1.A Transmesenteric Hernia in a Child: Gangrene of a Long Segment of Small Bowel through a Large Mesenteric Defect.
Chan Yong PARK ; Jung Chul KIM ; Soo Jin CHOI ; Shin Kon KIM
The Korean Journal of Gastroenterology 2009;53(5):320-323
Intestinal obstruction is a common surgical emergency. Transmesenteric hernia is an unusual cause of bowel obstruction that may result in irreversible damage of the bowel and a fatal outcome. Once incarceration of the bowel occurs, strangulation and gangrene follow immediately. The mortality rate associated with this condition is about 15%, but in the presence of gangrene of the bowel, the mortality rate is more than 50%. An accurate preoperative diagnosis of a transmesenteric hernia is very difficult and rarely made. Therefore, in patients with small bowel obstruction, in the absence of a history of previous surgery to suggest adhesions or an external hernia, the possibility of a transmesenteric hernia must be considered. We describe a case with gangrene of a long segment of the small bowel caused by a transmesenteric hernia through a large defect of small bowel mesentery in a child.
Child
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Diagnosis, Differential
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Female
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Gangrene
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Hernia/complications/*diagnosis/radiography
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Humans
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Ileal Diseases/*diagnosis/radiography/surgery
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Intestinal Obstruction/etiology/radiography
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Intestine, Small/*pathology/surgery
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Mesentery
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Tomography, X-Ray Computed
2.Cutaneous Polyarteritis Nodosa Presented with Digital Gangrene: A Case Report.
Seung Won CHOI ; Sogu LEW ; Sung Do CHO ; Hee Jeong CHA ; Eun A EUM ; Hyun Chul JUNG ; Jae Hoo PARK
Journal of Korean Medical Science 2006;21(2):371-373
Cutaneous polyarteritis nodosa (CPAN) is an uncommon form of vasculitis involving small and medium sized arteries of unknown etiology. The disease can be differentiated from polyarteritis nodosa by its limitation to the skin and lack of progression to visceral involvement. The characteristic manifestations are subcutaneous nodule, livedo reticularis, and ulceration, mostly localized on the lower extremity. Arthralgia, myalgia, peripheral neuropathy, and constitutional symptoms such as fever and malaise may also be present. We describe a 34-yr-old woman presented with severe ischemic change of the fingertip and subcutaneous nodules without systemic manifestations as an unusual initial manifestation of CPAN. Therapy with corticosteroid and alprostadil induce a moderate improvement of skin lesions. However, necrosis of the finger got worse and the finger was amputated.
Vasodilator Agents/therapeutic use
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Skin Diseases, Vascular/*complications/drug therapy/pathology
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Polyarteritis Nodosa/*complications/drug therapy/pathology
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Humans
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Gangrene/*etiology/surgery
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Fingers
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Female
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Amputation
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Alprostadil/therapeutic use
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Adult
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Adrenal Cortex Hormones/therapeutic use