• Title/Summary/Keyword: prolapse

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Laparoscopic-assisted Colopexy by Two-Portal Access in a Dog with Recurrent Rectal Prolapse

  • Lee, Seung-Yong;Park, Se-Jin;Park, Tae-Yeong;Kim, Hyun-Jin;Kim, Jung-Hoon;Seok, Seong-Hoon;Kim, Young-Ki;Lee, Hee-Chun;Yeon, Seong-Chan
    • Journal of Veterinary Clinics
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    • v.33 no.3
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    • pp.165-167
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    • 2016
  • A case of rectal prolapses in a one-year-old intact male mixed-breed dog, weighing 6.8 kg was presented with one-week history of protruded tubular pink mass through the anus along with mucosal necrosis. The prolapse was non-reducible, so rectal amputation and anal purse-string suture was performed. Prolapse recurred 9 days after the surgery, purse-string suture and conservative treatment were attempted with no-good results. Laparoscopic-assisted incisional colopexy technique was applied to treat the recurrent rectal prolapse, but failed 6 days after surgery. This was followed by non-incisional colopexy technique, which prevented recurrence during the 3 months of follow-up period. Despite the episode of recurrence, the laparoscopic-assisted colopexy technique treated rectal prolapse successfully. This is the first report in Korea, which describes laparoscopic-assisted colopexy in the dog.

Postoperative Evaluation for Ventricular Septal Defect Associated with Aortic Valvular Prolapse (대동맥판 탈출이 동반된 심실 중격 결손증의 술후 평가)

  • 선기남;구자홍;조중구;김공수
    • Journal of Chest Surgery
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    • v.32 no.2
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    • pp.119-123
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    • 1999
  • Background: From January 1989 to December 1996, we analyzed 22 cases of ventricular septal defect associated(VSD) with aortic valvular prolapse. Material and Method: The mean age of the patients was 7 years with a range of 6 months to 22 years . Thirteen patients were male and 9 were female. The types of VSD were Kirklin type I in 13 , Kirklin type II in 8 and Kirklin type I+II in one. Result: The preoperative echocardiographic findings were aortic valvular prolapse in 10 patients, aortic valvular prolapse associated with aortic regurgitation in 6, and only aortic regurgitation in 2. Aortic valvular prolapse were found in operation field in 4 that was not be in preoperative echcardiography. Preoperative mean Qp/Qs, systolic PAP, systolic RVP were 1.48${\pm}$0.42, 27.9${\pm}$9.87, 32.9${\pm}$10.87 mmHg, respectively. Twenty patients underwent patch closure of VSD, and two patients with moderate aortic regurgitation and prolapsed of the aortic valve underwent patch closure of VSD and aortic valvuloplasty. Short and long term echocardiographic follow-up in 8 patients who had preoperative aortic regurgitation were found to have improved or not aggravated by performing VSD patch closure only and patch closure with valvuloplasty in 2. Twelve patients who had only preoperative aortic valvular prolapse had no change in prolapsed valve in postoperative echocardiography. Conclusion: Early closure of VSD with patch is necessary in VSD with aortic valvular prolapse even in associated with mild regurgitation. But in moderate regurgitation, VSD closure with valvuloplasty is recommended.

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The Latest Trend of Dynamic MR Defecography for the Chronic Constipation Patient (만성 기능성 변비 환자에서 동적 MR Defecography의 최신동향)

  • Yoon, Seok-Hwan
    • Journal of radiological science and technology
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    • v.27 no.4
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    • pp.17-21
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    • 2004
  • With advancement of the medical imaging technology, the dynamic pelvic MRI (magnetic resonance imaging) has been introduced and used for dynamic MR defecography to improved diagnosis of the patients. At the early stage of its use, it was mostly used to diagnose enterocele or cystocele, then its use was extended to diagnose the organ prolapse and other dysfunctional pelvis organs. There now have been many reports of other diseases such as the functional constipation and others. This paper introduces the pelvis MRI and the dynamic MR defecography and reports the future trend in their clinical applications. Until recently, the studies with pelvic MRI were mostly focused on observing the movement of the pelvis in the supine position. Yang and 26 others reported good result in observing the patients with the pelvic organ prolapse by using the pubococcygeal line as the anatomical index. Using the fast gradient recalled acquisition (fast GRASS), they compared cystocoele, genitourinary prolapse, enterocoele and rectocoele with the control group. Kruyt et al. observed the posterior compartment and reported that MRI was more helpful than the fluoroscopy. Healy et al. applied the dynamic MRI test on the patients with constipation or incontinence as well as the control group without those symptoms. Since then, MRI technology has further advance by Lienemann, who was able to attain the more detailed images using the fast T2 weighted turbo spin echo technology, and others. If its limitation in diagnosing intussusception and the like, since the observation can be made only from the supine position, can be overcome with open MR or others, it is envisages that the method can eventually replace the radiological defecography.

