Foreign bodies, such as surgical sponges or drains, are sometimes retained after surgical procedures.1 Retention of a drain in the breast tissue postoperatively is an unusual complication. This report describes two cases of characteristic sonographic findings related to retained silastic drains following breast surgery.
*Ultrasonography, Mammary ; Silicones ; Postoperative Complications/*diagnosis/radiography/ultrasonography ; *Mammography ; Humans ; Foreign Bodies/*diagnosis/radiography/ultrasonography ; Female ; Drainage/*instrumentation ; Dimethylpolysiloxanes ; Adult

Optical coherence tomography (OCT) has been recently applied to investigate coronary artery disease in interventional cardiology. Compared to intravascular ultrasound, OCT is able to visualize various vascular structures more clearly with higher resolution. Several validation studies have shown that OCT is more accurate in evaluating neointimal tissue after coronary stent implantation than intravascular ultrasound. Novel findings on OCT evaluation include the detection of strut coverage and the characterization of neointimal tissue in an in-vivo setting. In a previous study, neointimal healing of stent strut was pathologically the most important factor associated with stent thrombosis, a fatal complication, in patients treated with drug-eluting stent (DES). Recently, OCT-defined coverage of a stent strut was proposed to be related with clinical safety in DES-treated patients. Neoatherosclerosis is an atheromatous change of neointimal tissue within the stented segment. Clinical studies using OCT revealed neoatherosclerosis contributed to late-phase luminal narrowing after stent implantation. Like de novo native coronary lesions, the clinical presentation of OCT-derived neoatherosclerosis varied from stable angina to acute coronary syndrome including late stent thrombosis. Thus, early identification of neoatherosclerosis with OCT may predict clinical deterioration in patients treated with coronary stent. Additionally, intravascular OCT evaluation provides additive information about the performance of coronary stent. In the near future, new advances in OCT technology will help reduce complications with stent therapy and accelerating in the study of interventional cardiology.
Atherosclerosis/diagnosis/pathology/ultrasonography ; Coronary Artery Disease/*diagnosis/pathology/ultrasonography ; Humans ; Postoperative Complications/diagnosis/pathology/ultrasonography ; Stents/*adverse effects ; Tomography, Optical Coherence/*methods ; Ultrasonography, Interventional

Various complications following laparoscopic cholecystectomy have been reported. We describe a case of intraabdominal abscess formation which was developed two months after the inadvertently spilling of gallstones laparoscopic cholecystectomy in a patient with acute cholelithiasis. The condition was initially found on computed tomography and the diagnosis was confirmed with ultrasound. Although this is a rare complication of laparoscopic cholecystectomy, the spilling of gallstones should be recognized as a potential source of intra-abdominal abscess formation even in a patient presenting months after laparoscopic cholecystectomy. We suggest that routine use of the specimen retrieval bag is highly recommended especially for beginners of laparoscopic cholecystectomy during their initial learning period.
Abdominal Abscess ; Abscess* ; Cholecystectomy, Laparoscopic* ; Cholelithiasis ; Diagnosis ; Gallstones* ; Humans ; Learning ; Postoperative Complications ; Ultrasonography

Stump appendicitis is an acute inflammation of the residual appendix and a rare complication after an appendectomy. Although the signs and symptoms do not differ from acute appendicitis, the diagnosis is often not considered because of the past surgical history. Only a small number of stump appendicitis cases have been reported, but there has been no report of stump appendicitis in Korea. Herein, we report a case of stump appendicitis. A 28-year-old female was admitted to our hospital due to right lower quadrant abdominal pain. Fifteen months ago, the patient had a laparoscopic appendectomy under the diagnosis of an acute appendicitis, but she subsequently suffered from intermittent abdominal pain and fever. Abdominal ultrasonography and CT scan showed an inflamed appendiceal stump. Laparoscopic stump appendectomy was done and the biopsy revealed stump appendicitis.
Acute Disease ; Adult ; *Appendectomy ; Appendicitis/*diagnosis/surgery/ultrasonography ; Appendix/surgery ; Diagnosis, Differential ; Female ; Humans ; Postoperative Complications/*diagnosis/ultrasonography ; Tomography, X-Ray Computed

