우하복부 동통 환자에서 복부전산화단층촬영의 임상적 유용성

원창식,노혜린,박승배,김양희,채기봉 대한대장항문학회 2008 Annals of Coloproctolgy Vol.24 No.6

Purpose: This study was performed to evaluate the usefulness of abdominal computed tomography (CT) for patients with right lower quadrant (RLQ) pain. Methods: Between January 2006 and July 2008, 191 consecutive patients with RLQ pain underwent abdominal CT (CT group). Forty-two patients who had undergone abdominal ultrasound (US group) and 52 patients without abdominal CT or abdominal ultrasound for RLQ pain (clinical Dx group) underwent emergent operations. Using the Alvarado scoring system, we scored all patients. The abdominal CT was performed in the abdominal and pelvic area with contrast. Results: One hundred twenty-one (63.4%) of the 191 patients in the CT group were preoperatively diagnosed as having acute appendicitis and underwent surgery. There were three cases of negative appendectomy (1.6%). In the US group and the clinical Dx group, the negative appendectomy rates were 4.8% and 3.8%, respectively. The sensitivity of the abdominal CT was 96.7%. In the CT group, in addition to acute appendicitis, colitis, nonspecific enteritis, diverticulitis, urinary stone, ovary, uterine, and diseases were indentified. Conclusions: In this study, abdominal CT scans in patients with RLQ pain were useful for the diagnosis acute appendicitis and for the differential diagnosis of other diseases presenting with RLQ pain. The false positive rate was significantly lower in the CT group than in the other groups. Purpose: This study was performed to evaluate the usefulness of abdominal computed tomography (CT) for patients with right lower quadrant (RLQ) pain. Methods: Between January 2006 and July 2008, 191 consecutive patients with RLQ pain underwent abdominal CT (CT group). Forty-two patients who had undergone abdominal ultrasound (US group) and 52 patients without abdominal CT or abdominal ultrasound for RLQ pain (clinical Dx group) underwent emergent operations. Using the Alvarado scoring system, we scored all patients. The abdominal CT was performed in the abdominal and pelvic area with contrast. Results: One hundred twenty-one (63.4%) of the 191 patients in the CT group were preoperatively diagnosed as having acute appendicitis and underwent surgery. There were three cases of negative appendectomy (1.6%). In the US group and the clinical Dx group, the negative appendectomy rates were 4.8% and 3.8%, respectively. The sensitivity of the abdominal CT was 96.7%. In the CT group, in addition to acute appendicitis, colitis, nonspecific enteritis, diverticulitis, urinary stone, ovary, uterine, and diseases were indentified. Conclusions: In this study, abdominal CT scans in patients with RLQ pain were useful for the diagnosis acute appendicitis and for the differential diagnosis of other diseases presenting with RLQ pain. The false positive rate was significantly lower in the CT group than in the other groups.

복식호흡 운동이 월경통에 미치는 영향

표정수,민주화,이동건,구봉오,Pyo, Jeong-Soo,Min, Ju-Hwa,Lee, Dong-Gun,Goo, Bong-Oh 대한고유수용성신경근촉진법학회 2015 PNF and Movement Vol.13 No.2

Purpose: Abdominal breathing exercises are recommended to activate the breathing muscles and the pelvic floor muscles, as well as to increase postural alignment during exhalation. The purpose of this study was to clarify the effect of improving abdominal muscle strength on menstrual pain in women in their twenties using abdominal breathing exercises. Method: In this study, 32 female university students were included as the subjects. The subjects were divided into two groups based on the area of menstrual pain: lumbar pain (n=16) and lower abdomen pain (n=16). The abdominal breathing positions were divided into two positions, which included a hook lying position and hip and knee flexions at $90^{\circ}$ in the supine position. Exercises were used to strengthen the abdominal muscles during exhalation. Four sets of the exercises were completed three times a week over the course of eight weeks. The degree of pain was measured using the Numeric Rating Scale (NRS). Muscle thickness was measured using an ultrasound. Result: The thickness of the transverse abdominis (TrA) and internal oblique (IO) increased in the lower abdomen pain group. However, thickness of the external oblique (EO) did not increased following abdominal breathing. No significant difference in posture was identified in the lower abdomen group. TrA thickness increased significantly in the lumbar pain group. However, thickness did not increase significantly in the lumbar pain group. In addition, the lumbar pain group experienced no significant effects on posture. IO thickness increased following hip and knee flexions at $90^{\circ}$ in the lumbar pain group. Menstrual pain decreased following intervention in both groups. There was no significant difference in the degree of pain reduction between both groups. Conclusion: As examples of alternative medicine, abdominal breathing exercises may be effective in decreasing menstrual pain.

