A spontaneous rupture into the sigmoid colon and peritoneal cavity is a most unusual complication for a mature cystic teratoma of the ovary. A 38-year-old woman with acute lower abdominal pain, presenting as peritonitis, visited our hospital. Physical examination revealed tenderness, rebound tenderness, and vague palpable mass in the right lower quadrant of the abdomen. A pelvic computed tomographic scan demonstrated a right ovarian cystic mass with bone and fat tissue, which had ruptured into the sigmiod colon, and peritoneal fluid collection. During a laparotomy, the ovary tumor was found to be densely adherent to the rectosigmoid junctional wall; also a solid element of the ovary tumor containg hair and skin tissue seemed to be in continuity with colonic lumen, and the ovarian wall was ruptured with spillage of purulent exudate into the peritoneal cavity. En bloc resection of the tumor-bearing segment of the sigmoid colon, together with the adherent right ovary and salpinx was carrried out. The diagnosis of a mature teratoma of the ovary was made by histologic examination of a surgical specimen; the tumor had perforated the sigmoid colon wall, had protruded into the bowel lumen, and had ruptured the intraperitoneal cavity due to inflammation its wall.
Abdomen ; Abdominal Pain ; Adult ; Ascitic Fluid ; Colon ; Colon, Sigmoid* ; Diagnosis ; Exudates and Transudates ; Fallopian Tubes ; Female ; Hair ; Humans ; Inflammation ; Laparotomy ; Ovarian Cysts ; Ovary* ; Peritoneal Cavity* ; Peritoneum ; Peritonitis ; Physical Examination ; Rupture* ; Rupture, Spontaneous ; Skin ; Teratoma*

No abstract available.
Cholecystectomy, Laparoscopic*

No abstract available.
Child* ; Humans

PURPOSE: To recanalize the occlusive lesion of superficial femoral artery at origin site by retrograde approach via popliteal artery. MATERIALS AND METHODS: 15 patients, who were poor surgical candidates due to coronary artery disease and who had severe occlusive lesion of superficial femoral artery close to its origin with good distal runoffs to popliteal artery, were selected. Patients were all~men and range of age were from 53 years to 66 years (mean age:63 years). Range of lesion length were from 15cm to 30cm (mean length:22.4cm). Localization of popliteal artery was done with Doppler stethoscope or "road-map" DSA. The method of recanalization were transluminal endarterectomy catheter (TEC), TEC and angioplasty, thrombolysoangioplasty (TLA). RESULT: Retrograde puncture of popliteal artery were done in 15 patients successfully. TEC & PTA was performed in 9 patients, TEC only in 2 patients, and TLA & PTA in 2 patients. During the follow-up period of 5 months to 2 years reocclusion did not occurr in 10 patients except for 1 patient with poor cardiac output in whom it occured 1 day later. Remained 4 patients were lost in follow up. Any neurologic or vascular complication did not occur. CONCLUSION: Retrograde approach of superficial fernoral artery via popliteal artery in patients with difficult vascular intervention by common method provides a useful, alternative recanalization method.
Angioplasty ; Arteries ; Cardiac Output ; Catheters ; Coronary Artery Disease ; Endarterectomy ; Femoral Artery* ; Follow-Up Studies ; Humans ; Popliteal Artery* ; Punctures ; Stethoscopes

Laparoscopic cholecystectomy has been popularized all over the world as the treatment of choice for unnecessory symptomatic or asymptomatic gall stones. Initially, this surgery was applied to limited indications, but nowadays the indications of the surgery have been expanded to include severe, inflamed, complicated patients with gall stones, which used to be thought of as contraindications in the past. Surgeon,s technical improvement and newly devised surgical instruments made it possible to expand the limit of surgical indications for laparoscopic cholecystectomy. However, anatomical disorientation due to severe inflammed gall bladder is still the drawback to the possible occurrence of laparoscopic bile duct injury and bleeding. We have a clinical analysis of 32 cases of laparoscopic cholecystectomy for acute cholecystitis or G.B.empyema, surgical time,safety and case were evaluated. Two patients were converted to open laparotomy because of intraoperative bile duct injury and anatomical disorientation by hepatic flexure colonic interposition. As a result, we suggest that even in patients with subphrenic abscess or bile peritonitis secondary to G.B.empyema could be the indications for the laparoscopic cholecystectomy if surgeon's ability or patient's condition allow it.
Bile ; Bile Ducts ; Cholecystectomy, Laparoscopic* ; Cholecystitis, Acute ; Cholelithiasis* ; Colon ; Gallstones ; Hemorrhage ; Humans ; Laparotomy ; Peritonitis ; Subphrenic Abscess ; Surgical Instruments ; Urinary Bladder

