Adolescent ; Child ; Child, Preschool ; Female ; Gastroesophageal Reflux ; complications ; Humans ; Infant ; Male ; Retrospective Studies ; Superior Mesenteric Artery Syndrome ; complications ; Vomiting ; etiology

Intestinal malrotation presents with different clinical characteristics, depending upon the age of the patient. The medical records of 44 patients treated for intestinal malrotation with/without midgut volvuls between January 2002 and August 2009 at Seoul National University Children's Hospital were reviewed retrospectively. Patients were grouped by the age criteria of 1 and 12 months. Fourteen patients were under 1 month of age (31.8%), 9 patients between 1 month and 12 months (20.5%) and 21 patients over 12 months (47.7%). Twenty patients (45.5%) presented with volvulus. Vomiting (66%) and abdominal pain (20%) were the most common symptoms. UGIS (68.2%) was the most frequent diagnostic tool. Mean postoperative hospital stay was 13.7 days. There were 7 mild postoperative complications. Volvulus was more frequent in patients under 1 month (p=0.025) than over 1 month. The interval between diagnosis and operation was shorter in patients under 1 month (p=0.003) than in patients over one month of age. In the age between under and over 12 months, volvulus was more common in those under 12 months of age, but the difference was not significant. The interval from diagnosis to operation was shorter in patients under 12 months than over 12 months of age (p=0.001). Vomiting was the most frequent symptom in patients under 12 months. On the other hand, abdominal pain was the most frequent symptom in patients over 12 months. In conclusion, patients with intestinal malrotation had age-related differences in the presence of midgut volvulus, the interval between diagnosis and operation, and clinical symptoms. The age of the patient should be considered in order to determine adequate treatment of malrotation.
Abdominal Pain ; Hand ; Humans ; Intestinal Volvulus ; Length of Stay ; Medical Records ; Postoperative Complications ; Retrospective Studies ; Vomiting

BACKGROUNDS: Intestinal obstruction is one of the main causes of neonatal operations. It is caused by congenital factors, inherited diseases, and acquired diseases. A study was made to understand the status of neonatal intestinal obstruction cases at our hospital. METHODS: This was a clinical analysis of 53 cases of neonatal intestinal obstruction which had been experienced from March 1992 to February 1998 at the Department of General surgery, Sung-Ae General Hospital. RESULTS: 1) Operations for neonatal intestinal obstructions accounted for 42.4% of all neonatal operations. 2) There were 38 males and 15 females; the male-to-female ratio was 2.5:1. 3) Gestational period of 9 cases (16.9%) was less than 36 weeks and the weight in 10 cases (18.8%) wre below 2,500 gm at birth. 4) The main clinical symptoms on admission were vomiting or abdominal distension. 5) There were 49 cases (92.4%) of mechanical obstruction and 4 cases of a paralytic ileus. 6) Associated anomalies were present in 9 cases (16.9%). 7) The postoperative complication and motality rates were 30.1% and 7.5% respectively. CONCLUSIONS: Our clinical data might provide clinical suspicisions leading to early diagnosis and treatment.
Early Diagnosis ; Female ; Hospitals, General ; Humans ; Intestinal Obstruction* ; Intestinal Pseudo-Obstruction ; Male ; Parturition ; Postoperative Complications ; Vomiting

