1.Subcutaneous Emphysema Mimicking Gas Gangrene Following Perforation of the Rectum: A Case Report.
Keun Bae LEE ; Eun Sun MOON ; Sung Taek JUNG ; Hyoung Yeon SEO
Journal of Korean Medical Science 2004;19(5):756-758
We report a case of extensive subcutaneous emphysema of the lower extremity mimicking gas gangrene following perforation of the rectum in a 38-yr-old man. Subcutaneous emphysema of the leg may rarely occur secondary to perforation of the gastrointestinal tract and has often created serious diagnostic problems and high mortality rates. Therefore, prompt diagnosis and aggressive treatment is imperative.
Adult
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Diagnosis, Differential
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Gas Gangrene/*radiography
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Humans
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Intestinal Perforation/*radiography
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Male
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Rectal Diseases/*radiography
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Subcutaneous Emphysema/*radiography
2.Small Bowel Obstruction due to Enterolith.
Hyun Il HONG ; Byong Duk YE ; Sang Nam YOON
The Korean Journal of Gastroenterology 2009;54(3):139-142
No abstract available.
Aged, 80 and over
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Calcinosis/complications/*diagnosis/radiography
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Calculi/complications/*diagnosis/radiography
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Humans
;
Ileum/pathology
;
Intestinal Diseases/*diagnosis/etiology/radiography
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Intestinal Obstruction/*diagnosis/etiology/radiography
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Male
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Tomography, X-Ray Computed
3.Midgut Volvulus in a 70-year-old Man Due to Intestinal Nonrotation.
Byung Soo JIE ; Eun Ok KIM ; Jin Seok KIM ; Hwa Jeong LEE ; Youn Mi SONG ; Youngshin KIM ; Sung Hoon JUNG ; Jung Hwan OH
The Korean Journal of Gastroenterology 2013;61(5):282-285
Intestinal malrotation is a congenital disorder that results from the failure of normal bowel rotation and fixation during the 5th gestational week. The incidence of intestinal malrotation is <0.2%, but prompt diagnosis is important because this anomaly can cause midgut volvulus and lead to fatalities. Compared to infants presenting with acute symptoms, such as abdominal pain, vomiting, or diarrhea, adult patients complain of intermittent self-limited abdominal pain. We present a case of intestinal malrotation complicated by midgut volvulus improved with conservative care in a 70-year-old man. The diagnosis was suggested on the basis of imaging findings.
Aged
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Angiography
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Colonic Diseases/*diagnosis/radiography
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Diagnosis, Differential
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Humans
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Intestinal Volvulus/*diagnosis/radiography
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Male
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Mesenteric Artery, Superior/radiography
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Tomography, X-Ray Computed
4.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
5.Intestinal Neuronal Dysplasia.
The Korean Journal of Gastroenterology 2007;50(3):145-156
Intestinal neuronal dysplasia (IND) type B is a disease of the submucosal plexus of intestine manifesting chronic intestinal obstruction or severe chronic constipation. IND is one of intestinal dysganglionoses and clinically closely associated with Hirschsprung's disease. Until recently, it is not fully clear whether IND is a congenital malformation or an acquired secondary condition related to some gastrointestinal problems. However, recently published data and consensus reports have enhanced our understanding of the pathogenesis and management of IND. The aim of this paper was to review the current state of knowledge regarding the controversial issues of IND including the etiology, classification, diagnostic criteria, and available therapeutic intervention.
Child
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Colon/*innervation/radiography
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Constipation/etiology
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Enteric Nervous System/*abnormalities
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Ganglia/pathology
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Gastrointestinal Motility
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Hirschsprung Disease/pathology
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Humans
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Immunohistochemistry
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Intestinal Diseases/*diagnosis/pathology
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Intestinal Mucosa/pathology
6.Comparison of Double Balloon Enteroscopy and Small Bowel Series for the Evaluation of Small Bowel Lesions.
