• 대한수의학회지
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• 제46권1호
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• pp.83-86
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• 2006

About 8 year-old castrated male Yorkshire terrier was presented for evaluation of dysuria, stranguria, hemtauria, and pollakiuria. On history taking, dysuria first was observed three months ago and these signs were waxed and waned. Physical examination revealed mild left perineal swelling. On routine laboratory examination, no significant findings were identified. Positive contrast urogram identified peritoneal herniation of urinary bladder. Urinalysis showed proteinuria and hematuria. Urine sediment revealed epithelial cells, white blood cells and rod-shaped bacteria. Pseudomonas aeroginosa was isolated from urine obtained through cystocentesis, and had resistance against fourteen antibiotics. Cystitis caused by P. aeruginosa concurrent with cystolithiasis and perineal hernia was diagnosed. Cystotomy, herniorrhaphy and EDTA-Tris solution lavage of bladder were performed. The patient was recovered to normal condition 2 days after treatment. Two weeks later, bacterial culture of urine was negative and any abnormality in ultrasonogram and urinalysis was not observed except calcium oxalate dihydrate crystals.

• 대한수의학회지
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• 제49권4호
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• pp.351-354
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• 2009

Diaphragmatic hernias, whether congenital or acquired (traumatic), are rarely observed in the horse. Acquired diaphragmatic hernias typically occur secondary to trauma or an increase in intraabdominal pressure due to falling, heavy exercise, or parturition. Diaphragmatic herniorrhaphy is difficult to perform in adult horses and the horses with symptomatic diaphragmatic hernias usually die. A 10- year old, 340 kg, Jeju horse (crossbred) broodmare with sudden onset of gait disorder and a moderate emaciation was examined. Findings on physical examination included conjunctivitis, dehydration, shallow breathing, dyspnea, weaken heart beat, lack of auscultatable sounds from the gastrointestinal tract, and anorexia. Rectal temperature was $38.4^{\circ}C$ and respiratory rates were moderately increased. There were slight signs of acute colic. The broodmare died one day after non-specific treatment of fluids, nutriment, antibiotics and non-steroidal anti-inflammatory drug. The cause of death was strangulation of the small intestine through a diaphragmatic hernia. The rent was about 2 cm in diameter and located in the central right part of diaphragm. Around 60 cm of small intestine was protruded into thoracic cavity through the rent. The cause of the hernia could not be ascertained. The broodmare had been pastured with many other horses, and the groom had not noticed any aggressive behavior among them. It was, however, speculated that trauma by stallion's attack may have been the cause of the diaphragmatic hernia, because the new horse may be the object of behaviors ranging from mild threats to seriously aggressive kicking, squealing, rearing, and biting.

• Journal of Trauma and Injury
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• 제33권2호
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• pp.128-133
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• 2020

Traumatic abdominal wall hernias (TAWHs) are uncommon and the incidence of this, which is rarely encountered in clinical practice, has been estimated at 1%. Furthermore, blunt transection of the entire abdominal wall musculature caused by seatbelt is a very rare complication. We report a case of adult with a complete disruption of the entire anterolateral abdominal wall muscle following the seatbelt injury. A 32-year-old male was wearing a seat belt in a high speed motor vehicle collision. Abdominal computed tomography (CT) scan revealed the complete disruption of bilateral abdominal wall musculatures including TAWH without visceral injury. However, injuries of small bowel and sigmoid colon were observed in the intra-operative field. The patient underwent the repair by primary closure of the defect with absorbable monofilament sutures. This case suggests that especially in TAWH patients, even if a CT scan is normal, clinicians should keep the possibility of bowel injury in mind, and choose a treatment based on the clinical findings.

• Advances in pediatric surgery
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• 제12권2호
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• pp.147-154
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• 2006

One day surgery in children has been practiced for last 10 years in this institution. This study is to examine its safety and effectiveness for patients younger than 15 years old treated at the Department of Pediatric Surgery, Asan Medical Center, from September. 1996 to December, 2005. A total of 3,709 patients, 37 % of the total pediatric operations, are included in this retrospective study. The most prevalent ages were between 1 and 3 years olds (1,199 patients). Twenty patients were younger than 6 months, and they all had one day surgery safely. Operations were herniorrhaphy in 3,126 patients,followed by excisional biopsy, chemoport removal, and OK 432 injection. There were 12 cases (0.32 %) of unplanned admissions, 7 occurred within 6 months of one day surgery. Perioperative fever was the most common cause of admission in 4 cases. The related conditions of unplanned admission were bleeding in 2 cases and radical surgery in 2. One day surgery in this institution was easily accessible and safe. This is to the result of appropriate selection of patients, cooperation with anesthesiologists, adequate control of postoperative pain, and home care programs.

