• Advances in pediatric surgery
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• 제10권2호
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• pp.123-126
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• 2004

Intestinal obstruction secondary to intraabdominal adhesion is a well-known postoperative complication occurring after appendectomy. The aim of this study was to measure the incidence and clinical manifestations of mechanical intestinal obstruction after appendectomy for perforated appendicitis. We reviewed all of the children (age <16 years) who had been treated for appendicitis at Asan Medical Center between January 1996 and December 2001. Inclusion criterion included either gross or microscopic evidence of appendiceal perforation. Exclusion criteria were interval appendectomy, and patients immune compromised by chemotherapy. Associations of intestinal obstruction with age, sex, operation time, and use of peritoneal drains were analyzed. Four hundred and sixty two open appendectomies for appendicitis were performed at our department. One hundred and seventeen children were treated for perforated appendicitis (78 boys, 39 girls). The mean age was 8.9 years (range 1.5 to 14.8 years). There were no deaths. Eight patients were readmitted due to intestinal obstruction, but there was no readmission due to intestinal obstruction in patients with non-perforated appendicitis. The interval between appendectomy and intestinal obstruction varied from 12 days to 2 year 7 months. Four patients needed laparotomies. In three of four, only adhesiolysis was performed. One child needed small bowel resection combined with adhesiolysis. There was no significant association between age or sex and the development of intestinal obstruction. This was no association with operative time or use of peritoneal drain. Patients who required appendectomy for perforated appendicitis have a higher incidence of postoperative intestinal obstruction than those with nonperforated appendicitis. For the patients with perforated appendicitis, careful operative procedures as well as pre and postoperative managements are required to reduce adhesions and subsequent bowel obstruction.

• Clinical and Experimental Pediatrics
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• 제51권2호
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• pp.219-221
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• 2008

저자들은 발열과 식욕저하를 주소로 패혈증 의증으로 전원 된 27일된 신생아에서 구토와 혈변 등은 없었으나, 입원 당시 복부팽만과 단순복부촬영에서 보인 소장 확장소견으로 개복술을 실시한 결과 선천성 밴드에 의해 내탈장된 소장이 압박되어 유발된 장폐색증 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• 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.

• 한국임상수의학회지
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• 제33권3호
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• pp.179-182
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• 2016

An 11-year-old castrated male Maltese had vomiting, diarrhea, and abdominal distension for over two weeks and weight loss for several months. Clinical laboratory studies were not remarkable. Abdominal radiographs showed severe dilated intestine with a gravel sign. Colon was empty with normal diameter in the pneumocolon study. On ultrasonographs, most small bowel loops were dilated without normal peristalsis and showed abnormal thin wall. Barium contrast study revealed remarkably delayed gastric emptying and transit time up to $6^{th}$ day. On exploratory laparotomy, there were no mechanical obstruction and extra-intestinal abnormalities except severe dilated small intestine. Chronic fibrosing lymphohistiocytic leiomyositis with atrophy of tunica muscularis in the small intestines and colon was identified through full thickness biopsy and histopathology. Therefore, primary myopathic chronic intestinal pseudo-obstruction was diagnosed. This dog is survival with symptomatic treatments for eight months.

• Advances in pediatric surgery
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• 제2권2호
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• pp.148-150
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• 1996

Transmesenteric hernia, a type of internal hernias, is a rare cause of intestinal obstruction. This intraperitoneal hernia has no sac and is formed by protrusion of a loop of bowel through an aperture in the mesentery. Incarceration leads to intestinal obstruction and subsequently, strangulation and gangrene of varing lengths of intestine. This is a case report of 4-year-old girl with transmesenteric herniation of the terminal ileum through a defect in its own mesentery. Strangulation of the affected bowel necessitates resection and primary anastomosis with repair of mesenteric defect. The postoperative course was uneventful. Acute intestinal obstruction in the absence of an external hernia and with no history of a previous surgical procedure suggests the possibility of an internal hernia, especially if the patient has a history of chronic intermittent abdominal distress.

• 한국임상수의학회지
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• 제33권4호
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• pp.210-213
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• 2016

A 9-year-old, mixed-breed, castrated male dog presented with a one-week history of severe vomiting. Abdominal radiography showed a dilated small intestine loop. Abdominal ultrasonography showed small-intestine distension up to 5 cm in diameter without mechanical obstruction. During exploratory laparotomy, an aperistaltic ileal segment was resected. There was no narrowed cavity in the resected plane. Histopathologic and immunohistochemical findings confirmed visceral myopathy due to intestinal adenocarcinoma in the ileum and revealed partial destruction of the longitudinal and circular muscles with fibrosis. Chronic intestinal pseudo-obstruction caused by adenocarcinoma was diagnosed after considering the above investigative results.

• Clinical and Experimental Pediatrics
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• 제52권2호
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• pp.261-264
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• 2009

장 중복낭종은 드문 선천성 기형 질환으로 구강에서 항문까지 어느 곳에서나 발견할 수 있고 장관과 교통하기도 한다. 특히 맹장의 장 중복낭종은 더욱 드문 질환이다. 이들은 구토나 반복적인 복통과 위장관 출혈 및 변비 등의 증상으로 급성 장폐색을 발생시키며 생후 2년내 80%에서 발견된다. 저자들은 신생아에서 맹장의 장 중복낭종에 의해 발생한 장 폐색 1예를 경험하였기에 보고하고자 한다.

• Parasites, Hosts and Diseases
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• 제29권1호
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• pp.93-96
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• 1991

서울에 거주하는 상사 직원인 31세 남자가 이틀전부터 시작된 갑작스런 하복부 복통으로 입원하였다. 단순복부촬영상 기계적인 장폐색 소견을 보여 실험적 개복술을 실시한 바 공장부위의 장막에 봉와직염이 있었고 출혈점 부위에서 길이 1 cm인 선충을 발견하였다. 이 충체 절단면의 Y-자 모양 측선의 특징을 기초로 Anisakis 유충으로 동정하였다. 우리나라의 아니사키스중 보고례에 대하여 간단히 요약하고 이 질환이 장폐색증의 감별진단의 대상이 되어야 함을 강조하였다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제27권4호
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• pp.197-205
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• 2024

T-lymphocytic intestinal leiomyositis is a rare cause of "pediatric intestinal pseudo-obstructions." Diagnosis may be difficult and requires full-thickness bowel biopsies during laparotomy or laparoscopy with possible enterostomy. Currently, immunosuppressive therapy is the only available treatment. A delay in diagnosis and therapy may negatively affect the prognosis because of ongoing fibrotic alterations; therefore, early diagnosis and consequent treatment are crucial. This review summarizes the available information on the nosology, diagnostic steps, and treatment modalities. Here, we report the youngest case of enteric leiomyositis reported in the last two decades and analyze its management by reviewing previous cases.

• Neonatal Medicine
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• 제15권2호
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• pp.196-199
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• 2008

저자들은 Hirschsprung 병을 의심한 환아에서 Cajal세포 감소에 의한 미숙아 가성 장 폐쇄를 경험하였기에 보고하는 바이다. 심한 복부 팽만과 장 폐쇄 증상으로 결장 절개술이 필요한 미숙아에서 ganglion cell의 존재 유무 뿐만 아니라 Cajal 세포의 결핍도 확인할 필요가 있을 것으로 생각된다.