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

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

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

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

Congenital anomalies of the pancreaticobiliary structure may go undetected until adulthood, and they can be the cause of unexplained jaundice, abdominal pain, nausea and vomiting. In addition to such associated disease, as cholangitis, gallstone, cholangiocarcinoma and pancreatitis, recognition of these variant anatomies is clinically important for planning surgery and for preventing inadvertent surgical injury. Although congenital abnormalities and variations of the biliary ducts are common, and variations in the drainage and course of the cystic duct are also frequently seen, variation of the cystic duct opening into the right hepatic duct is rare; further, it is important to avoid erroneous ligation of the hepatic duct during surgery. We report here on a case of aberrant cystic duct opening into the right hepatic duct along with acute pancreatitis.
Abdominal Pain ; Cholangiocarcinoma ; Cholangitis ; Congenital Abnormalities ; Cystic Duct* ; Drainage ; Gallstones ; Hepatic Duct, Common* ; Intraoperative Complications ; Jaundice ; Ligation ; Nausea ; Pancreatitis* ; Vomiting

PURPOSE: 'White-eye blowout' fracture is often occur in young patients and defined as blow out fracture with little or no clinical sign of soft tissue trauma such as edema, ecchymosis, but with marked motility restrictions in vertical gaze. In this conditions, immediate operation is essential. We reported the clinical investigation study of these cases about clinical symptoms and radiologic findings and introduce our experiences about immediate operations in 'white-eye blowout' fractures. METHODS: From January 2008 to December 2009, nine pediatric patients who were diagnosed as pure white-eye blowout fractures were involved this study. Patients with other facial bone fractures or with poor general medical condition were excluded. In all cases, we performed immediate operation within 48 hours. RESULTS: All patients had diplopia, vertical gaze restriction or systemic symptoms. Six patients had nausea, vomiting and syncope caused by oculocardiac reflex. In all patients, preoperative symptoms were improved after immediate operation. There were no postoperative complications such as infection, hematoma or wound dehiscence. CONCLUSION: When we meet the young patients with history of periocular trauma, with little or no soft tissue trauma signs, but with marked vertical gaze restriction or general symptoms caused by oculocardiac reflex, we should immediately examine by facial bone computed tomography and refer the patient to ophthalmologist for ophthalmic evaluations. If patient is diagnosed as orbital floor fracture with entrapped muscle or soft tissue, the earlier surgical reduction get better clinical outcomes.
Diplopia ; Ecchymosis ; Edema ; Facial Bones ; Floors and Floorcoverings ; Hematoma ; Humans ; Muscles ; Nausea ; Orbit ; Postoperative Complications ; Reflex, Oculocardiac ; Syncope ; Vomiting

BACKGROUND: Propofol is an intravenous anesthetic characterized by rapid induction and prompt recovery. Recently, its is used widely in clinical practice, especially when early discharge is advisable. We conducted this study for the evaluation of the effects of propofol as a sole intravenous anesthetic on the operation with minimal pain such as TUL(transurethral lithotripsy). METHODS: Patients were recruited for ASA class 1 and 2 from those who received TUL operation. Propofol was administered 2 mg/kg for induction and continuously infused at the rate of 1.2~1.4 mg/kg/hr after the loss of consciousness. With the stabilization of the vital signs, we reduced the dose of propofol to 1.0~1.2 mg/kg/hr. We checked the patients' movement, vital signs, recovery time and monitored the appearance of the symtoms such as nausea, vomiting postoperatively. RESULTS: 1) The average time of operation was 15+/-12 minutes. 2) The average recovery time was 15+/-9 minutes(range 2~30 min). 3) Blood pressure and peripheral oxygen saturation(SpO2) were declined during anesthesia, but SpO2 was normalized in the recovery room. 4) No significant complications were observed. 5) Mild movement of the patient was noticed in the begining of operation, but it did not affect the surgical procedure. CONCLUSIONS: Propofol was effective as a sole intravenous anesthetic to minimize postoperative complications such as nauea, vomiting for TUL with minimal pain.
Anesthesia ; Anesthetics, Intravenous* ; Blood Pressure ; Humans ; Lithotripsy* ; Nausea ; Oxygen ; Postoperative Complications ; Propofol* ; Recovery Room ; Unconsciousness ; Vital Signs ; Vomiting