No abstract available.
Twins, Conjoined*

No abstract available.
Hirschsprung Disease*

No abstract available.

Intestinal obstruction is the commonest cause for emergency surgical intervention in the newborn. An extremely rare cause of intestinal obstruction in the neonate is a congenital abnormality consisting of segmental absence of intestinal musculature with intact serosa and mucosa. This report represents not only the fourth reported case of this anomaly but also the first case associated with long segment Hirschsprung's disease in English-written literatures.
Infant, Newborn ; Humans

Stasis dermatitis is one of the important skin manifestations of venous stasis. Therefore, the searching for the cause of venous stasis is importrnt. Two cases of stasis dermatitis with inferior vena caval obstruction are reported and possible etiologic factor is discussed. Case I The patient, 38-year-old carpenter, was admitted at Choong Buk Medical Center in April, 1974 with superficial venous engorgement of the lower extremities which had begun to appear two years after severe blunt trauma to both legs in 1962. 5 years prior to admission, abdomial venous engorgement and abdominal fullness developed and was exaggerated gradually. Since 2 years prior to admission, he has been suffered from the recurrent exudative ulcer on the right lower leg The physical examination revealed mild icteric sclera, hepatomegaly, abdominal distension, tortuous venous engorgement on the abdomen, the lateral chest wall and the lower extremities, and edematous scaly brawny pigmentation of the lower legs. Esphagogram showed no esphageal varices. Inferior vena cavogram showed complete obstruction at the level of upper border of 2nd lumbar vertebra and well developed collateral circulation, Findings of skin biopsy on the right lower leg showed moderate acanthosis, increased pigmentation of bosal cell layer in the epidermis, capillary proliferation, diffuse inflammatory cell infiltration with increased fibrosis and hemosiderin granules in the dermis. Case II The patient. 36-year-old farmer, was admitted at Dept. of Dermatology, St. Mary's Hospital, Catholic Medical College in Sept., 1973.The physical examination revealed hepatomegaly, abdominal distension, superficial venous engorgement on the abdomen, the neck and the lower extrcmities, severe edema and pigmentation of the lower legs, and the multiplc. Exudative ulcers on the left lower leg. Liver scanning showed somewhat general enlargement with some mottlings along the margin and relative prominance of the left lobe. Liver biopsy revealed findings of non specific chrcnic hepatitis. Inferior vena cavogram through the left femoral vein showed complete obstruction at the level between 11th and 12th thoracic vertebrae.His peripheral edema and ascites was much subsided after adequate bed rest and the skin lesion improved with scar formation.
Abdomen ; Adult ; Ascites ; Bed Rest ; Biopsy ; Capillaries ; Cicatrix ; Collateral Circulation ; Dermatitis* ; Dermatology ; Dermis ; Edema ; Epidermis ; Femoral Vein ; Fibrinogen ; Fibrosis ; Hemosiderin ; Hepatitis ; Hepatomegaly ; Humans ; Hyperemia ; Leg ; Liver ; Lower Extremity ; Neck ; Physical Examination ; Pigmentation ; Sclera ; Skin ; Skin Manifestations ; Spine ; Thoracic Wall ; Ulcer ; Varicose Veins

Intestinal duplication is a rare congenital anomaly. The diagnostic approach is difficult because of the differences in its location and clinical presentation. To evaluate the diagnostic as well as the therapeutic approaches in children, the medical records of 20 patients with intestinal duplications which had been operated upon from July 1980 to October 2002 were analyzed, retrospectively. The range of age was from 1 day to 11 years. The variables, such as age, sex, clinical presentation, diagnostic method, localization, anatomic type, treatment, complication, and combined anomalies were analyzed. Most of the cases were presented as incidental finding. The majority of the duplications except hindgut were cystic type. Treatment included segmental intestinal resection, excision of the lesion without intestinal resection, and septotomy. Seventy-five percent of the patients were detected before 1 year of age. The anatomic type of the lesion was closely related with its location. The cases of hindgut were almost always tubular type except 1 case. Clinical presentation was related to age, location, and anatomic type. There were no specific diagnostic methods. Perfect localization and application of appropriate operation are the most important requirements for successful treatment.
Child ; Gastrointestinal Tract ; Humans ; Incidental Findings ; Intestines ; Medical Records ; Retrospective Studies