• Advances in pediatric surgery
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• 제20권1호
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• pp.7-11
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• 2014

The present study compared the postoperative analgesic effects of ilioinguinal and iliohypogastric nerve block with infiltration of local anesthetics (bupivacaine) into the wound in children after inguinal hernia repair. Ninety children below 7 years old who were scheduled elective inguinal hernia repair were randomly allocated into one of three groups. The patients in nerve block (NB) group, ilioinguinal and iliohypogastric nerve block was done with 0.5 mL/kg of 0.25% bupivacaine. The patients in infiltration of local anesthetics (LI) group, 0.5 mL/kg of 0.25% bupivacaine was infiltrated into the wound after surgery. The patients in control group were allocated as a Control group. Postoperative pain was assessed at 1, 3, 5, and 24 hours after operation with FLACC scale and additional analgesic consumption were counted. The three groups were not significantly different in age, sex, body weight, and duration of operation. Pain scores at 1 hour and 3 hours after operation were significantly higher in Control group than in NB group and LI group (p<0.01), whereas there were no difference between NB group and LI group. The rescue analgesics administration was significantly higher in Control group (n=11) than in NB group (n=6) and LI group (n=7) (p<0.05). There were 2 cases of transient femoral nerve palsy in NB group. Both of ilioinguinal and iliohypogastric nerve block and infiltration of local anesthetics into the wound provided effective postoperative analgesia in early postoperative period following inguinal hernia repair in children. But no difference between the two methods. Technically, infiltration of local anesthetics into the wound was easier and safer than ilioinguinal and iliohypogastric nerve block.

• Advances in pediatric surgery
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• 제16권2호
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• pp.101-107
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• 2010

Herniorrhaphy of Indirect inguinal hernia (IIH) is one of the most frequently performed surgical procedures in children. The overall incidence of inguinal hernias in childhood ranges from 0.8 to 4.4 %. The incidence is up to 10 times higher in boys than girls, especially much higher in premature infants. IIHs in children are basically an arrest of embryologic development rather than an acquired weakness, which explains the increased incidence in premature infants. In normal development, the processus vaginalis closes, obliterating the peritoneal opening of the internal ring between 36th and 40th week of gestation. This process is often incomplete, leaving a small patent processus in many newborns. However, closure continues postnatally, and the rate of patency is inversely proportional to age of the child. The presence of a patent processus vaginalis is a necessary but not sufficient variable in developing a congenital IIH. In other words, all congenital IIHs are preceded by a patent processus vaginalis, but not all patent processus vaginalis go on to become IIHs. The overall incidence of IIH in population is approximately 1 to 2 % and the incidence of a processus vaginalis is approximately 12 to 14%, clinically appreciable IIH should develop in approximately 8 to 12 % of patients with a patent processus vaginalis. Although the classic open inguinal hernia repair remains the gold standard for most pediatric surgeons, laparoscopic repair is being performed in many centers. Like open technique, laparoscopic technique is fundamentally a high ligation of the indirect hernia sac with or without internal ring ligation. The advantages of laparoscopic approach include the ease of examining the contralateral internal ring, the avoidance of access damage to vas and vessels during mobilization of cord, decreased operative time, and an ability to identify unsuspected direct or femoral hernias. Almost all groin hernias in children are IIHs and occur as a result of incomplete closure of processus vaginalis. The treatment is repair by high ligation of hernia sac, which can be done by an open or laparoscopic technique. The contralateral side can be explored by laparoscopy or left alone, open exploration is no longer indicated due to potential risk of infertility.

