• Title/Summary/Keyword: acute abdomen pain

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Omental Torsion and Infarction Secondary to Omental Hernia in the Right Inguinal Canal (오른쪽 서혜부 탈장에 의해 이차적으로 발생한 대망의 염전 및 경색)

  • Yu Hyun Lee;Jae Hoon Lim;Heon-Kyun Ha
    • Journal of the Korean Society of Radiology
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    • v.81 no.4
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    • pp.1003-1007
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    • 2020
  • Omental torsion secondary to inguinal hernia has rarely been reported as a cause of acute abdominal pain. However, in our case, omental infarction due to prolonged inguinal hernia-associated omental torsion led to the formation of a large omental mass with marginal fibrosis, and the patient presented with chronic abdominal pain. A 74-year-old man presented with complaints of lower abdominal pain for 1 month; subsequently, bilateral inguinal hernias were identified through inguinal ultrasonography. CT scans revealed that the greater omentum was trapped within the right inguinal canal, leading to omental torsion. The greater omentum, distal to the pedicle, appeared as a 30 cm-sized oblong fibrofatty mass in the right lower abdomen and pelvic cavity. Laparoscopic omentectomy with hernia repair was successfully performed.

Bibliographic Study on Wibub(위法) (위법에 관한 文獻的 考察)

  • Jee, Seon-young;Lee, Byung-wook;Kim, Sang-chan;Byun, Sung-hui;Kim, Han-kyun
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.16 no.2
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    • pp.46-56
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    • 2003
  • Objects: The purpose of this thesis is to consider classification of Wibub(위법), heating method of Wibub(위법) and the diseases for which Wibub(위법) is efficacious through bibliographic basements. Methods: We bibliographically studied on Wibub(위법) through 20 existing oriental documents. Results: Summarized as follows; 1. Wibub(위법) is an external therapy of applying heated herbal powder or granules wrapped in a cloth or applying heated implements to the affected part. 2. Wibub(위법) is divided into two types. One is Yakwi(약위) which uses medicine, the other is Wibub(위법) which only uses implements. 3. The heating methods of Wibub(위법) are various. there are using directly heated medicine, using heated implement and using Naengwi(냉위) and Yeolwi(열위) in turns. 4. Wibub(위법) is efficacious for mammary disease like as acute mammaritis, mastitis, anal disease like as hemorrhoids, proctoptosis, sore, muscle disease, multiple abscess, pyogenic infection of bone, gonarthritis externally and efficacious for cold paralysis, cold limbs, vomiting with diarrhea, mass in abdomen, abdominal pain, constipation, urinary disease like as dysuria, ischuria internally. Conclusions: As the aboves. Wibub(위법) is able to be used variously in clinical cases. so we consider that it is necessary to study methods which improve practical use of Wibub(위법).

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A Case of Tuberculous Peritonitis Mimicking Surgical Abdomen (외과적 복부질환으로 오인된 결핵성 복막염 1례)

  • Kim, Hyun-Jin;Kim, Hae-Soon;Seo, Jeong-Wan;Choi, Kum-Ja;Lee, Sun-Wha;Sung, Sun-Hee
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.5 no.2
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    • pp.181-185
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    • 2002
  • Childhood tuberculous peritonitis is difficult to diagnose especially in cases without pulmonary involvement. It may present as mechanical ileus, perforation, simulating acute appendicitis, enterocolitis or intusussception. Early diagnosis in children may be difficult, largely because of variable vague symptoms and nonspecific signs. Surgery has often been required for pathologic confirmation. We have experienced a case of tuberculous peritonitis presenting with abdominal pain, abdominal distension and persistent high fever in a 10-year-old boy who was diagnosed by explo-laparotomy and pathologic confirmation from biopsy specimen from omentum. The patient was treated with antituberculous drugs and recovered uneventfully.

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A Case of Anticoagulant-induced Spontaneous Intramural Intestinal Hematoma (항응고제에 의한 자발성 장관 벽내 혈종 1예)

  • Park, Ho Joon;Kim, Gwang Ha;Park, Sang Kyu;Park, Do Youn
    • The Korean journal of helicobacter and upper gastrointestinal research
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    • v.18 no.3
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    • pp.204-208
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    • 2018
  • Spontaneous intramural hematoma is a rare complication of oral anticoagulants, and its incidence is expected to increase because of the increasing number of elderly patients undergoing anticoagulant therapy. Clinical manifestations of spontaneous intramural hematoma vary from mild abdominal pain to intestinal obstruction or acute abdomen. Early diagnosis is important because most patients can be treated successfully without surgery. The role of endoscopy in the diagnosis of intramural hematoma is not well established because almost all cases are diagnosed non-invasively with computed tomography scans. However, confirmation of the intramural hematoma through direct visualization of the involved bowel mucosa is helpful, if the imaging diagnosis is uncertain. We report a case of anticoagulant-induced spontaneous intramural hematoma, which was diagnosed using endoscopy, with relevant literature review.

