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복부 초음파 검사 보편화 시대의 소아 장중첩증의 임상적 고찰 - 소장형과 대장형의 비교 -
김완성,정진호,이종훈,박재균,문현종,신혁재,이종인,Kim, Wan-Sung,Jeong, Jin-Ho,Lee, Jong-Hoon,Park, Jae-Kun,Moon, Hyoun-Jong,Shin, Hyuk-Jai,Lee, Jong-In 대한소아외과학회 2011 소아외과 Vol.17 No.1
We analyzed the clinical characteristics and outcome of ileocecal and small bowel intussusceptions (ICI and SBI) in the pediatric patients. From August 2003 to July 2010, 144 children with intussusception were included in this study. We retrospectively reviewed the clinical records and Imaging study findings. A total of 86 children with ICI and 58 children with SBI were diagnosed. Children with SBI were older than ICI ($36.6{\pm}24.6$ months vs. $24.2{\pm}21.6$ months, p=0.002). Typical symptoms such as irritability, abdominal mass, bloody stool were more frequent in ICI than SBI (p<0.05) patients. In the ICI group, intussusceptums were reduced with air reduction (84.5%), surgery (17.4%), and spontaneity (1.2%). All patients in the SBI group were reduced spontaneously. SBI occurred in older age and was reduced spontaneously more frequently than ICI. Conservative management with close observation with follow-up by ultrasonography is recommended for SBI.
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박종섭(Jong Seob Park),이종인(Jong In Lee),정진호(Jin Ho Jeong),이종훈(Jong Hoon Lee),문현종(Hyoun Jong Moon),박재균(Jea Kun Park),신혁재(Hyuk Jae Shin) 대한외과학회 2009 Annals of Surgical Treatment and Research(ASRT) Vol.77 No.3
Purpose: Bezoars are the uncommon result of ingestion of poorly digestible or indigestible substances. It is defined as retained concretions of animal or vegetable material in the gastrointestinal tract. The aim of this study was to review and analyze in these cases with reviewing literature. Methods: The medical records of 12 cases, treated between May 1999 and April 2009, were reviewed. The clinical characteristics, as well as the diagnostic evaluations and results of medical and surgical treatment, were also analyzed retrospectively. Results: Of the 12 cases, 6 men and 6 women, the bezoars were in the stomach, jejunum and ileum or in both stomach and jejunum in 1, 2, 7 and 2 cases, respectively. 4 patients (33.3%) had a history of gastric or duodenal ulcer following previously received gastric surgery such as subtotal gastrectomy or truncal vagotomy with pyloroplasty. In 3 cases, the bezoars were found in operative field under the impression of intestinal obstruction due to adhesive ileus, which could not be found by preoperative radiologic evaluation. Among the 12 cases, 11 cases were successfully treated by operative and endoscopic removal, but 1 case expired due to sepsis. Conclusion: A bezoar occurs mainly in patients who have previously undergone a gastric operation. Surgeons should keep in mind the possibility of bezoars in patients presenting an intestinal obstruction following a past gastric operation. The principle of treatment for bezoars used to be surgery, but recently gastric bezoars are often treated by gastrofiberscopy.
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