Ji Yun JO ; Jeong Sik BYEON ; Kee Don CHOI ; Hye Won PARK ; Gin Hyug LEE ; Seung Jae MYUNG ; Hwoon Yong JUNG ; Suk Kyun YANG ; Weon Seon HONG ; Jin Ho KIM ; Hyun Kwon HA
The Korean Journal of Gastroenterology 2006;48(1):25-31
BACKGROUND/AIMS: The role of double balloon enteroscopy (DBE) is still evolving. The aim of this study was to compare the diagnostic yield of DBE with that of small bowel series (SBS). METHODS: We enrolled patients with suspected small bowel disease consecutively, and performed both DBE and SBS in all patients. RESULTS: Eighteen patients (M:F=12:6, 14-82 years) were included. Indications for small bowel evaluation were obscure gastrointestinal bleeding (10), abdominal pain (5), diarrhea (2) and abnormal CT finding (1). Of 10 obscure gastrointestinal bleeding patients, 6 showed the same findings in both studies. However, 4 showed negative findings in SBS while DBE detected erosions or ulcerations. Of 5 abdominal pain patients, 3 showed the same results in both studies. However, 2 demonstrated different results. One was suspected of early Crohn's disease in SBS, but proved to be normal in DBE, and the other was suspected of malignancy in SBS but was suspected of benign ulcers in DBE. Of 2 chronic diarrhea patients, one was diagnosed as Crohn's disease in both studies. The other was suspected of tuberculosis in SBS but diagnosed as lymphangiectasia by DBE with biopsy. One patient with jejunal wall thickening in CT proved to be normal in both DBE and SBS. There were no serious complications associated with DBE and SBS. CONCLUSIONS: DBE is better than SBS in terms of diagnostic accuracy. DBE may become an important method for the evaluation of small bowel diseases.
Adolescent
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Adult
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Aged
;
Aged, 80 and over
;
Endoscopes, Gastrointestinal
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*Endoscopy, Gastrointestinal
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Female
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Humans
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Intestinal Diseases/*diagnosis/radiography
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*Intestine, Small/pathology/radiography
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Male
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Middle Aged
7.A Case of Lower Gastrointestinal Bleeding Caused by Primary Iliac Arterio-colic Fistula.
Young Il KIM ; Seon Young PARK ; Won Joo KI ; Ho Seok KI ; Kyoung Won YOON ; Hyun Soo KIM ; Sung Kyu CHOI ; Jong Sun REW
The Korean Journal of Gastroenterology 2010;56(2):113-116
Arterio-enteric fistula is a very rare cause of massive lower gastrointestinal hemorrhage. We report here on a case of massive hematochezia caused by iliac arterio-colic fistula in a 60-year-old woman who had a recent history of spinal surgery for herniated nucleus pulposus. Abdomen computed tomography showed the extravasation of radiocontrast media from right iliac artery encased by an intraabdominal abscess into the adjacent dilatated colon. Also, diagnostic angiography revealed the active extravasation of radiocontrast media via a fistula between right iliac artery and colon. Although successful endovascular exclusion of the fistula with stent graft and coils was performed, disseminated intravascular coagulation and multi-organ failure were developed.
Colonic Diseases/complications/*diagnosis
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Female
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Gastrointestinal Hemorrhage/*etiology
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Humans
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Iliac Artery/*radiography
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Intestinal Fistula/complications/*diagnosis
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Middle Aged
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Stents
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Tomography, X-Ray Computed
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Vascular Fistula/complications/*diagnosis
8.Successful management of colonic perforation with a covered metal stent.
Sang Woo KIM ; Wook Hyun LEE ; Jin Soo KIM ; Ha Nee LEE ; Soo Jung KIM ; Seok Jong LEE
The Korean Journal of Internal Medicine 2013;28(6):715-717
Self-expandable stents are widely available for the treatment of perforation of the gastrointestinal tract. Because of the risk of migration, there has been no report of the use of self-expandable stents for the treatment of perforation of the colon or rectum. This is a report of successful treatment of iatrogenic colonic perforation during balloon dilatation of anastomotic stricture with a fully covered stent. Fully covered, self-expandable metallic stents can be considered useful tools for management of this condition.