Added Value of Diffusion Weighted Imaging for Detecting Pancreatic Abnormality in Patients with Clinically Suspected Acute Pancreatitis

  • Nam, In Chul;Kim, Seung Ho;Kim, Seon-Jeong;Lim, Yun-jung
    • Investigative Magnetic Resonance Imaging
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    • v.20 no.4
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    • pp.241-249
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    • 2016
  • Purpose: To evaluate the added value of diffusion weighted imaging (DWI) to computed tomography (CT) for detecting pancreatic abnormality in patients with clinically suspected acute pancreatitis (AP). Materials and Methods: 203 patients who underwent abdomen CT and subsequent DWI to do a workup for epigastric pain were analyzed. Two blinded radiologists independently performed an interval reading based on CT image sets first, then based on combined CT and DWI image sets. The diagnostic criterion on DWI was the increased signal intensity in the pancreas to that of the spleen. For quantitative analysis, the third radiologist measured ADC value of the pancreas in each patient. Results: For AP (n = 43), the sensitivity for detecting pancreatic abnormality increased, from 42% to 70% for reader 1 (P < 0.05) and from 44% to 72% for reader 2 (P < 0.05). For borderline pancreatitis (n = 42), the sensitivity also increased, from 10% to 26% for reader 1 (P < 0.05) and from 7% to 29% for reader 2 (P < 0.05). The mean ADC values (unit, ${\times}10^{-3}mm^2/s$) were significantly different among the three groups (for AP, $1.09{\pm}0.16$; for borderline pancreatitis, $1.28{\pm}0.2$; for control, $1.46{\pm}0.15$, P < 0.05). Conclusion: Sensitivity for detecting pancreatic abnormality increased significantly after adding DWI to CT in patients with clinically suspected AP.

Henoch-Scholein Purpura Presenting with Acute Abdominal Pain Preceding Skin Rash : Review of 23 Cases (급성 복통이 피부 발진에 선행한 Henoch-Schonlein Purpura 23례에 대한 고찰)

  • Chang, Ju Young;Kim, Yong Joo;Kim, Kyo Sun;Kim, Hee-Ju;Seo, Jeong Kee
    • Clinical and Experimental Pediatrics
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    • v.46 no.6
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    • pp.576-584
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    • 2003
  • Purpose : For the early diagnosis of Henoch-Schonlein purpura(HSP) presenting with acute abdominal pain preceding skin rash. Methods : The clinical, endoscopic and radiological records of 23 cases of HSP, presenting with gastrointestinal symptoms preceding skin rash were reviewed. Results : The intervals from the onset of abdominal pain to the development of the skin rash were one day to 30 days(median five days), most of them were within two weeks. The presenting abdominal symptoms were abdominal pain(23 cases), vomiting(16 cases), hematochezia or melena(eight cases) and hematemesis(three cases). The abnormal endoscopic findings include coalescing erythematous lesions, areas of submucosal hemorrhage and superficial erosions and ulcers. The upper gastrointestinal endoscopy showed the abnormalities in 21 of 23 cases, which were observed in the duodenum( 21 cases), the stomach(12 cases) and the esophagus(one case). Duodenitis with hemorrhage and/or erosions in the descending duodenum was the sole endoscopic abnormality in two cases and was the most marked finding in three cases. Sigmoidoscopy showed the abnormalities in six of eight cases. The abdominal ultrasonogram showed abnormalities in 12 of 17 cases, which included small bowel wall thickening(eight cases) and intramural hemorrhage(three cases). Recurrences after three months of symptom free intervals developed in four cases; three of them had persistent nephritis beyond one year. Conclusion : The erosive hemorrhagic duodenitis in the descending duodenum in the upper endoscopy and the small bowel wall thickening in the abdominal ultrasonogram can be useful findings in the diagnosis of HSP presenting with acute abdomen.

Perforation of Meckel's Diverticulum in Children (소아에서 발생한 천공성 메켈게실)

  • Ghil, Tae-Hwan;Yun, Jung-Hoon;Kim, Sang-Woo;Huh, Young-Soo
    • Advances in pediatric surgery
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    • v.8 no.1
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    • pp.28-32
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    • 2002
  • Meckel's diverticulum (MD) occurs in approximately 2 % of the population. The major complications of MD are bleeding, intestinal obstruction, infection and perforation. Perforation is the least common but most serious complication, the incidence od which is about 5-10 %. The causes of perforation are inflammatory diverticulitis and peptie ulceration. the purpose of study is to review the characteristics of perforated MD in children. Six patients with perforated MD who had been operated upon at the Department of Pediatric Surgery, Yeungnam University Hospital from April 1984 to July 2001 were included. Male predominated in a ratio of 5:1 and there were 2 neonates. The chief complaints were abdominal pain and distension. Half of the children showed a past history of bloody stools. The average age was 4 year and 9 months. The mean distance from the ileocecal valve to the diverticulum was 60 cm. Average length of the diverticulum was approximately 3 cm and width was 1.7 cm. The perforation site was the tip of the diverticulum in 3 cases, the base in 2 cases and along the lateral border in one. In two patients, ectopic gastric mucosa was found in the specimen. All of the patients were operated upon with a diagnosis of peritonitis of unknown etiology. In conclusion, when a child shows symptoms of acute abdomen or peritonitis, especially in boys, with the history of bloody stools and episodic abdominal pain, perforated MD should be suspected.

