A Case of Cecal Volvulus Presenting with Chronic Constipation in Lissencephaly / 대한소아소화기영양학회지

Cecal volvulus is uncommon in pediatric patients and there are few reports of cecal volvulus with cerebral palsy. Here, we report the case of a 19-year-old male patient who presented with abdominal distension, a history of cerebral palsy, refractory epilepsy due to lissencephaly, and chronic constipation. An abdominal x-ray and computed tomography without contrast enhancement showed fixed dilated bowel intensity in the right lower abdomen. Despite decompression with gastric and rectal tube insertion, symptoms did not improve. The patient underwent an exploratory laparotomy that revealed cecal volvulus. Cecal volvulus usually occurs following intestinal malrotation or previous surgery. In this patient, however, intestinal distension accompanying mental disability and chronic constipation resulted in the development of cecal volvulus. We suggest that cecal and proximal large bowel volvulus should be considered in patients presenting with progressive abdominal distension combined with a history of neuro-developmental delay and constipation.

A Study on Nutritional Status of Iron and Lipids in Infants

PURPOSE: This study was conducted to get baseline data to establish a guideline for the infant nutrition by observing the feeding practice and nutritional intake during infancy and evaluationg the nutritional status of iron and lipids at 12-month-old infants. METHODS: This survery was cnducted from July to November, 1992. Subjects were healthy infants who were brought to Yeungnam University Hospital for vaccination. We followed up feeding methods for 6 months in 120 infants, and laboratory tests which include hemoglobin, fematocrit, MCHC, ferritin, total cholesterol, HDL-cholesterol, triglyceride and urea nitrogen/creatinine ratio were done in 36 infants at 12 months of age. RESULTS: Male to female sex ratio was 1.6:1 in total 120 study infants. Among 36 infants who took laboratory tests, five infants were breast-fed, 25 were formula-fed, and 6 were mexed-fed. Percentage of the formula-fed infants increased as their monthly age increases. Although 54.2% of the studied infants were started weaning diet at four months of age, 10.8% of infants were not given any weaning diet until 6 month of age. Breastfed infnats had lower hemoglobin(10.6+/-1.8g/dl), hematocrit(32.6+/-3.6%), serum ferritin(13.6+/-13.1ng/ml)(p<0.05), and 15.6% of them had anemia and 16.7% of them had iron deficiency. Serum lipids levels except total cholesterol in breaset-fed female infants were comparable between groups. CONCLUSIONS: We confirm that the incidence of iron deficiency anemia was increased in breast fed infants and there was no difference in lipids levels according to different feeding methods. Adequate iron supplementation through weaning diets is one of the most important problems in breast milk feeding