Most intussusceptions occur in children and no etiologic factor can be determined in most cases. In contrast, adult intussusception is rare and many cases in adults are generally related to neoplasm such as lymphoma, carcinoid tumor, malignant tumor, sarcoma, benign tumor and congenital abnormalities. Intussusception in adults that's due to primary malignant lymphoma of the terminal ileum is a rare clinical condition. We describe here two cases of ileo- colonic-type intussusception that were due to primary malignant lymphoma of the terminal ileum. The clinical, radiographic and pathologic finding are described along with a brief review of the literature.
Adult* ; Carcinoid Tumor ; Child ; Congenital Abnormalities ; Humans ; Ileum* ; Intussusception* ; Lymphoma* ; Sarcoma

Meckel's diverticulum is the most common congenital anomaly that results from an incomplete obliteration of omphalomesenteric duct. But only 10% of Meckel's diverticulums are symptomatic. The most common presentation in children is painless rectal bleeding, while intestinal obstruction is more common in adults. Obstruction with a Meckel's diverticulum is usually attributed to intussusception, volvulus, inflammatory adhesion, or an internal hernia. Author's experienced multi-directionally rotated Meckel's diverticulum causes intestinal obstruction with gangrenous change in a child and removed successfully with laparoscopic assistance. To our knowledge, this appears to be a first case report of a torsion of Meckel's diverticulum associated with intestinal obstruction in Korea, which was treated by laparoscopic procedure.
Adult ; Child ; Hemorrhage ; Hernia ; Humans ; Intestinal Obstruction* ; Intestinal Volvulus ; Intussusception ; Korea ; Laparoscopy ; Meckel Diverticulum* ; Vitelline Duct

Purpose: While a carcinoma of the splenic flexure is uncommon, is associated with a high risk of obstruction, and has a dual lymphatic drainage system, A COST study excluded transverse colon cancer, including splenic flexure colon cancer. This study reviews our experience with splenic flexure colon cancer treated laparoscopically and discusses a appropriate, safe laparoscopic surgical procedure. Methods: The authors reviewed the medical records of patients who underwent laparoscopic surgery for splenic flexure colon cancer from January 1995 to June 2006. The splenic flexure colon was defined as 5 cm from the splenic flexure proximally and distally by using radiologic studies. Curative surgery for splenic flexure colon cancer was defined as: primary cancer removal, a safe resected margin, no metastasis, and a complete lymphadenectomy including high ligation of left colic artery and of the left branch of the middle colic artery. Results: A total of 407 patients underwent laparoscopic surgery for colon cancer; among them, 15 patients underwent a laparoscopic left colectomy for splenic flexure colon cancer. The mean age of the patients was 63.8 years, and the male-to-female ratio was 9:6. The mean operation time was 325.3+/-95.1 minutes, and the average hospital stay was 15.8+/-4.9 days. The average number of harvested lymph nodes was 12.3+/-9.7, the average distal resection margin was 15.3+/-7.6 cm, and the average proximal margin was 10.7+/-3.2 cm. One case of chyle discharge and one case of ileus developed, but were treated conservatively. There was no surgical mortality. Conclusions: A laparoscopic left colectomy for splenic flexure colon cancer is a technically feasible and safe procedure with acceptable short-term outcomes in experienced hands.
Female ; Male ; Humans ; Mortality

PURPOSE: To evaluate the effectiveness and safety of fentanyl-TTS in the management of radiotherapy induced acute pain and cancer pain treated with radiotherapy. MATERIALS AND METHODS: Our study was open labelled prospective phase IV multi-center study. the study population included patients with more 4 numeric rating scale(NRS) score pain although managed with other analgesics or more than 6 NRS score pain without analgesics. Patients divided into two groups; patients with radiotherapy induced pain (Group A) and patients with cancer pain treated with radiotherapy (Group B). All patients received 25 ug/hr of fentanyl transdermal patch. Primary end point was pain relief; second end points were change in patient quality of life, a degree of satisfaction for patients and clinician, side effects. RESULTS: Between March 2005 and June 2005, 312 patients from 26 participating institutes were registered, but 249 patients completed this study. Total number of patients in each group was 185 in Group A, 64 in Group B. Mean age was 60 years and male to female ratio was 76:24. Severe pain NRS score at 2 weeks after the application of fentanyl was decreased from 7.03 to 4.01, p=0.003. There was a significant improvement in insomnia, social functioning, and quality of life. A degree of satisfaction for patients and clinician was very high. The most common reasons of patients' satisfactions was good pain control. Ninety six patients reported side effect. Nausea was the most common side effect. There was no serious side effect. CONCLUSION: Fentanyl-TTS was effective in both relieving pain with good tolerability and improving the quality of life for patients with radiotherapy induced acute pain and cancer pain treated with radiotherapy. The satisfaction of the patients and doctors was good. There was no major side effect.
Academies and Institutes ; Acute Pain ; Analgesics ; Female ; Fentanyl* ; Humans ; Male ; Nausea ; Prospective Studies ; Quality of Life ; Radiotherapy* ; Sleep Initiation and Maintenance Disorders ; Transdermal Patch*