No abstract available.
Intestinal Obstruction* ; Ultrasonography*

Internal hernia is an unusual cause of the intestinal obstruction. The advances of CT make the diagnosis more easier than in the past. We report one case of internal hernia with herniation of the ileum into the lesser omenturn. The diagnosis could be made when abdominal radiographs showed fixed clustering of the small bowel loops in upper abdomen medial to the stomach. CT and ultrasound showed characteristic interposition of the ileum between the left hepatic lobe and the stomach.
Abdomen ; Diagnosis ; Hernia* ; Ileum ; Intestinal Obstruction ; Stomach ; Ultrasonography

With recent technical advances, increasing use of sonography in the initial evaluation of patients with abdominal disease may allow the detection of unexpected tumor within the abdominal cavity. Easiness of sonographic detection of bowel pathology, purposely or unexpectedly, warrants the inclusion of bowel loops during ultrasound examination when a patient complains of symptoms indicating diseases of the bowel. In patients complaining of acute abdominal symptoms or nonspecific gastrointestinal symptoms and showing signs such as abdominal pain, diarrhea, hematochezia, change of bowel habit, or bowel obstruction, sonography may reveal the primary causes and may play a definitive role in making a diagnosis. On ultrasonography, abnormal lesions may appear as fungating mass with eccentrically located bowel lumen (pseudokidney sign) or symmetrical or asymmetrical, encircling thickening of the colonic wall (target sign). In patients with mass or wall thickening detected on ultrasonography, additional work-up such as barium study, CT or endoscopy would be occasionally necessary for making a specific diagnosis.
Abdomen, Acute/ultrasonography ; Aged ; Appendicitis/ultrasonography ; Colorectal Neoplasms/ultrasonography ; Diverticulitis/ultrasonography ; Female ; Gastrointestinal Diseases/ultrasonography+ACo- ; Gastrointestinal Neoplasms/ultrasonography ; Human ; Inflammatory Bowel Diseases/ultrasonography ; Intestinal Obstruction/ultrasonography ; Intestinal Perforation/ultrasonography ; Intestines/ultrasonography ; Male ; Stomach/ultrasonography ; Ultrasonography/instrumentation

Intussusception is the most common cause of intestinal obstruction in early childhood and characterized by periodic colicky abdominal pain or irritability, vomiting, current jelly stool, and sausage-like abdominal mass. Meckel's diverticulum is common intestinal anomaly presenting with painless rectal bleeding during first 2 year of age. It is recognized as a common leading point of intussusception in childhood. Hematemesis is the rare clinical manifestation of both intussusception and Meckel's diverticulum. A 7-year-old girl presented with hematemesis was diagnosed as having intussusception by abdominal ultrasonography. Meckel's diverticulum was the leading point of intussusception in this case.
Abdominal Pain ; Child ; Female ; Hematemesis* ; Hemorrhage ; Humans ; Intestinal Obstruction ; Intussusception* ; Meckel Diverticulum* ; Ultrasonography ; Vomiting

The initial radiologic evaluation of a patient with acute abdominal symptoms begins with plain abdominal radiographs. Plain abdominal radiographs are helpful for the diagnosis of intestinal obstruction and pneumoperitoneum. However, cross-sectional imaging modalities, such as ultrasonography or computed tomography, are necessary for specific diagnosis of acute abdomen. Ultrasonography is a non-invasive and comfortable tool for patients visiting emergency room. This article describes the ultrasonographic findings of most common diseases presenting with acute abdominal symptoms.
Abdomen, Acute* ; Diagnosis ; Emergency Service, Hospital ; Humans ; Intestinal Obstruction ; Pneumoperitoneum ; Ultrasonography*

Intussusception frequently occurs in children as the main causes of intestinal obstruction in childhood but relatively rare in adult. A 65-year-old male visited our hospital because of abrupt onset right lower quadrant pain with tenderness for three days. He had a previous history of appendectomy and alcoholic liver cirrhosis. On physical exam, bowel sound was decreased. Abdomen ultrasonography showed a kidney like mass and abdominal computed tomography revealed the typical target lesion in the ileocecal area. Colonoscopy was performed which failed to find any lesion leading to intussusception. After the colonoscopy, the abdminal pain had disappeared, and we would not find any intussusception sign by abdominal ultrasonography. Colonocopy was done two weeks later. No pathologic lesion was found, then. We report a case of adult idiopathic ileocecal intussusception reduced by colonoscopy.
Abdomen ; Adult* ; Aged ; Appendectomy ; Child ; Colonoscopy* ; Humans ; Intestinal Obstruction ; Intussusception* ; Kidney ; Liver Cirrhosis, Alcoholic ; Male ; Ultrasonography

