Adult (비만 성인에서 복부 내장지방과 단순 비만 지표와의 연관성 연구)

  • Yoo, Jin-Sook;Song, Yun-Kyung;Lim, Hyung-Ho
    • Journal of Korean Medicine Rehabilitation
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    • v.20 no.2
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    • pp.129-143
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    • 2010
  • Objectives : This study examined search on how the obesity indices, that are largely used in clinics such as waist circumference(WC), body mass index(BMI) and waist-hip ratio(WHR), are related to the visceral fat that was measured from abdominal computed tomography(CT) and the ratio of visceral fat/subcutaneous fat. Then, two groups ware compared in order to find out which characteristics of ordinary adults relationship with the abdominal obesity. Two groups are divided as follows; ones who are obese based on the measurement of WC and the others who are obese based on the level of BMI. Methods : A group of 63 test subjects that were gathered in the oriental medical hospital of Kyung-Won university is divided into two groups; ones (n=51, general obesity; group A) who have $BMI{\geq}25$ and $WC{\geq}85$, and the others (n=12, abdominal obesity; group B) who have BMI<25 and $WC{\geq}85$. Then, each group's obesity indices, abdominal CT, lipid level, glucose, adiponectin, leptin and C-reactive protein(CRP) are compared. In addition, subjects are again divided into two to examine the characteristics; ones (n=14, visceral obesity; group C) with visceral obesity based on the ratio between visceral fat and subcutaneous fat measured through abdominal CT, and the others (n=38, non-visceral obesity; group D) who are obese but not viscerally obese. Results & Conclusions : As a measurement that applies abdominal visceral fat and subcutaneous fat, BMI and WC can be considered as an appropriate obesity index while WHR cannot appropriately apply the abdominal fat amount. Moreover, the study indicates that abdominal obesity group based on the ratio of visceral fat/subcutaneous fat has more significant difference than the abdominal obesity group based on the WC in case of blood lipid index.

Risk Factors for Recurrent Abdominal Pain in Children with Nonorganic Acute Abdominal Pain

  • Piriyakitphaiboon, Varisa;Sirinam, Salin;Noipayak, Pongsak;Sirivichayakul, Chukiat;Pornrattanarungsri, Suwanna;Limkittikul, Kriengsak
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.25 no.2
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    • pp.129-137
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    • 2022
  • Purpose: The purpose of this study was to identify the risk factors for recurrent abdominal pain (RAP) in children who presented with nonorganic acute abdominal pain. Methods: A retrospective, single study was conducted on 2-15-year-old children diagnosed with nonorganic acute abdominal pain at the pediatric outpatient department of Vajira Hospital, Nawamindradhiraj University, between January 2015 and December 2019. The potential risk factors were analyzed using univariate and multivariate analyses. Results: Of the 367 patients with nonorganic acute abdominal pain, 94 (25.6%) experienced RAP within three months. In this group with RAP, 76 patients (80.8%) were diagnosed with functional gastrointestinal disorders, including functional dyspepsia, irritable bowel syndrome, functional abdominal pain-not otherwise specified, and functional constipation. History of gastrointestinal infection (p=0.011), mental health problems (p=0.022), abdominal pain lasting ≥7 days (p<0.001), and change in stool frequency (p=0.001) were the independent risk factors associated with RAP in children with nonorganic acute abdominal pain; their odds ratios and 95% confidence intervals were 3.364 (1.314-8.162), 3.052 (1.172-7.949), 3.706 (1.847-7.435), and 2.649 (1.477-4.750), respectively. Conclusion: RAP is a common problem among children who first present with nonorganic acute abdominal pain. The identification of risk factors may provide proper management, especially follow-up plans for this group in the future.

Use of abdominal compression device in colonoscopy: a systematic review and meta-analysis

  • Yousaf Zafar;Ahmed Mustafa Rashid;Syed Sarmad Javaid;Ahmed Kamal Siddiqi;Adnan Zafar;Arsalan Zafar Iqbal;Jagpal Singh Klair;Rajesh Krishnamoorthi
    • Clinical Endoscopy
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    • v.56 no.4
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    • pp.446-452
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    • 2023
  • Background/Aims: Colonoscopy for screening is associated with unpleasant experiences for patients, and abdominal compression devices have been developed to minimize these problems. However, there is a paucity of data supporting the therapeutic benefits of this strategy. This study examined the effects of using an abdominal compression device during colonoscopy on the cecal intubation time (CIT), abdominal compression, patient comfort, and postural changes. Methods: We searched PubMed and Scopus (from inception to November 2021) for randomized controlled trials that assessed the effects of an abdominal compression device during colonoscopy on CIT, abdominal compression, patient comfort, and postural change. A random-effects meta-analysis was performed. Weighted mean differences (WMDs) and Mantel-Haenszel odds ratios (ORs) were calculated. Results: Our pooled analysis of seven randomized controlled trials revealed that abdominal compression devices significantly reduced CIT (WMD, -0.76 [-1.49 to -0.03] minutes; p=0.04), abdominal compression (OR, 0.52; 95% confidence interval [CI], 0.28-0.94; p=0.03), and postural changes (OR, 0.46; 95% CI, 0.27-0.78; p=0.004) during colonoscopy. However, our results did not show a significant change in patient comfort (WMD, -0.48; 95% CI, -1.05 to 0.08; p=0.09) when using an abdominal compression device. Conclusions: Our findings demonstrate that employing an abdominal compression device may reduce CIT, abdominal compression, and postural change but have no impact on patient comfort.

Two Cases of Laparoscopic Adhesiolysis for Chronic Abdominal Pain without Intestinal Obstruction after Total Gastrectomy

  • Choi, Hyun Jung;Yoon, Sang Chul;Kim, Yong Jin
    • Journal of Gastric Cancer
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    • v.12 no.4
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    • pp.249-253
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    • 2012
  • Chronic abdominal pain remains a challenge to all known diagnostic and treatment methods with patients undergoing numerous diagnostic work-ups including surgery. However, the surgical treatment of patients with chronic intractable abdominal pain is controversial. There has been no discussion of the indications for adhesiolysis in cases of obstruction or strangulation of the bowel, and adhesiolysis by laparotomy has never gained acceptance as a treatment modality for chronic abdominal pain. One of the reasons for this lack of acceptance is the high complication rate during and after adhesiolysis. Laparoscopic surgery has been accepted as a technique for diagnostic and therapeutic procedures in general surgery. Laparoscopy allows surgeons to see and treat many abdominal changes that could not otherwise be diagnosed. Here we report two cases of successful symptomatic improvement through laparoscopic adhesiolysis for chronic abdominal pain without intestinal obstruction after total gastrectomy.

Acute Abdominal Pain in Children

  • Kim, Joon Sung
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.16 no.4
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    • pp.219-224
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    • 2013
  • Acute abdominal pain is a common complaint in childhood, and it can be caused by a wide range of underlying surgical and non-surgical conditions. The most common non-surgical condition is gastroenteritis, while the most common surgical condition is appendicitis. Abdominal pain in children varies with age, associated symptoms, and pain location. Although acute abdominal pain is usually benign and self-limiting, there are uncommon but life-threatening conditions that require urgent care. Meticulous history taking and physical examinations are essential to determine the cause of acute abdominal pain and to identify children with surgical conditions such as appendicitis.