Newborns with ileal atresia frequently present with abdominal distension, bilious vomiting, and failure to pass meconium. Diagnosis is usually established on plain x-ray of the abdomen by the findings of distended small bowel loops and air-fluid levels. In the period of October 1988 to February 1994, 8 patients with congenital ileal atresia were operated and the following results were obtained. 1. Eight patients were comprise of 4 males and 4 females, the ratio of male and female was 1 : 1. 2. Six patients(75%) had been admitted to our hospital during three days of life. 3. Congenital ileal atresia was in 8 cases : Type I in two(25%), Type II in two(25%), Type III a in three(37.5%), Type III b in one(12.5%). 4. There was one premature patient who was small for gestational age. 5. Overall, abdominal distension and bilious vomiting occurring in seven patients, were frequent presenting complaints. 6. Diagnosis was possible with clinical symptom and simple abdomen. 7. Operative treatment was undertaken as soon as the diagnosis was made. In seven cases a primary end-to-end anastomosis was performed after resection of dilated proximal loop. 8. A total of four associated congenital anomalies were found in one patient. 9. Postoperative complications occurred in three cases(37.5%).
Abdomen ; Diagnosis ; Female ; Gestational Age ; Humans ; Infant, Newborn* ; Male ; Meconium ; Postoperative Complications ; Vomiting

The use of a locally prepared polyethylene glycol electrolyte lavage solution (PEG-ELS) for preoperative bowel preparation of pediatric patients undergoing colostomy/ileostomy closure was compared with a standard three day regimen.Twenty-three patients were randomly assigned to either PEG-ELS or a standard three day bowel preparation, For both groups,? there were no significant differences in the changes in the pre and post-prep body weights, hematocrit, and serum electrolytes.Patients did not exhibit? abdominal cramps nor vomiting with either preparation. Intra-operative assessment showed adequate cleansing of bowels in both procedures. Postoperative complications were?not related to the preparations.? This study shows that using a locally prepared polyethylene glycol?electrolye lavage solution may be an excellent alternative to the standard?three day bowel preparation in pediatric patients.

Human ; Male ; Female ; Ileostomy ; Colostomy ; Therapeutic Irrigation ; Polyethylene Glycols ; Colic ; Hematocrit ; Vomiting ; Postoperative Complications ; Cathartics

PURPOSE: Hypertrophic pyloric stenosis (HPS) is a common condition affecting infants that causes severe projectile non-bilious vomiting in the first few months of life. Although open pyloromyotomy is the standard treatment for HPS, recently, the laparoscopic approach has rapidly been adopted by pediatric surgeons. The aim of this study is to determine the efficacy and safety of laparoscopic pyloromyotomy by comparing the clinical results of laparoscopic and open pyloromyotomy. METHODS: Between January 2007 and September 2012, a cohort of 69 children who underwent pyloromyotomy at Seoul National University Children's Hospital were followed; open pyloromyotomy (OP, n=56) and laparoscopic pyloromyotomy (LP, n=13). A retrospective analysis of patient's characteristics and clinical outcomes in patients with open or laparoscopic pyloromyotomy for HPS was performed. The evaluated characteristics included gestational age, sex, birth weight, age and weight at operation. Clinical outcomes included operation time, length of hospital stay, time to postoperative full feeds without vomiting, number of postoperative vomiting and complications. RESULTS: There were no significant differences in characteristics, length of hospital stay and time to postoperative full feeds without vomiting between the two groups. Incidence of postoperative vomiting in the LP group was significantly lower than that in the OP group (OP: 5.07+/-4.60 vs. LP: 2.00+/-2.16, p=0.035). In contrast, the operation time was longer, following the LP group (OP: 26.30+/-9.95 vs. LP: 44.15+/-19.56, p<0.001). Complications such as perforation of mucosal layer (OP: 2 vs. LP 1, p>0.999) and wound problems (OP: 4 vs. LP 1, p>0.999) were found to be similar in both groups. CONCLUSION: Both open and laparoscopic pyloromyotomy are safe procedures for the management of hypertrophic pyloric stenosis. Incidence of vomiting was statistically superior in the laparoscopic group. In addition, postoperative complications were fewer in this group. However, an improvement in the operation time will be needed for the future development of laparoscopic pyloromyotomy.
Birth Weight ; Child ; Cohort Studies ; Gestational Age ; Humans ; Incidence ; Infant ; Laparoscopy ; Length of Stay ; Postoperative Complications ; Postoperative Nausea and Vomiting ; Pyloric Stenosis, Hypertrophic ; Retrospective Studies ; Vomiting

OBJECTIVETo assess the impacts on postoperative nausea and vomiting of the patients with laparoscopic surgery undergoing the general anesthesia by electroacupuncture (EA) at different frequencies at bilateral Neiguan (PC 6).