Adrenal myelolipomas are rare benign tumors consisting of mature fat and hematopoietic elements resembling bone marrow. Due to the frequent use of ultrasound and computerized tomography their presence is now more frequently discovered. Although these tumors are usually asymptomatic and only found incidentally at autopsy, they can cause local symptomes or hemorrhage requiring surgical excision. We present the case of a large surgically and histologically confirmed, adrenal myelolipoma with retroperitoneal hemorrhage due to spontaneous rupture in a 32-year old man.
Adrenal Glands ; Autopsy ; Bone Marrow ; Hemorrhage* ; Myelolipoma* ; Rupture, Spontaneous* ; Ultrasonography

Adrenal myelolipomas are rare benign tumors consisting of mature fat and hematopoietic elements resembling bone marrow. Due to the frequent use of ultrasound and computerized tomography their presence is now more frequently discovered. Although these tumors are usually asymptomatic and only found incidentally at autopsy, they can cause local symptomes or hemorrhage requiring surgical excision. We present the case of a large surgically and histologically confirmed, adrenal myelolipoma with retroperitoneal hemorrhage due to spontaneous rupture in a 32-year old man.
Adrenal Glands ; Autopsy ; Bone Marrow ; Hemorrhage* ; Myelolipoma* ; Rupture, Spontaneous* ; Ultrasonography

The classic clinical manifestations of acute suppurative cholangitis were first described by Charcot in 1877 as a triad of fever(and chill),jaundice and right upper quadrant pain. In 1959,Reynolds and Dargan characterized acute suppurative cholangitis as a distinct clinical entity manifested by a clinical pentad of Charcot,s three signs plus shock and central nervous system depression.We have clinical analysis of acute suppurative cholangitis,218 cases who were admitted in Chonnam Hospital from Jan.1989 to Dec.1995.All cases were treated conservatively initially,and then delayed operation was performed when the patients were improved from the septic condition by cholangitis.
Central Nervous System ; Cholangitis* ; Humans ; Jeollanam-do ; Shock

PURPOSE: The causes of encopresis are complex and multifactorial. Through application of new sophisticated techniques and armamentarium, it has been possible to find more specific aspects of the anorectal function in pediatric patients with refractory defecation disorders. However, quality research of which therapeutic option could be suitable, is still lacking. The current study was designed to assess outcome of treatment according to the treatment algorithm based on the clinical and physiologic findings. METHODS: 22 patients (15 boys, 7 girls) with encopresis were analyzed, retrospectively. For exclusion of the organic cause, barium contrast study and anoscopy were carried out in all cases. Patients were categorized and made treatment algorithm by using leading symptoms and findings of anorectal physiologic tests. Treatment outcomes were analysed in the basis of respective therapeutic options. RESULTS: Patients were categorized as constipation dominant group (n=15) and incontinence dominant group (n=7). Suggested etipathogeneses were as follows; fecal impaction and/or motility disorder (n=7), overflow incontinence (n=6), sensory defect of the rectum (n=4), puborectalis incoordination (n=3), anal hypertonia (n=2). Treatment options were as follows; conventional therapy (CT) only (n=7), CT plus biofeedback (n=9), CT plus balloon sensory retraining (n=4), and CT plus internal sphincterotomy or Nitroglycerine application (n=2). All patients were undertaken a toilet training and psychologic consultation. Regarding to the therapeutic outcome, 19 (86 percent) of overall 22 patients were improved in the mean period of 2.5 (range, 0.1-7) years follow-up. CONCLUSIONS: If therapy could be undertaken according to the optional algorithm based on the clinical and physiologic findings, it could be useful guide for clinical decision making to help the therapy. Moreover, through the combination therapy including medication, psychological consultation, and biofeedback treatment, encopretic children achieve acceptable outcome with a long-term compliance.
Ataxia ; Barium ; Biofeedback, Psychology ; Child ; Compliance ; Constipation ; Decision Making ; Defecation ; Encopresis* ; Fecal Impaction ; Follow-Up Studies ; Humans ; Nitroglycerin ; Rectum ; Retrospective Studies ; Toilet Training ; Treatment Outcome*

We experience a case of 34-year-old Turner's syndrome(45, XO) associated with atrial septal defect(secondum type) and mitral valve prolapse who was admitten due to moderate exertional dyspnea. It is well know hat chromosomal abnormality is one of the etiology of congenital heart disease. In case of Turner's syndrome, coarctation of aorta or bocuspid aortic valve is frequently combined, but atrial septal defect simultaneously with mitral valve prolapse is not reported till now in Krea. We report this case with a brief review of the literature.
Adult ; Aortic Coarctation ; Aortic Valve ; Chromosome Aberrations ; Dyspnea ; Heart Defects, Congenital ; Heart Septal Defects, Atrial* ; Humans ; Mitral Valve Prolapse* ; Mitral Valve* ; Turner Syndrome*