Successful Treatment of Abdominal Cutaneous Entrapment Syndrome Using Ultrasound Guided Injection

Hong, Myong Joo,Kim, Yeon Dong,Seo, Dong Hyuk The Korean Pain Society 2013 The Korean Journal of Pain Vol.26 No.3

There are various origins for chronic abdominal pain. About 10-30% of patients with chronic abdominal pain have abdominal wall pain. Unfortunately, abdominal wall pain is not thought to be the first origin of chronic abdominal pain; therefore, patients usually undergo extensive examinations, including diagnostic laparoscopic surgery. Entrapment of abdominal cutaneous nerves at the muscular foramen of the rectus abdominis is a rare cause of abdominal wall pain. If abdominal wall pain is considered in earlier stage of chronic abdominal pain, unnecessary invasive procedures are not required and patients will reach symptom free condition as soon as the diagnosis is made. Here, we report a case of successful treatment of a patient with abdominal cutaneous nerve entrapment syndrome by ultrasound guided injection therapy.

Case Report : Successful Treatment of Abdominal Cutaneous Entrapment Syndrome Using Ultrasound Guided Injection

( Myong Joo Hong ),( Yeon Dong Kim ),( Dong Hyuk Seo ) 대한통증학회 2013 The Korean Journal of Pain Vol.26 No.3

There are various origins for chronic abdominal pain. About 10-30% of patients with chronic abdominal pain have abdominal wall pain. Unfortunately, abdominal wall pain is not thought to be the first origin of chronic abdominal pain; therefore, patients usually undergo extensive examinations, including diagnostic laparoscopic surgery. Entrapment of abdominal cutaneous nerves at the muscular foramen of the rectus abdominis is a rare cause of abdominal wall pain. If abdominal wall pain is considered in earlier stage of chronic abdominal pain, unnecessary invasive procedures are not required and patients will reach symptom free condition as soon as the diagnosis is made. Here, we report a case of successful treatment of a patient with abdominal cutaneous nerve entrapment syndrome by ultrasound guided injection therapy. (Korean J Pain 2013; 26: 291-294)

학동기 소아에서 반복성 재발성 복통과 불안 성향과의 관련성

문지영,문경래,Moon, Ji-Young,Moon, Kyung-Rye 대한소아소화기영양학회 2007 Pediatric gastroenterology, hepatology & nutrition Vol.10 No.2

목 적: 복통은 소아에서 흔히 보는 소화기 증상 중의 하나이다. 복통이 지속적으로 반복되면 불안이나 우울증 같은 정서적 장애를 호소하게 된다. 그리고 이로 인해 어린이들의 정서적 발달 및 인격형성에 부정적인 영향을 미치고, 다른 여러 가지 정신적 신체적 정상을 유발시키기도 한다. 이에 저자들은 복통과 불안 성향의 연관성을 알아보고 소아 복통의 치료에 심리적인 요인의 고려의 필요성을 확인하기 위하여 연구를 시행하였다. 방 법: 광주 광주광역시에 소재하는 1개 초등학교 1학년부터 6학년 학생 1254명, 남아 592명, 여아 662명을 대상으로 복통의 양상을 평가하였으며, 불안의 정도는 한국판 상태-특성 불안검사 YZ형(STAI-YZ: Spielberger's State-Trait Anxiety Inventory YZ form) 설문지를 이용하여 비교 분석하였다. 결 과: 1) 전체 1,254명 중 지난 1년간 복통이 있었던 아이의 수는 709명(56.5%)이었으며, 이 중 69명(5.5%)이 만성 반복성 복통이었다. 2) 특성 불안 및 상태 불안으로 진단한 아이는 각각 116명(9.3%), 63명(5.0%)이었다. 3) 최근 1년 동안 복통이 있었던 군과 만성 반복성복통이 있었던 군에서 없었던 군에 비해 특성 및 태 불안 척도가 모두 의의 있게 높았다. 4) 복통의 정도가 심할수록 특성 및 상태 불안 척도가 의의 있게 높았다. 5) 상태 불안 척도가 높은 아이는 상태 불안 척도도 높았다. 6) 복통의 기간, 빈도, 지속시간, 발생시기, 복통의 부위를 구분하였을 때 특성 및 상태 불안 척도에 유의한 차이가 없었다. 7) 특성 불안이 있는 군이 복통을 경험한 학생의 비율은 전체 116명 중 80명(69.0%)로 특성 불안이 없는 군 1,138명 중 593명(52.1%)에 비해 의의 있게 많았다. 상태 불안군에서도 63명 중 46명(73%)으로 상태불안이 없는 군 1,191명 중 645명(59.2%)에 비해 의의 있게 많았다. 8) 특성 불안이 있는 군의 RAP에 대한 위험도는 특성 불안이 없는 군에 비해 1.96배 높았고, 상태 불안이 있는 군은 없는 군에 비해 2.37배높았다. 결 론: 소아 복통은 상태 및 특성 불안과 밀접한 연관성이 있으므로, 복통의 치료에 불안과 같은 요인을 고려해야 할 것으로 판단된다. Purpose: It has been reported that children with chronic pain have higher levels of anxiety than age-matched controls. Therefore, this study was designed to determine the relationship between anxiety and recurrent abdominal pain in elementary school children. Methods: In 2005, we surveyed 1,254 elementary school children (592 boys and 662 girls) whose ages ranged from 7 to 12 years. The degree of trait and state anxiety was compared between agroup suffering from intermittent abdominal pain, a group suffering from recurrent abdominal pain and a normal control group following the Korean version of Spielberger's State-Trait Anxiety Inventory YZ form (STAI-YZ). Results: 709 (56.5%) and 69 (5.5%) of the patients reported intermittent abdominal pain and and recurrent abdominal pain, respectively, during the 12 month period before this study was conducted, and trait and state anxiety values for each of these groups was 116 (9.3%) and 63 (5.0%), respectively. In addition, the State-Trait Anxiety score was significantly higher in the group with intermittent abdominal pain and RAP than the anxiety score of the normal control group. Additionally, the STAI-YZ score increased in proportion to the severity of abdominal pain, but was not correlated with the duration, frequency, onset time or location of abdominal pain. Furthermore, the proportion of the group with abdominal pain in the group that had trait or state anxiety was significantly higher than the proportion of the group that did not have trait and state anxiety. Conclusion: Recurrent abdominal pain during childhood is correlated with state and trait anxiety, therefore, psychological factors, such as anxiety duringtreatment, must also be considered when determining the cause of recurrent abdominal pain.