METHODSOne hundred and twenty female patients with laparoscopic surgery undergoing the general anesthesia were randomized into 4 groups: 2 Hz EA treatment group (group A), 2 Hz/100 Hz EA treatment group (group B), 100 Hz EA treatment group (group C) and a control group (group D), 30 cases in each one. The same anesthetic program was adopted in each group. For the patients in A, B and C groups, in the first half a hour undergoing the conventional drug anesthesia, acupuncture was applied to bilateral Neiguan (PC 6). After arrival of qi, HANS-200A electroacupuncture apparatus was connected, at the frequency as 2 Hz, 2 Hz/100 Hz and 100 Hz separately. The electric stimulation was discontinued at the end of surgery. The life physical signs after surgery, the occurrence of postoperative nausea and vomiting and the severity grades of postoperative nausea and vomiting were observed and recorded for the patients in each group.

RESULTSThe differences in the postoperative 1 h heart rate, mean arterial pressure (MAP), finger pulse oxygen saturation and respiratory frequency were not significant statistically in comparison of the patients among groups (all P > 0.05). The incidence of postoperative nausea and vomiting of the patients in group B was lower apparently than that in A, C and D groups [10.0% (3/30) vs 30.0% (9/30), 36.7% (11/30), 53.3% (16/30), all P < 0.01]. The severity of postoperative nausea and vomiting of the patients in group B was lower apparently than that in the rest three groups (all P < 0.01).

CONCLUSIONThe electroacupuncture at 2 Hz/100 Hz reduces effectively the incidence and the severity of postopera tive nausea and vomiting of the patients with laparoscopic surgery undergoing the general anesthesia.

Acupuncture Points ; Adolescent ; Adult ; Aged ; Electroacupuncture ; Female ; Humans ; Laparoscopy ; adverse effects ; Male ; Middle Aged ; Postoperative Complications ; etiology ; therapy ; Postoperative Nausea and Vomiting ; therapy ; Vomiting ; etiology ; therapy ; Young Adult

There is a continuing debate among surgeons about whether postoperative adhesive small bowel obstruction is best managed operatively or nonoperatively. This retrospective study was designed to determine the factors influencing the treatment modality of postoperative small bowel obstruction. A clinical analysis was conducted on 112 cases of small bowel obstruction after previous abdominal operation, who were admitted to the department of general surgery of Korea Veterans Hospital from January, 1984 to December, 1994. The patients were divided into two groups according to the modality of treatment: operatively(N=35) and nonoperatively(N=77) treated groups. Clinical parameters such as age, sex, symptoms and signs, type of previous operation, interval between previous operation and admission due to obstructive symptoms, time period from onset of symptoms to admission, and interval from admission to operation, were compared between two groups. Among 112 cases, the conservative treatment was performed in 77 cases and operative management was performed in 35 cases. There was no significant difference in the distribution of age and sex between two groups. The previous operations leading to adhesive intestinal obstruction were appendectomy(18.8%), gastroduodenal operation(17.0%), operation for multiple organ injury(16.1%), and Obsetric & Gynecologic surgery(9.8%) in that orders. The interval between previous abdominal operation and admission was under 1 month in 20 cases, 1 to 6 months in 10 cases, 7 to 12 months in 16 cases, and 1 to 2 years in 16 cases. The major symptoms and signs were abdominal pain, abdominal tenderness, vomiting, abdominal distension, hyperperistalsis, and leukocytosis. Among the above signs and symptoms, continuous abdominal pain, leukocytosis, and tachycardia were significantly higher in the operative group compared to those of the nonoperative group. The most common procedures of operative management were adhesiolysis, small bowel resection, bypass surgery, and colon resection in that orders. The incidence of postoperative complications was 31.4% and the most common complication was wound infection. In conclusion, at admission, the presence of strangulating signs such as continuous abdominal pain, leukocytosis, and tachycardia in patients with small bowel obstruction after previous abdominal operation mandates early operative intervention rather than conservative treatment.
Abdominal Pain ; Adhesives ; Colon ; Hospitals, Veterans ; Humans ; Incidence ; Intestinal Obstruction ; Korea ; Leukocytosis ; Postoperative Complications ; Retrospective Studies ; Tachycardia ; Vomiting ; Wound Infection