Torsion of the gallbladder is a uncommon disease. Since Wendel reported the first case of torsion of the gallbladder in 1898, approximately 400 or more cases have been reported on. A mobile gallbladder with abnormal anatomical fixation to the liver is required for this torsion. Twisting of the mobile gallbladder on its pedicle creates occlusion of the blood supply or bile flow to the organ, and gangrene and necrosis finally occurs. Prompt surgery is required for this condition. Unless cholecystectomy is performed, this condition could cause severe postoperative complications or death to the patient. Torsion of the gallbladder has been known to occur frequently in thin, elderly females. Because of its medical rarity, diagnosis of torsion prior to operative exploration is extremely difficult and the diagnosis is generally maded by laparotomy. We report here on a case of torsion of the gallbladder. The patient was an 82 years old female who complained of severe epigastric pain, nausea, and vomiting. Ultrasonography and computed tomography were performed and these modalities demonstrated a distended gallbladder with wall thickening; the gallbladder didn't contain stones. Explorative laparotomy and cholecystectomy was then performed. We found that the necrotized gallbladder was twisted around its pedicle. We report here on a case of gallbladder torsion and we discuss the clinical features and diagnostic methods for this malady.
Aged ; Aged, 80 and over ; Bile ; Cholecystectomy ; Diagnosis ; Female ; Gallbladder* ; Gangrene ; Humans ; Laparotomy ; Liver ; Nausea ; Necrosis ; Postoperative Complications ; Ultrasonography ; Vomiting

PURPOSE: There is no agreement concerning the management of ureteropelvic junction obstruction(UPJO) in children. We reviewed our experience over 10 years for children with UPJO to analyze the clinical course and desirable treatment modality. MATERIALS AND METHODS: We reviewed the medical records of 80 consecutive children with UPJO and they were diagnosed between December 1994 and November 2004. There were 67 boys and 13 girls. A total of 94 kidneys in 80 patients were evaluated with urinalysis, ultrasonography, diuretic renogram and (99m)Tc-DMSA renal scanning. The natural progression of disease, the management method and the perioperative outcomes were retrospectively compared. RESULTS: Fifty of the 80 patients were prenatally diagnosed by fetal hydronephrosis or who were diagnosed at younger than 1 year(group A), and 30 patients were diagnosed at older than 1 year(group B). In group A, 18 patients underwent dismembered pyeloplasty before 1 year(A1) and 2 patients underwent nephrectomy due to severe deterioration of their renal function(<5%). Among the other 30 patients, delayed pyeloplasties were performed in 20 patients(A2) and 10 patients were managed conservatively(A3). In group B, 22 patients underwent pyeloplasty immediately (B1), and the other 8 patients underwent delayed pyeloplasty(B2). On the comparison of renal functional change among the patients in group A, the A1 patients had better renal functional improvement than the A2 and A3 patients. However, there was no statistical difference between the patients in B1 and B2. The postoperative complication rates were not significantly different in all the groups. CONCLUSIONS: It is thought that early operation is more effective for improving the renal function in children younger than one year.
Child ; Diagnosis* ; Female ; Humans ; Hydronephrosis ; Kidney ; Kidney Pelvis ; Medical Records ; Nephrectomy ; Postoperative Complications ; Retrospective Studies ; Ultrasonography ; Ureteral Obstruction ; Urinalysis

ObjectiveTo investigate the diagnosis and management of penile fracture.