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Prolapse Gastropathy Presenting with Hematemesis in a 3-year-old Child - A Case Report (3세 소아에서 토혈을 주소로 내원한 위식도 탈출증 1례)

  • Cho, Jin-Seong;Ryoo, Eell;Lee, Gun;Kim, Jae-Kwang
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.6 no.2
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    • pp.183-186
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    • 2003
  • Prolapse gastropathy is not uncommon in adult, but is not reported yet in previously healthy children. A 3-year-old child came to our emergency room after a 1-day history of emesis episodes with coffee-ground hematemesis. During the endoscopic procedure, and the process of retching and vomiting was observed and a tense knuckle of gastric mucosa was seen to be forcefully and repeated prolapsed into the distal esophageal mucosa, and mucosal hematoma was found in the gastric fundus. Upper gastrointestinal study revealed no abnormality and 24 hour pH monitoring revealed no pathologic gastroesophageal reflux. Retching is thought to cause the forceful prolapse and induce subsequent trauma of gastric mucosa. This case illustrates that the episodes of vigorous retching and resultant gastric mucosa are now considered to be the cause of the hematemesis and epigastric pain in children.

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Rectal Prolapse in Children (어린이 탈직장의 경화요법)

  • Lee, Myung-Duk;Kim, Won-Woo
    • Advances in pediatric surgery
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    • v.1 no.2
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    • pp.133-139
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    • 1995
  • Because rectal prolapse in pediatric age was known to have a self-limitting natural history in weeks to years, this disease is prone to be regarded as a minor condition to the most of surgeons. But to the children and the parents who have to be suffered each time could be a heavy distress. Even though operative or nonoperative methods can be applicable for treatment, the main problem is in surgeon's side, whose preference is based on the experiences of adult patients. The authors have experienced 16 cases of ano-rectal prolapse for 9 years since 1986. Eleven of them were true rectal prolapses. In 7 cases of true type, injection therapy has been tried. One ml of five percent phenol in glycerine was injected into the submucosal layer of the ano-rectal angle level at both lateral and posterior sides. After first trial of each cases, 5 of them were cured completely so far. Recurrences were in two cases, but one of them was temporary to be subsided afterward. Complete bowel cleansing and adequate sedations were required as preoperative preparations. Two days' oral antibiotics and two weeks' laxatives for free of defecation straining were recommended after the procedure. The safety of sclerosis was supported by the experimental histology. In pediatric rectal prolapse, sclerosis seems to be a safe and effective treatment of choice without any significant morbidity.

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Outcomes of Mitral Valve Repair: Quadrangular Resection versus Chordal Replacement

  • Park, Kwon-Jae;Woo, Jong Soo;Yi, Jung Hoon;Park, Jong Yoon
    • Journal of Chest Surgery
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    • v.46 no.2
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    • pp.124-129
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    • 2013
  • Background: Mitral valve repair for posterior mitral leaflet (PML) prolapse has been considered to be a standard treatment because of its high success rate and high level of patient satisfaction. The aim of this study was to evaluate the clinical results of two different techniques of PML prolapse, quadrangular resection (QR) and chordal replacement (CR). Materials and Methods: The subjects consisted of 56 patients who had undergone mitral valve repair for PML prolapse between November 1997 and December 2010. The patients were divided into two groups according to surgical technique. Among them, 31 patients underwent QR (group QR) and 25 patients had CR (group CR). We reviewed the medical records of the patients retrospectively to compare the clinical outcomes of both groups. Results: After mitral valve repair, the degree of mitral regurgitation (MR) in both groups decreased to the to a mild degree or less and the amount of remnant MR was slightly higher in the CR group but it was not statistically different. Three patients received mitral valve-related reoperation (2 in the QR group and 1 in the CR group). Freedom from mitral valve-related reoperation at 7 years was 93% for the QR group and 96% for the CR group and was not significantly different between the two groups. Conclusion: Both QR and CR showed excellent long-term results and were considered equally effective methods for PML prolapse.