복벽에서 기원한 복통 환자의 평가

채현석 ( Hiun Suk Chae ),문도준 ( Do Jun Moon ),김윤태 ( Yoon Tae Kim ),이정수 ( Jung Soo Lee ) 대한내과학회 2009 대한내과학회지 Vol.76 No.5

Background/Aims: We analyzed patients with abdominal pain of undetermined etiology, referred to physiatrists by gastroenterologists, and determined the clinical features of patients with abdominal wall pain. Methods: A retrospective chart review of 100 patients referred by gastroenterologists over 4 years was performed. A visceral etiology of abdominal pain was excluded by the gastroenterology work-up using radiologic and endoscopic studies, and medical treatment. The clinical features and outcomes of abdominal wall pain were examined. We determined the long-term outcome by telephone. Results: Of 100 patients with abdominal pain of undetermined etiology, 89% of the patients were identified as having pain arising in the abdominal wall, and the right flank area was the most common site of pain. The pain had a musculoskeletal origin in 90.4% of the patients and a neurogenic origin in 9.6%. Treatment by the physiatrists resulted in complete or partial pain relief in 73% of the patients. The diagnosis remained unchanged after a mean of 22.67 (range 6.5-55) months in 95.5% of the patients. Long-term effects of management were seen in 73.6% of the patients. Conclusions: In a small group of patients with abdominal pain of unknown etiology, the source of pain could be in the abdominal wall. Recognizing abdominal wall pain could lead to an accurate diagnosis, reduced medical costs and effective treatment. (Korean J Med 76:564-570, 2009)

의식하 진정 대장내시경 검사 중 복부통증 관련 요인

안지현 ( Ahn Jihyun ),정인숙 ( Jeong Ihn Sook ) 부산대학교 간호과학연구소 2018 글로벌 건강과 간호 Vol.8 No.2

Purpose: This study aimed to determine the severity of patients’ abdominal pain symptom during and post-colonoscopy under conscious sedation and to determine associations between abdominal pain and demographic and colonoscopic characteristics. Methods: Cross-sectional study was conducted on 115 outpatients undergoing colonoscopy under conscious sedation in a single tertiary hospital. Pain symptom was evaluated 10 times through nonverbal behavioral observation tool with score from 0 to 20. Pain severity was analyzed with descriptive statistics, and abdominal pain-related factors were determined via multiple logistic regression. Results: Mean peak pain score was 7.43 out of 20 points during colonoscopy and 34 patients (29.6%) showed peak pain score of over 10 points. Based on multiple logistic regression, female gender (odds ratio=2.85), concern before colonoscopy (odds ratio=1.02), and time to cecum (odds ratio=1.12) were significantly related with abdominal pain during colonoscopy under conscious sedation. Conclusion: Based on the results obtained, nurses should inform colonoscopy candidates of potential abdominal pain during colonoscopy under conscious sedation. In addition, nurses should consider nursing interventions including warm pack application to effectively relieve abdominal pain during colonoscopy in candidates with presence of risk factors.