Aged ; Female ; Hernia, Obturator ; complications ; Humans ; Intestinal Obstruction ; diagnostic imaging ; etiology ; Tomography, X-Ray Computed ; Ultrasonography

Mucocele of the appendix is an uncommon disorder, usually found incidentally during ultrasonography or radiographic studies. It occurs predominantly in the sixth or seventh decades,and has a distinct female predominance. Pseudomyxoma peritonei is a rare condition resulting from a ruptured mucin-producing lesion of the appendix or ovary. It is not easily diagnosed clinically before operation and only histopathologic finding provides the correct final diagnosis. Treatment should consist of evacuation of the mucinous ascites and removal of the mucocele. Reoperations for correction of intestinal obstruction may be needed. The role of chemotherapy is uncertain, and external radiation is probably of no value. We experienced a case of colonic adhesion caused by pseudomyxoma peritonei that originated from the vermiform appendix. This patient was 75 year old female who had suffered from lower abdominal pain associated with constipation and tenesmus for 5 days. We performed ileocecal resection and ileocecal anastomosis. We report this case with brief review of the literature.
Abdominal Pain ; Aged ; Appendix ; Ascites ; Colon* ; Constipation ; Diagnosis ; Drug Therapy ; Female ; Humans ; Intestinal Obstruction ; Mucins ; Mucocele ; Ovary ; Pseudomyxoma Peritonei* ; Ultrasonography

PURPOSE: To evaluate ultrasonographic accuracy in the differentiation of a bezoar from feces in a small bowel obstruction showing feces-like material just proximal to the transitional zone in abdominal computed tomography (CT). METHODS: This study included 14 patients who showed feces-like material just proximal to the transitional zone, among 302 patients diagnosed with small bowel obstruction on abdominal CT. The diagnostic signs of a bezoar on ultrasonography included an arc-like surfaced intraluminal mass, posterior acoustic shadow and twinkling artifacts. The diagnostic performance of ultrasonography in each patient was compared with a final diagnosis that was surgically or clinically made. RESULTS: Among the 14 patients, seven were ultrasonographically diagnosed as having a bezoar, and five of the seven were surgically diagnosed as having a phytobezoar. The remaining two of the seven showed complete symptomatic improvement before surgery. The other seven patients were ultrasonographically diagnosed as not having a bezoar. Among them, six patients were conservatively treated with symptomatic improvement, suggesting the absence of a bezoar. The remaining one patient was confirmed not to have a bezoar during adhesiolysis. In all patients, the ultrasonographic diagnosis agreed with the clinically confirmed diagnosis. CONCLUSION: Ultrasonography might be an accurate method for the differential diagnosis of feces-like material just proximal to the transitional zone in abdominal CT. It can help radiologists to quickly and easily diagnose a bezoar.
Acoustics ; Artifacts ; Bezoars* ; Diagnosis ; Diagnosis, Differential ; Feces* ; Humans ; Intestinal Obstruction ; Intestine, Small ; Tomography, X-Ray Computed ; Ultrasonography

PURPOSE: Intestinal duplications are rare congenital malformations that may require surgical intervention. This study attempted to elucidate the clinical characteristics and the management of this disease. METHODS: We reviewed the experience of 13 intestinal duplications confirmed with postoperative pathologic reports from January 1989 to September 2001 at Seoul National University Children's hospital. RESULTS: Nine patients were female and 4 were male. Ages ranged from a few days to 5 years (61.4% younger than 1 year). The most common symptom was a vomiting. The major diagnostic method recorded was abdominal ultrasonography. The location of the 12 cystic duplicaions was the ileum in 7 cases, the anus in 2 cases, the duodenun in 1 case, the jejunun in 1 case and the rectum in 1 case. A tubular duplication from the transverse colon to the anus with communication was found in one case. The diameter of the cystic duplications averaged 3.45 cm, and the average length of the tubular duplication was 40 cm. Treatment used was resection and anastomosis of the involved intestine in 8 cases, septostomies in 2, anoplasty in 1, marsupialization in 1 and transanal excision in 1. There were no postoperative complications or mortality experienced. Gastric mucosa was found in 3 of 7 ileal duplications, small intestinal mucosa was found in the duodenal duplication, and squamous epitheliums were found in the rectal and anal duplications. CONCLUSION: Congenital intestinal duplication presents as an intestinal obstruction or an abdominal mass in childhood. Abdominal ultrasonography is a major diagnostic method and surgical intervention is mandatory.
Anal Canal ; Colon, Transverse ; Epithelium ; Female ; Gastric Mucosa ; Humans ; Ileum ; Intestinal Mucosa ; Intestinal Obstruction ; Intestines ; Male ; Mortality ; Postoperative Complications ; Rectum ; Seoul ; Ultrasonography ; Vomiting