METHODSFrom June 1993 to May 2017, 46 cases of penile fracture were treated in our hospital, averaging 33.5 (25－42) years of age and 3.45 (1－10) hours in duration, of which 41 occurred during sexual intercourse, 4 during masturbation and 1 during prone sleeping, 4 with hematuria, but none with dysuria or urethral bleeding. Hematoma was confined to the penis. Emergency surgical repair was performed for all the patients, 45 under spinal anesthesia and 1 under local anesthesia, 16 by coronal proximal circular incision and the other 30 by local longitudinal incision according to the rupture location on ultrasonogram. The tunica albuginea ruptures averaged 1.31 (0.5－2.5) cm in length, which were sutured in the "8" pattern for 6 cases and with the 3－0 absorbable thread for 18 cases. The skin graft or negative pressure drainage tube was routinely placed, catheters indwelt, and gauze used for early pressure dressing. In the recent few years, elastic bandages were employed for 3－5 days of pressure dressing and antibiotics administered to prevent infection. The stitches and catheter were removed at 7 days after surgery.

RESULTSShort-term postoperative foreskin edema occurred in 14 of the 16 cases of circular degloving incision, but no postoperative complications were observed in any of the cases of local incision. Twenty-eight of the patients completed a long-term follow-up of 49.4 (10－125) months, which revealed good erectile function, painless erection, and satisfactory sexual intercourse.

CONCLUSIONSFor most penile fractures, local longitudinal incision is sufficient for successful repair of the tunica albuginea, with mild injury, no influence on the blood supply or lymph reflux, and a low rate complications. It therefore is obviously advantageous over circular degloving incision except when the cavernous body of urethra is to be explored, which necessitates circular degloving incision below the coronal groove.

Adult ; Coitus ; Edema ; etiology ; Hematoma ; diagnosis ; etiology ; Humans ; Male ; Masturbation ; complications ; Penile Erection ; Penis ; injuries ; Postoperative Complications ; etiology ; Rupture ; diagnosis ; etiology ; surgery ; Surgical Wound ; Ultrasonography ; Urethra ; surgery

Intraabdominal abscess usually causes distress with fever, leukocytosis, pain and toxicity. Diagnosis of intraabdominal abscess is occasionally difficult and it has high morbidity. However radiologic method, such as ultrasonography, CT scan, or RI scan are helpful to early detection of intraabdominal abscess. Among these methods, ultrasonography is a noninvasive technique and performed without discomfort to patient. And also differential diagnosis between cystic and solid lesion is very easy and sequential ultrasonography in same patient is valuable for the evaluation of treatment effect. We analyzed the ultrasonic features of 48 cases with intraabdominal abscesses and the results are as follows; 1. In total 48 cases, the intraabdominal abscesses were 30 cases, the retroperitoneal abscesses, 5 cases, and the visceral abscesses, 13 cases. 2. The causes of the intraabdominal abscesses were perforating appendicitis (25 cases), postoperative complications (5 cases), pyogenic and amebic hepatic abscesses (13 cases), and the other (5 cases). 3. Round or oval shaped lesions were 26 cases (54%), irregular shape, 18 cases (38%), and multiple abscess formation in 4 cases (8%). 4. The size of the lesions were between 5 and 10cm in diameter in 54% of total 48 cases, and the most frequent feature of the echo pattern of the lesions was cystic with or without internal echogenicity (69%).
Abdominal Abscess* ; Abscess ; Appendicitis ; Diagnosis ; Diagnosis, Differential ; Fever ; Humans ; Leukocytosis ; Liver Abscess ; Methods ; Postoperative Complications ; Tomography, X-Ray Computed ; Ultrasonics ; Ultrasonography

