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A Case of Acute Pancreatitis without Abdominal Pain.

Jae Hui KIM ; Min Ji GOO ; Jae Min CHO ; Eun Sil PARK ; Ji Hyun SEO ; Jae Young LIM ; Chan Hoo PARK ; Hyang Ok WOO ; Hee Shang YOUN

Korean Journal of Pediatric Gastroenterology and Nutrition.2005;8(2):275-278.

We report a boy with acute pancreatitis without abdominal pain accompanied by hepatic hematoma and massive ascites due to unperceived trauma. The case was difficult to diagnose with image study and the level of amylase. Strong suspicion of pancreatic injury based on mechanism of injury and clinical evaluation would be required to avoid a delay in diagnosis.
Abdominal Pain* ; Amylases ; Ascites ; Diagnosis ; Hematoma ; Humans ; Male ; Pancreatitis*

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A Case of Esophageal Candidiasis in a Healthy Child.

Joseph JO ; Sin Ae PARK ; Kyung Dan CHOI

Korean Journal of Pediatric Gastroenterology and Nutrition.2005;8(2):269-274.

Esophageal candidiasis is an opportunistic infection, often reported in patients who have acquired immune deficiency syndrome (AIDS), a neoplastic disease, or undergoing protracted antibiotic therapy. Impaired cell mediated immunity was often considered as the major predisposing factor in patients of esophageal mucosal colonization of Candida spp. However, it is increasingly reported that the occurrence of esophageal candidiasis with no underlying disease or immune suppression. We have experienced a case of esophageal candidiasis in a 15-year-old girl who was immunologically normal and have no underlying disease and whose main symptoms were epigastric and retrosternal pain with dysphagia. This case suggests the possibilities of candidal infections in children without predisposing factors such as immune compromised conditions, so it will be needed to differentiate the esophageal candidiasis among healthy children with symptoms of odynophagia and dysphagia.
Acquired Immunodeficiency Syndrome ; Adolescent ; Candida ; Candida albicans ; Candidiasis* ; Causality ; Child* ; Colon ; Deglutition Disorders ; Female ; Humans ; Immunity, Cellular ; Opportunistic Infections

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A Case of Erythropoietic Protoporphyria with Severe Liver Dysfunction and Neurological Symptoms.

Bo Hyun KIM ; Young Nyun PARK ; Ki Sup CHUNG

Korean Journal of Pediatric Gastroenterology and Nutrition.2005;8(2):263-268.

Erythropoietic protoporphyria is a genetic disorder due to a deficiency of ferrochelatase resulting in excessive accumulation and excretion of protoporphyrin. The predominant clinical feature is photosensitivity. Severe hepatic failure occurs in a small percentage of patients, and neurological symptoms are very rare. We report a case of erythropoietic protoporphyria associated with severe hepatic dysfunction and neurological symptoms. A 9-year-old girl presented with severe abdominal pain, nausea, weakness and pain of extremities, and urinary retention. Ultrasonogram and abdominal CT scanning revealed a diffuse infiltrated and enlarged liver. Liver biopsy showed deposition of dense dark brown pigment within the bile, hepatocytes and Kupffer cells. Plus, dense dark brown deposits gave a red birefringent under polarize light. Porphyrin studies demonstrated markedly elevated serum free erythrocyte protoporphyrin. This girl was diagnosed as erythropoietic protoporphyria with severe liver dysfunction and neurological symptoms.
Abdominal Pain ; Bile ; Biopsy ; Child ; Erythrocytes ; Extremities ; Female ; Ferrochelatase ; Hepatocytes ; Hepatomegaly ; Humans ; Kupffer Cells ; Liver Diseases* ; Liver Failure ; Liver* ; Nausea ; Protoporphyria, Erythropoietic* ; Tomography, X-Ray Computed ; Ultrasonography ; Urinary Retention

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Bleeding due to Vitamin K Deficiency as Presenting Symptom of Cholestasis.

Won Tae BAE ; Jung Sook YEOM ; Eun Sil PARK ; Ji Hyun SEO ; Jae Young LIM ; Chan Hoo PARK ; Hyang Ok WOO ; Hee Shang YOUN

Korean Journal of Pediatric Gastroenterology and Nutrition.2005;8(2):257-262.