PURPOSE: This study was performed to be helpful in early diagnosis and treatment of the children with peptic ulcer disease. METHODS: The authors observed 36 children with peptic ulcer disease who had been admitted to Hanyang University Hospital during the 11 year 4 mont period from January 1981 to April 1992 retrospectively. The diagnosis was established in 33.3% by gastric endoscopy, in 25% by upper gastrointestinal barium study, in 11.7% by gastric endoscopy and upper gastrointestinal barium study simultaneously, and in 30% by emergency operation. RESULTS: 1) Age and sex incidence of chidlren with peptic ulcer disease(3 days to 16 years old) showed that males predominated in a proportion of 8:1 and 83.3% were 7 years of age or older. Under the age of 7, the incidence of gastric ulcer was greater than that of duodenal ulcer and above the age of 7 duodenal ulcer was 2.6 times more frequent than gastric ulcer. 2) The chief comlaints on admission were abdominal pain in 17 patients(47%), hematemesis or melena in 15 patients(25%), vomiting in 6 patients(16%). There was a tendency that abdominal pain also increased as the age increased. 3) Most common blood type among 13 patients with duodenal ulcer was Rh+O type(53.8%). 4) Of the 15 children who had gastrointestinal bleeding, 10(43.3% of duodenal ulcer) were doudenal ulcer and 4(33.3% of gastric ulcer) were gastric ulcer. Severe anemia(Hb<7g/dl) was shown in only 5 patients with duodenal ulcer. 5) According to the region of the ulcer, 20(86.9%) of 23 children with doudenal ulcer had ulcers in doudenal bulb and 8(66.7%) of 12 children with gastric ulcer had ulcers in antrum. 6) 18 children with duodenal ulcer, 7 children with gastric ulcer and 1 child with gastroduodenal ulcer had complications. Of the 26 children, bleeding occured in 10 children, perforation occured in 7 children and obstruction occured in one child. 7) 23 children were treated medically and 13 children were treated surgically. 11 patients received operation due to panperit unitis(perforation), 1 patients(71%) were treated medically, however, under 7 year of age, 5 patients(62%) received surgical treatment. Surgical methods used were primary closure(4 patients), vagotomy with pyloroplasty(1 patients), subtotal gastrectomy with gastrojejunostomy(7 patients) and antrectomy with gastroduodenostomy(1 patients). CONCLUSIONS: We conclude that it is important to diagnose early peptic ulcer disease in children, who have nonspecific symptoms and signs above mentioned, to prevent possible complications including failure to thrive.
Abdominal Pain ; Barium ; Child* ; Diagnosis ; Duodenal Ulcer ; Early Diagnosis ; Emergencies ; Endoscopy ; Failure to Thrive ; Gastrectomy ; Hematemesis ; Hemorrhage ; Humans ; Incidence ; Infant* ; Male ; Melena ; Peptic Ulcer* ; Retrospective Studies ; Stomach Ulcer ; Ulcer ; Vagotomy ; Vomiting

No abstract available.
Female ; Mosaicism* ; Ovary*

Of 72 cases with vitelline duct and vessel remnants, 45 (62.5%) had symptomatic lesions (mean age, 27.9 months) with male preponderance (4.6: 1). Among the 45 symptomatic lesions, there were 22 cases of Meckel's diverticulum, 6 cases of Meckel's diverticulum with fibrous band attached to the umbilicus, 6 cases of patent vitelline duct, 5 cases of vitelline artery remnant as fibrous band, 2 cases of umbilical sinus, 2 cases of umbilical polyp, and 2 cases of vitelline cyst. Twenty three cases (51%) presented with intestinal obstruction, 6 (13%) with rectal bleeding, 4 (9%) with perforated Meckel's diverticulum, 5 with intestinal fluid drainage through umbilicus, 5 with umbilical lesion, and 1 with abdominal mass. Intestinal obstruction due to fibrous band developed at infancy (average age, 4.6 months). About 82% of complicated Meckel's diverticulum (n=28) presented less than 4 years of age. Seventeen Meckel's diverticulums, 8 obliterated vitelline artery remnants, and 1 vitelline vein remnant as fibrous band were found incidentally at laparotomy.
Arteries ; Drainage ; Hemorrhage ; Humans ; Intestinal Obstruction ; Laparotomy ; Male ; Meckel Diverticulum ; Polyps ; Umbilicus ; Veins ; Vitelline Duct* ; Vitellins*

Parenteral nutrition has been an essential part of postoperative care of neonates requiring major surgery soon after birth followed by prolonged period of no allowable enteral feeding. However, TPN via central venous catheters (central TPN), used in increasing trend, still presents significant morbidity. To find out whether TPN via peripheral veins (peripheral TPN) could be used as a viable alternative for postoperative parenteral nutrition in neonates, a clinical study was carried out by a retrospective analysis of 53 neonates subjected to peripheral TPN for more than 7 days after surgery for esophageal atresia with tracheoesophageal fistula, gastroschisis and omphalocele at the Division of Pediatric Surgery, Hanyang University Hospital, from 1983 to 1994. The mean total duration of TPN was 13.3 days (range: 7-58 days), the average daily total fluid intake was 117.6 ml/kg during TPN and 158.6 ml/kg during subsequent oral feeding. The average daily total calorie intake was 57.7 kcal/kg during full strength TPN and 101.3 kcal/kg during oral feeding. The mean urine output was maintained at 3.5 ml/kg/hour during TPN and at 3.6 ml/kg/hour during oral feeding. The increment of body weight observed during TPN was 132gm in TEF, 53gm in gastroschisis and 3gm in omphalocele patients, while loss of body weight was not oberved in each group. The mortality rate was 5.7% (3/53), related to underlying congenital anomalies but not to TPN. The common complications were laboratory findings suggestive of liver dysfunction in 23 cases (43.4%) with no significant clinical symptom or signs in any case, transient pulmonary edema in one case, and generalized edema in one case. The result of the study suggests that peripheral TPN could be used for adequate postoperative nutritional support in neonates requiring about 2 to 3 weeks TPN.
Body Weight ; Central Venous Catheters ; Edema ; Enteral Nutrition ; Esophageal Atresia ; Gastroschisis ; Hernia, Umbilical ; Humans ; Infant, Newborn ; Liver Diseases ; Mortality ; Nutritional Support ; Parenteral Nutrition ; Parenteral Nutrition, Total* ; Parturition ; Postoperative Care ; Pulmonary Edema ; Retrospective Studies ; Tracheoesophageal Fistula ; Veins*