This clinical report is a review of the medical records of the 161 cases of postoperative adhesive intestinal obstruction treated at the Department of Surgery, Chung-Goo Sungsim General Hospital during 5 years from January 1991 to December 1995. The results of the study are as follows; 1) The most frequent age group was the 4th decade and the most prevalent age groups in the strangulated intestinal obstruction were below 10 years and above 60 years. 2) There was no difference among the types of previous abdominal operations in terms of the possibility of the strangulation. 3) The incidence of postoperative complication in the strangulated intestinal obstruction(58.3%) was higher than that in the non-strangulated intestinal obstruction(7.7%). 4) The overall mortality rate was 2.5%. The mortality rate in the strangulated intestinal obstruction was 8.3%, and was higher than that in the non-strangulated intestinal obstruction. 5) It is ideal to operate just before progression to strangulation, but it is not easy to decide when it happens. An operation should be considered in the following cases. (1) The presence of two or more symptoms; abdominal pain, obstipation, vomiting and abdominal distension. (2) The presence of two or more signs; leukocytosis, fever, tachycardia, localized abdominal tenderness, rebound tenderness and continuous abdominal pain. (3) Clinical signs of deterioration after 72 hours of conservative treatment.
Abdominal Pain ; Adhesives* ; Fever ; Hospitals, General ; Humans ; Incidence ; Intestinal Obstruction ; Leukocytosis ; Medical Records ; Mortality ; Postoperative Complications ; Tachycardia ; Vomiting

PURPOSE: When patients underwent emergency surgery for suspected appendicitis, colon resection could be performed at the time of the initial operation. The aim of this study was to evaluate 42 cases underwent colectomy for suspected acute appendicitis. METHODS: A retrospective analysis of 42 patients underwent colectomy for suspected acute appendicitis was performed over the period from January 1997 to December 2003 at the department of surgery, Kangnam Sacred Heart hospital, Hallym university. RESULTS: The sex ratio were 1.2:1. The mean age was 37.7 years. Right lower quadrant pain was present in all patients. Nausea and vomiting occurred in 18 cases (42.8%). Preoperative fever was 11 cases (26.1%). Abdominal ultrasound was most commonly performed preoperatively. The operative findings showed cecal mass with pericecal abscess was 20 cases (47.5%) and cecal mass with inflammation, 11 cases (26.1%), etc. The pathologic findings showed cecal diverticular abscess was 18 cases (42.8%) and pericecal abscess, 9 cases (21.4%), periappendiceal abscess, 5 cases (11.9%), etc. Type of operation was ileocecectomy, 29 cases (69.04%), and right hemicolectomy, 12 cases (28.57%), and extended right hemicolectomy, 1 case. Postoperative complications developed in 12 cases (28.57%), but those were uneventful. CONCLUSIONS: When an unexpected and suspicious cecal mass was found at operation for suspected appendicitis, the resection of all clinically apparent disease including colectomy could be considered. So, the surgeon must be aware of the possibility of these condition and choose the appropriate treatment.
Abscess ; Appendicitis* ; Colectomy* ; Colon ; Emergencies ; Fever ; Heart ; Humans ; Inflammation ; Nausea ; Postoperative Complications ; Retrospective Studies ; Sex Ratio ; Ultrasonography ; Vomiting