Acalculous cholecystitis is an inflammation of the gallbladder in the absence of gallstones. Diagnosing this condition is often difficult because of the patient's debilitated medical condition and because of the limitation of biliary imaging technique. Nonetheless, its recognition and therapy are critically important, for if left untreated, many patients will die. During 10 years and 6 months from January 1986 to June 1996, 52 patients underwent assessment and treatment for acalculous cholecystitis at the Department of Surgery, Kyungpook National University Hospital. A clinical analysis of those patients was done and the following results were obtained: The incidence rate was 3.5%. The most prevalent age group was the seventh decade (13cases), and the male-to-female ratio was 1.4 : 1. Possible etiologic factors were found in 25 cases (48.1%). These factors were surgery in 5 cases (9.6%), trauma in 5 cases (9.6%), sepsis in 5 cases (9.6%), clonorchiasis in 5 cases (9.6%), and others in 5 cases(9.6%). Neither Ascariasis nor Salmonellosis was found as a predisposing factor in this study.The main cardinal symptoms and physical signs were similar to those of calculous cholecystitis. The sensitivities of diagnostic imaging by ultrasonography and computed tomography were 88.4% and 100%, respectively. Of the 52 patients, 46 cases underwent cholecystectomy, and 6 cases were initially treated by percutaneous transhepatic cholecystostomy. Of these 6 cases, two patients had cholecystostomies during subsequent abdominal operations for other conditions. Two patients had the cholecystostomy tube removed 2 months after an uneventful recovery and have had no further biliary problems. The other two patients died. The operative findings were cholecystitis only in 26 cases (56.5%), cholecystitis with localized peritonitis in 18 cases (39.1%), and cholecystitis with generalized peritonitis in 2 cases (4.3%). Postoperative complications occurred in 16 cases (34.8%), and wound infection was the most common complication (62.5% of all complications).The overall mortality was 9.6%. Conclusively, acalculous cholecystitis had high morbidity and mortality in this study. Once the diagnosis of acalculous cholecystitis is made, the gallbladder should be drained or removed. A decision as to the best approach depends on the specific situation and will require close cooperation between the internist, the surgeon, and the radiologist.
Acalculous Cholecystitis* ; Ascariasis ; Causality ; Cholecystectomy ; Cholecystitis ; Cholecystostomy ; Clonorchiasis ; Diagnosis ; Diagnostic Imaging ; Gallbladder ; Gallstones ; Gyeongsangbuk-do ; Humans ; Incidence ; Inflammation ; Mortality ; Peritonitis ; Postoperative Complications ; Salmonella Infections ; Sepsis ; Ultrasonography ; Wound Infection

PURPOSE: Neonatal neuroblastoma (NBL) is the most common malignant tumor in neonates, but there have been few studies about it. The purpose of this study was to investigate the clinical features of NBL and to compare prenatal and postnatal diagnosed groups. METHODS: Nineteen patients who were diagnosed with NBL prenatally or within 28 days after birth from February 1986 to February 2013 in Seoul National University Hospital were enrolled in the study. The patients were categorized according to the International Neuroblastoma Staging System (INSS) and Children's Oncology Group (COG). Retrospective medical-record reviews were performed on these patients. The operative date, complication, pathological stage, and overall survival of the prenatally diagnosed group and the postpartum diagnosed group were compared. RESULTS: Tumor was detected via prenatal ultrasonography in 8 patients (42.1%), and 11 patients (57.9%) were diagnosed within 28 days after birth. Based on INSS, the patients were divided into the stage I (n=8), stage II (n=1), stage III (n=3), stage IV (n=4), and stage IVs (n=3) groups, respectively. Based on COG, on the other hand, the patients were divided into the low-risk (n=8), intermediate-risk (n=8), and high-risk (n=3) groups. The postoperative complication rate was 29%. One patient died from complications from chemotherapy. The other 18 patients' mean follow-up period was 77.7 months. The differences between the postoperative complication rate, proportion of early-stage tumor, and overall survival of the prenatal and postnatal groups were not statistically significant (p=0.446, p=0.607, p=0.414). CONCLUSION: NBL showed favorable outcomes but relatively higher postoperative complications. There seem to be no significant statistical differences in the postoperative complications, proportion of early-stage tumor, and overall survival between the prenatally diagnosed group and the postpartum diagnosed group.
Drug Therapy ; Follow-Up Studies ; Hand ; Humans ; Infant, Newborn ; Neuroblastoma* ; Parturition ; Postoperative Complications ; Postpartum Period* ; Prenatal Diagnosis ; Retrospective Studies ; Seoul ; Ultrasonography, Prenatal