Clinical findings in neonates and infants with cholestasis characteristically include prolonged jaundice, acholic stool, pruritus and failure to thrive. We report two cases of cholestasis presenting with spontaneous bleeding due to vitamin K deficiency. Laboratory studies on admission revealed moderate liver dysfunction and a bleeding tendency due to vitamin K deficiency. After administration of vitamin K, the bleeding tendency disappeared. Vitamin K deficiency was resulting from a combination of cholestasis-induced fat malabsorption and low vitamin K supplementation due to breast-milk feeding. Cholestasis should be considered in neonate and infant with a bleeding tendency.
Cholestasis* ; Failure to Thrive ; Hemorrhage* ; Humans ; Infant ; Infant, Newborn ; Jaundice ; Liver Diseases ; Pruritus ; Vitamin K Deficiency* ; Vitamin K* ; Vitamins*

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A Case of Haddad Syndrome.

Min Kyu LEE ; Joon Sung KIM ; Seong Jong PARK ; Ki Su KIM ; In Koo KIM ; Chong Hyun YOON ; Kyung Mo KIM

Korean Journal of Pediatric Gastroenterology and Nutrition.2005;8(2):252-256.

The combination of Congenital central hypoventilation syndrome with Hirschsprung's disease, also known as Haddad syndrome, belongs to the family of diseases now designated as Neurocristopathies. We have experienced a case of Haddad syndrome in a male infant who presented with repetitive abdominal distension, bilious vomiting, and sleep apnea. Following colon study and rectal biopsy disclosed the absence of the ganglion cell. And the infant could not be weaned from mechanical ventilation since birth because of the absence of effective, spontaneous respiration during sleep. As he was diagnosed as Haddad syndrome, tracheostomy and ileostomy were performed consecutively. At the age of 4 months, he was relatively healthy but remained ventilator-dependent. We report the first Korean case of Haddad syndrome with a brief review of the related literature.
Biopsy ; Colon ; Ganglion Cysts ; Hirschsprung Disease ; Humans ; Hypoventilation ; Ileostomy ; Infant ; Male ; Parturition ; Respiration ; Respiration, Artificial ; Sleep Apnea Syndromes ; Tracheostomy ; Vomiting

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A Case of Ileao-ileal Intrauterine Intussusception in a Preterm Neonate.

Bo Young LEE ; Yeo Hyang KIM ; Jin Bok HWANG ; Chun Soo KIM ; Sang Lak LEE ; Tae Chan KWON ; Hee Jung LEE ; Woo Hyun PARK

Korean Journal of Pediatric Gastroenterology and Nutrition.2005;8(2):247-251.

Intussusception in a preterm neonate is a very rare disorder. We experienced a case of intrauterine intussusception presented with symptoms of the small bowel obstruction in a preterm infant whose gestational age was 28(+2) weeks. Urgent ultrasonography of abdomen revealed no definite intussuscepted segment. At emergent surgery performed on the 11th days of life under the diagnosis of distal small bowel obstruction, an ileo-ileal intussusception with distal ileal atresia without perforation was found.
Abdomen ; Diagnosis ; Gestational Age ; Humans ; Infant, Newborn* ; Infant, Premature ; Intestinal Atresia ; Intussusception* ; Ultrasonography

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A Case of Pleural Effusion Associated with Acute Hepatits A.

Dong Il KIM ; Jae Ock PARK ; Chang Hwi KIM

Korean Journal of Pediatric Gastroenterology and Nutrition.2005;8(2):243-246.

Pleural effusion represents a rare complication of acute hepatitis A infection. Twelve year-old girl was admitted with complaints of general weakness, nausea and icteric sclerae. She also complained of right chest pain. Right decubitus view of chest radiograph showed pleural fluid accumulation. Laboratory findings were as follows: AST/ALT 1692/1970 IU/L, total/direct bilirubin 4.48/3.66 mg/dL and HA IgM Ab (+). On the seventh day of hospitalization, her general condition was much improved and chest radiography showed resolved pleural effusion.
Bilirubin ; Chest Pain ; Female ; Hepatitis A ; Hospitalization ; Humans ; Immunoglobulin M ; Nausea ; Pleural Effusion* ; Radiography ; Radiography, Thoracic ; Sclera ; Thorax

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A Case of Abdominal Tuberclosis Mimicking Ovarian Cancer.