Successful Treatment of Abdominal Cutaneous Entrapment Syndrome Using Ultrasound Guided Injection

홍명주,김연동,서동혁 대한통증학회 2013 The Korean Journal of Pain Vol.26 No.3

There are various origins for chronic abdominal pain. About 10−30% of patients with chronic abdominal pain have abdominal wall pain. Unfortunately, abdominal wall pain is not thought to be the first origin of chronic abdominal pain; therefore, patients usually undergo extensive examinations, including diagnostic laparoscopic surgery. Entrapment of abdominal cutaneous nerves at the muscular foramen of the rectus abdominis is a rare cause of abdominal wall pain. If abdominal wall pain is considered in earlier stage of chronic abdominal pain, unnecessary invasive procedures are not required and patients will reach symptom free condition as soon as the diagnosis is made. Here, we report a case of successful treatment of a patient with abdominal cutaneous nerve entrapment syndrome by ultrasound guided injection therapy.

한 발 서기 시 복부 압박 벨트가 요통 환자의 정적 균형에 미치는 영향

주화평,최솔아,정다혜,한나린,우영근 대한고유수용성신경근촉진법학회 2017 PNF and Movement Vol.15 No.3

Purpose: This study aimed to measure static balance of low back pain patients while one-leg standing in abdominal compression belts. Methods: The study included 40 adult males and females at J university, divided into a low back pain patient group and a normal group through the Oswestry disability questionnaire (ODQ). The subjects were instructed to hold a one-leg standing posture for 15 seconds on a balance measurement plate while wearing an abdominal compression belt. Shifting distance (0.1 cm), mean velocity (cm/s), pressure, and contact area were analyzed using BioRescue (BioRescue, RMINGEIEIRIE, Rodez, France). The average value was used to measure the result 3 times for each condition. Results: Both normal and low back pain groups significantly decreased in the speed of sway while wearing the abdominal compression belt. Furthermore, the pressure of the center of motion significantly decreased in the low back pain groups while wearing abdominal compression belt. However, there were no significant differences in the speed of sway or the pressure of center of motion between groups after wearing the abdominal pressure belt. Conclusion: These results suggest that abdominal compression belts are one option for improving balance temporarily. However, balance after wearing abdominal compression vests depends on onset of back pain, age, and symptoms of pain in the groups with low back pain. Further research is needed to investigate muscle activity, dynamic balance, and the effect of the period of wearing abdominal compression belts in the variety of low back pain patients.

Risk Factors for Recurrent Abdominal Pain in Children with Nonorganic Acute Abdominal Pain

Varisa Piriyakitphaiboon,Salin Sirinam,Pongsak Noipayak,Chukiat Sirivichayakul,Suwanna Pornrattanarungsri,Kriengsak Limkittikul 대한소아소화기영양학회 2022 Pediatric gastroenterology, hepatology & nutrition Vol.25 No.2

Purpose: The purpose of this study was to identify the risk factors for recurrent abdominal pain (RAP) in children who presented with nonorganic acute abdominal pain. Methods: A retrospective, single study was conducted on 2–15-year-old children diagnosed with nonorganic acute abdominal pain at the pediatric outpatient department of Vajira Hospital, Nawamindradhiraj University, between January 2015 and December 2019. The potential risk factors were analyzed using univariate and multivariate analyses. Results: Of the 367 patients with nonorganic acute abdominal pain, 94 (25.6%) experienced RAP within three months. In this group with RAP, 76 patients (80.8%) were diagnosed with functional gastrointestinal disorders, including functional dyspepsia, irritable bowel syndrome, functional abdominal pain-not otherwise specified, and functional constipation. History of gastrointestinal infection (p=0.011), mental health problems (p=0.022), abdominal pain lasting ≥7 days (p<0.001), and change in stool frequency (p=0.001) were the independent risk factors associated with RAP in children with nonorganic acute abdominal pain; their odds ratios and 95% confidence intervals were 3.364 (1.314–8.162), 3.052 (1.172–7.949), 3.706 (1.847–7.435), and 2.649 (1.477–4.750), respectively. Conclusion: RAP is a common problem among children who first present with nonorganic acute abdominal pain. The identification of risk factors may provide proper management, especially follow-up plans for this group in the future.