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A Case of Tuberculosis Presented with Pseudoaneurysm of the Aorta and Acute Respiratory Distress Syndrome (복부 대동맥 가성동맥류와 급성호흡곤란증후군으로 동시에 발현한 결핵)

  • Lee, Eung-Jun;Cho, Han-Su;Yoon, Hyun-Sung;Lee, Jung-Hyun;Lee, Tae Hoon;Yoo, Kwang Ha;Lee, Kye Young;Kim, Sun Jong
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.4
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    • pp.298-302
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    • 2008
  • We experienced a case of tuberculosis presented simultaneously with pseudoaneurysm of the aorta and ARDS. A 63-year-old man was admitted with complaints of fever and right upper quadrant abdominal pain for a week. Chest X-ray on admission showed a normal finding. Sub-diaphragmatic abscess on abdomen CT scan was suspected and serosanguinous fluid was aspirated from the abscess pocket. On day 2, he was getting more dyspneic and chest X-ray revealed extensive bilateral infiltration. Aspirated fluid revealed AFB. Later, follow-up abdomen CT scan revealed a leakage of dye from the aneurysmal sac of the descending aorta which was previously diagnosed as sub-diaphragmatic abscess. An aortic stent was placed, covering the opening into the aneurysm. The sputum also showed positive AFB. The patient was successfully weaned from the ventilator, and discharged with anti-tuberculous medication on day 42. Follow-up abdomen CT scan 6 months later showed that the aneurymal sac was completely disappeared.

Ectopic Human Fasciola hepatica Infection by an Adult Worm in the Mesocolon

  • Kim, Ah Jin;Choi, Chang Hwan;Choi, Sun Keun;Shin, Yong Woon;Park, Yun-Kyu;Kim, Lucia;Choi, Suk Jin;Han, Jee Young;Kim, Joon Mee;Chu, Young Chae;Park, In Suh
    • Parasites, Hosts and Diseases
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    • v.53 no.6
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    • pp.725-730
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    • 2015
  • We report here an ectopic case of Fasciola hepatica infection confirmed by recovery of an adult worm in the mesocolon. A 56-year-old female was admitted to our hospital with discomfort and pain in the left lower quadrant of the abdomen. Abdominal CT showed 3 abscesses in the left upper quadrant, mesentery, and pelvic cavity. On surgical exploration, abscess pockets were found in the mesocolon of the sigmoid colon and transverse colon. A leaf-like worm found in the abscess pocket of the mesocolon of the left colon was diagnosed as an adult fluke of F. hepatica. Histologically, numerous eggs of F. hepatica were noted with acute and chronic granulomatous inflammations in the subserosa and pericolic adipose tissues. Conclusively, a rare case of ectopic fascioliasis has been confirmed in this study by the adult worm recovery of F. hepatica in the mesocolon.

Eight and a Half Syndrome: A Clinical Study of 2 Cases (8과 1/2 증후군 2례)

  • Park, Ji-Min;Kim, Jong-Han;Yoo, Je-Hyuk;Yoon, Ga-Young;Nam, Dong-Woo;Lee, Sang-Hoon;Kim, Jong-In
    • Journal of Acupuncture Research
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    • v.29 no.3
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    • pp.139-148
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    • 2012
  • Objectives : The purpose of this case is to report the improvement of two patients diagnosed with eight and a half syndrome after combination therapy of oriental and western medicine. Methods : We treated the patients with combination therapy of oriental and western medicine such as acupuncture, moxibustion, herbal medication, antithrombotic agents and steroid therapy. Changes of peripheral facial paralysis were evaluated using House-Brackmann facial grading system and the degree of dizziness, tenderness and pain of upper abdomen were assessed using numerous rating scale. Changes in motor grade of upper and lower extremities were evaluated using medical research council scale. Results : We have recently experienced two cases of eight and a half syndrome - a syndrome characterized by the coexistence of one and a half syndrome, a rare ophthalmoparetic syndrome characterized by a conjugate horizontal gaze palsy in one direction and an internuclear ophthalmoplegia in the other, and cranial nerve VII palsy. The one and a half syndrome was caused by acute cerebral infarction. Two patients in this report were improved through combination therapy of oriental and western medicine. Conclusions : We report the clinical course and treatment methods of eight and a half syndrome.