• Acute and Critical Care
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• 제33권4호
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• pp.276-279
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• 2018

In pediatric patients, a laryngeal mask airway (LMA) is usually used during minor surgeries that require general anesthesia. No esophageal injury has been reported after insertion of an LMA. We report a case of an esophageal injury with intramural dissection after an $i-gel^{(R)}$ (size, 1.5; Intersurgical Ltd.) insertion in a pediatric patient. A 2-month-old male infant was hospitalized for left inguinal herniorrhaphy. After induction of anesthesia, a trained resident tried to insert an $i-gel^{(R)}$. However, it was only successful after three attempts. Dysphagia was sustained until postoperative day 10, and the pediatrician observed duplication of the esophagus on gastroendoscopy. However, a whitish mucosal lesion, which looked like a scar, was observed, and previous lesions suggestive of esophageal duplication were almost healed on postdischarge day 11. His condition was diagnosed as dysphagia and esophagitis due to an esophageal laceration, not esophageal duplication. He was scheduled for symptomatic treatment with a proton pump inhibitor. In conclusion, although an esophageal injury or perforation in pediatric patients is rare, an LMA insertion or a procedure such as aspiration or nasogastric tube insertion should be performed gently to avoid a possible injury to the esophagus in pediatric patients.

• 현장농수산연구지
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• 제25권4호
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• pp.39-43
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• 2024

Little research has been done on investigating the specific characteristics of Jeju Ponies (Korean native horse) and Jeju Pony crossbreds. The authors performed evaluation of skin thickness of the skin of these breeds (n=205) at Jeju Race Park as a way of find of hippological difference. Results of this study showed that the Jeju Pony's skin were thicker than the Jeju Pony crossbred. The male's skin were thicker than the female's skin in two breeds respectively. Especially, in the Jeju Pony show significant differences (P < 0.05). In Jeju Pony crossbreds, as the skin thickness were thinner with age increase. 2-year-old group's skin significantly thinner than 3 and over 4-year-old groups. However, the Jeju Pony's skin were not significantly different by age. In conclusion, the authors thought that causes of the difference of the breeds were origin and genetic differences among the horse and the pony. Furthermore, the modified umbilical herniorrhaphy with rubber rings must be used cautiously in the Jeju Pony. It should be taken into account the animals' skin thickness when the leather goods created by using their skin.

• The Korean Journal of Pain
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• 제37권4호
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• pp.332-342
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• 2024

Background: Pre-operative ilioinguinal-iliohypogastric nerve block (II-IHNB) has a proven role in lessening acute postoperative pain and opioid consumption following hernia repair. However, its role in preventing post-herniorrhaphy groin pain (PHGP) is still unknown. The current study aims to assess pre-operative II-IHNB's impact on PHGP three and six months after open inguinal hernia repair under spinal anesthesia. Methods: Seventy patients posted for inguinal hernia surgery were randomly allocated into group A (received ultrasound-guided II-IHNB with 10 mL of 0.5% ropivacaine and 4 mg [1 mL] dexamethasone) and group B (received ultrasound-guided II-IHNB with 11 mL of 0.9% normal saline). The time to first analgesic request, pain scores, opioid consumption, DN4 score, and PHGP at 3 and 6 months were analyzed using appropriate statistical tests. Results: The numerical pain rating scale at movement in group A was significantly reduced at all the time intervals of 3, 6, 12, and 24 hours compared to group B. Total opioid usage was lower in group A (3.71 mg [3.90]) versus group B (12.14 mg [4.90]) with a mean difference of -8.43 mg (95% CI -10.54, -6.32), P < 0.001. The time required for the first rescue analgesic was significantly longer in group A (360 min [180-360]) versus (180 min [180-360]) in group B (P < 0.001). However, there was no difference in the incidence of PHGP at three and six months between the two groups. Conclusions: Pre-operative ultrasound-guided II-IHNB reduces postoperative analgesic requirement but does not reduce the incidence of chronic PHGP following hernia surgery at 6 months.

• 한국임상수의학회지
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• 제23권4권
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• pp.461-464
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• 2006

회음부 탈장은 나이든 수캐에서 골반강의 특발적인 약화로 일어난다. 14년령의 중성화되지 않은 수컷 시츄견이 우측 회음부 종창으로 건국대학교 부속 동물병원에 내원하였다. 3년간의 회음부 종창의 소견을 나타내는 병력을 가지고 있었으며, 방사선 검사에서 헤르니아 낭내의 직장과 결장의 확장이 관찰되었다. 회음부 탈장 교정술 중 바깥 항문조임근, 미골근, 그리고 항문 올림근이 약 3년간의 탈장으로 약화되어 있었고, 속폐쇄근의 변위만으로는 큰 결손부를 막기 어려워 polypropylene mesh를 이용하여 성공적인 수복이 이루어졌다.