Aged, 80 and over
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Colon/*injuries/pathology/radiography
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Colonic Diseases/diagnosis/*therapy
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Constriction, Pathologic
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Dilatation/*adverse effects
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Humans
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*Iatrogenic Disease
;
Intestinal Obstruction/diagnosis/*therapy
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Intestinal Perforation/diagnosis/etiology/*therapy
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Male
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*Metals
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Prosthesis Design
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Sigmoidoscopy
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*Stents
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Treatment Outcome
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Wound Healing
9.Intussusception in Korean Adults.
Sang Kuon LEE ; Woo Chan PARK ; In Chul KIM
Journal of the Korean Surgical Society 1998;55(5):713-718
BACKGROUNDS: Intussusception in adults, a rare disease, constitutes approximately 5% of all intussusceptions and accounts for 5% of all cases of intestinal obstruction. METHODS: The medical records of 21 adult patients with documented intussusception, who were treated at Catholic University Medical College from 1986 to 1997, were retrospectively analyzed, and the results were compared with those previously published in Korea and Western countries. RESULTS: Etiologic factors were found in 86% of cases, of which 8 cases (38%) were due to malignant disease. Clinically, abdominal pain, tenderness, nausea, and vomiting were most frequently found, but were nonspecific. Correct preoperative diagnosis was made in 28% of patients, and the diagnostic methods included plain abdominal radiography, barium contrast study, abdominal ultrasonography, and abdominal CT, the latter two playing an important role in the diagnosis. Ileocolic was the most common anatomical type. CONCLUSIONS: The surgical treatment of choice depends on the anatomical location of the lesion and on whether or not preoperative diagnosis has been made. In colonic intussusceptions primary resection without manual reduction is recommended while in enteric intussusceptions, a previous knowledge of preoperative diagnosis permits us to choose the most acceptable surgical procedure. A vigorous effort should be made, utilizing diagnostic methods, such as abdominal ultrasonography or CT, in order to make the correct preoperative diagnosis and, therefore, to help in making a correct surgical decision.
Abdominal Pain
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Adult*
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Barium
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Colon
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Diagnosis
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Humans
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Intestinal Obstruction
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Intussusception*
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Korea
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Medical Records
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Nausea
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Radiography, Abdominal
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Rare Diseases
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Retrospective Studies
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Tomography, X-Ray Computed
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Ultrasonography
;
Vomiting
10.Small Bowel Volvulus Induced by Mesenteric Lymphangioma in an Adult: a Case Report.
Jin Hee JANG ; Su Lim LEE ; Young Mi KU ; Chang Hyeok AN ; Eun Deok CHANG
Korean Journal of Radiology 2009;10(3):319-322
Mesenteric lymphangiomas are rare abdominal masses that are seldom associated with small bowel volvulus, and especially in adult patients. We report here on an unusual case of small bowel volvulus that was induced by a mesenteric lymphangioma in a 43-year-old man who suffered from repeated bouts of abdominal pain. At multidetector CT, we noticed whirling of the cystic mesenteric mass and the adjacent small bowel around the superior mesenteric artery. Small bowel volvulus induced by the rotation of the mesenteric lymphangioma was found on exploratory laparotomy. Lymphangioma should be considered as a rare cause of small bowel volvulus in adult patients.
Abdominal Pain/etiology
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Adult
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Contrast Media/diagnostic use
;
Diagnosis, Differential
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Humans
;
Intestinal Volvulus/*diagnosis/etiology/surgery
;
Intestine, Small/*radiography/surgery
;
Lymphangioma/*complications/surgery
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Male
;
Mesenteric Artery, Superior/*radiography/surgery
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Radiographic Image Enhancement/methods
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Rare Diseases
;
Tomography, X-Ray Computed