Jung Sook YEOM ; Jae Hui KIM ; Jae Min CHO ; Jeong Hee LEE ; Eun Sil PARK ; Ji Hyun SEO ; Jae Young LIM ; Chan Hoo PARK ; Hyang Ok WOO ; Hee Shang YOUN

Korean Journal of Pediatric Gastroenterology and Nutrition.2005;8(2):238-242.

We report the case of a girl with peritoneal tuberculosis (Tb) who presented with mimicking features of ovarian cancer including massive ascites, elevation of CA-125 and ovarian masses. These ovarian masses cannot be ruled out malingnacy with image study. Gram stain, acid-fast stain, bacteriological and mycological culture of centrifuged ascites cells were negative. Tumor markers revealed an elevated CA-125 level of 112 U/mL and adenosine deaminase level were significantly high with 118 U/L. Diagnostic laparoscopy was done. The histology of the peritoneum and the ovary showed multiple granulomatous nodules with epithelioid cells and multi-nucleated giant cells. And there were no evidence of malignancy. Furthermore acid-fast bacilli (AFB) was identified in this specimen. Peritoneal Tb was difficult to diagnosis in our patient because it mimicked ovarian cancer. And this is the first case of abdominal Tb mimicking ovarian cancer in children in Korea.
Adenosine Deaminase ; Ascites ; Child ; Diagnosis ; Epithelioid Cells ; Female ; Giant Cells ; Humans ; Korea ; Laparoscopy ; Ovarian Neoplasms* ; Ovary ; Peritoneum ; Peritonitis, Tuberculous ; Biomarkers, Tumor

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The Characteristics and Diagnostic Methods of Food Protein Induced Proctocolitis.

Ae Suk KIM ; Jin Bok HWANG

Korean Journal of Pediatric Gastroenterology and Nutrition.2011;14(Suppl 1):S47-S54. doi:10.5223/kjpgn.2011.14.Suppl1.S47

Food protein induced proctocolitis (FPIPC) is a non-IgE mediated food allergy. FPIPC occurs exclusively among breast-fed infants within the first months of life. FPIPC is often diagnosed clinically in normal-conditioned infants with rectal bleeding. But FPIPC among infancy with rectal bleeding is less general than conceived. The endoscopic findings reveal an edematous and erythematous mucosa with superficial erosions or ulcerations, bleeding and lymphoid nodular hyperplasia. The prominent eosinophilic infiltrates in the rectosigmoid mucosa are important for the histopathologic diagnosis of FPIPC. However, in explaining eosinophilic infiltration within the lamina propria of the mucosa, it is necessary to differentiate whether it is a part of normal findings or occurs due to inflammatory reactions. Oral food challenge and elimination test is performed to identify the same clinical reaction as the symptom of FPIPC by the administration of a specific type of food to infants. The most common causal food is cow's milk. Thus oral food challenge and elimination test can be the effective way of confirming FPIPC, reducing the possibility of misdiagnosis. The purpose of this report is to identify the characteristics of FPIPC, to introduce its diagnostic methods, and to suggest the future direction of research.
Diagnostic Errors ; Eosinophils ; Food Hypersensitivity ; Hemorrhage ; Humans ; Hyperplasia ; Infant ; Milk ; Mucous Membrane ; Proctocolitis ; Ulcer

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Stem Cell in Pediatric Gastrointestinal Tract Disease: Hirschsprung Disease.

Sun Hwan BAE

Korean Journal of Pediatric Gastroenterology and Nutrition.2011;14(Suppl 1):S42-S46. doi:10.5223/kjpgn.2011.14.Suppl1.S42

Stem cell is characterized with self-renewal and mult-potency. Many pediatric gastrointestinal diseases have defect in enterocytes, enteric nervous system, and Interstitial cell of Cajal. Various kinds of stem cell could be applied to these diseases. Here, the author introduces stem cell for pediatric gastrointestinal diseases, particularly Hirschsprung disease.
Enteric Nervous System ; Enterocytes ; Gastrointestinal Diseases ; Gastrointestinal Tract ; Hirschsprung Disease ; Stem Cells

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