Various Approaches and Treatments for Pelvic Organ Prolapse in Women

  • Chung, Soo-Ho;Kim, Woong Bin
    • Journal of Menopausal Medicine
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    • v.24 no.3
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    • pp.155-162
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    • 2018
  • Pelvic organ prolapse (POP) is bulging of one or more of the pelvic organs into the vagina and triggered by multiple causes. It is a very common disorder, especially among older women. POP is characterized by protrusion of the presentation part visible by the naked eye, and problems with urination or bowel movements. POP can be diagnosed based on the onset of symptoms and a pelvic exam, and management options include medical and surgical treatment. Although medical treatment cannot correct the abnormal herniation of the pelvic structures, this can help alleviate symptoms. One of the disadvantages of surgical interventions is recurrence, and advances in surgical techniques have decreased recurrence rates of POP. Therefore, author will explain the gynecology and urology approach and treatment.

A Case of a Polypoid Solitary Rectal Ulcer Syndrome with Rectal Prolapse (탈항을 동반한 용종성 고립성 직장 궤양 증후군 1예)

  • Kang, Jeong-Sic;Park, Hyun-Ju;Song, Tae-Won;Kim, Nam-Hee;Hwang, Jong-Hee;Kim, Dong-Wook;Lee, Chong-Guk;Kim, Han-Seong;Moon, Jin-Soo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.12 no.1
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    • pp.64-69
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    • 2009
  • Solitary rectal ulcer syndrome (SRUS) is a rare disorder in children. There are few investigations about the exact incidence and effective treatment of SRUS in children. We describe a 12-year-old male patient who had rectal prolapse for 9 years, hematochezia for 7 months, and was diagnosed with polypoid solitary rectal ulcer syndrome with rectal prolapse by colonoscopy. Anorectal manometry was also performed to evaluate the cause of frequent relapses.

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Review of Clinical Research of Korean Medicine on Postpartum Pelvic Organ Prolapse (산후 골반장기탈출증에 대한 한의학적 임상 연구 동향)

  • Park, Nam-Gyeong;Hwang, Young-Sik;Kim, Gyu-Tae;Park, Seung-Hyeok;Lee, Jin-Moo;Lee, Chang-Hoon;Jang, Jun-Bock;Hwang, Deok-Sang
    • The Journal of Korean Obstetrics and Gynecology
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    • v.33 no.4
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    • pp.93-112
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    • 2020
  • Objectives: The purpose of this study is to review the clinical research trends of postpartum pelvic organ prolapse and to recognize the efficacy of Korean medicine intervention. Methods: Based on seven domestic and foreign databases, including Research Information Sharing Service (RISS), Oriental Medicine Advanced Searching Integrated System (OASIS), Journal of Korean Obstetric and Gynecology, Cochrane Library Central, Pubmed, China National Knowledge Infrastructure (CNKI) and WangFang Med Online, we analyzed the clinical trials using Korean medicine intervention, which included acupuncture and herbal medicine. Data retrieval was carried out on May 18 to 20, 2020, and a total of 13 papers were included. Results: All papers were published in China and it contains nine randomized controlled trials, three clinical trials, and one case. The most frequently used intervention was herbal medicine, and Bupleuri Radix, Cimicifugae Rhizoma were used. The treatment group treated by Korean medicine intervention was more effective than the control group. Also, there were no significant side effects of Korean medicine. Conclusion: This study shows that Korean medicine can be effective and safe medical alternatives or options for pelvic organ prolapse patients. However, to laying the foundation of clinical guidelines and applying it to the real-world clinical scene, further follow-up research is needed.

A Review of Clinical Studies about Bojungikgi-tang Combined with Surgical Therapy on Rectal Prolapse - Focusing on Randomized Controlled Trial (직장 탈출증에 대한 보중익기탕과 수술 치료 병용요법의 임상 연구 고찰 - 무작위 대조군 연구를 중심으로)

  • Kyung-hwan Kong;Do-hyeon Kim
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.38 no.2
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    • pp.59-65
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    • 2024
  • Rectal prolapse is a condition where the rectal wall protrudes outside the anus. While it is a rare condition, it can cause discomfort for patients due to the protrusion of the rectal structure, discharge of mucus and blood, fecal incontinence, constipation, and other inconveniences. In this review, we analyzed a randomized controlled trial (RCT) study that used the herbal medicine Bojungikgi-tang(Buzhongyiqi-tang) as a complementary therapy to improve the weaknesses and side effects of the standard treatment, surgical therapy, for rectal prolapse. The analysis included 12 RCT studies, and in all studies, the prescription involved the use of Astragali Radix at the highest dosage. Among the 11 studies that evaluated efficacy, 7 studies showed a significant effect compared to the control group. In all 3 studies that evaluating recurrence rates and all 5 studies investigating complications after surgery, the experimental group showed significant effects. Based on these findings, this study could be considered as a foundational evidence for the application of bojungikgi-tang(Buzhongyiqi-tang) in clinical practice in Korean medicine for patients with rectal prolapse. It could also serve as foundational data for future research.