A Clinical Analysis of 179 Cases of Centipede Bite Patients Who Visited the Emergency Department in Korea

PURPOSE: To investigate the epidemiology and clinical characteristics of centipede bite injuries. METHODS: We conducted a retrospective study of clinical manifestations in patients who were identified between April 2005 to April 2007 as having suffered from centipede bites. Factors evaluated included sex, age, location and time of bite, part of body affected, clinical signs and symptoms, treatment modalities and complications. RESULTS: A total of 179 cases of centipede bite were identified. Centipede bites occurred between spring and autumn. 69.3% of bites happened at night. All patients were bitten on an exposed body parts, and the digit of both the handsand feet were the sites most often involved. Pain, swelling, erythema were the most frequent symptoms and signs. Most cases showed minor manifestations but, three patients needed to be admitted because of anaphylaxis. CONCLUSION: Centipede bites are relatively common in the summer season in rural and island areas, especially at night. Though the clinical symptoms of centipede bites are generally minor symptoms, emergency physicians need to possess accurate knowledge of the clinical manifestations in order to properly identify severe cases.

Stomal Complications in Children

This is a 20 year analysis of the problems associated with enterostomy formation, and closure. Forty-three stomas were established in 43 patients: 23 for anorectal malformations, 11 for Hirschsprung's diseases, 4 for necrotizing enterocolitis, 3 for multiple ileal atresias, 1 for volvulus neonatorum with perforation, and 1 for diaphragmatic hernia with colon perforation. Thirty boys and 13 girls were included (mean age 4.8 months). Stoma complications were encountered in 13 patients (30.2 %): stomal prolapse, stenosis, obstruction, paracolic hernia, retraction, dysfunction, and skin excoriation. Four patients (9.3 %) required stomal revision. Occurrence of complications was not related to age and primary disease, but sigmoid colostomy showed lower complication rate than transverse colostomy (20.0 % vs 42.9 %, p<0.05). There were five deaths but, only one (2.3 %) was directly related to the enterostomy complication. Twenty-one stomas were closed in our hospital and complications occurred in seven patients (33.3 %). The most common complication was wound sepsis in 5 children. In conclusion, because the significant morbidity of stomal formation still exists, refinements of the surgical technique seem to be required. Sigmoid loop colostomy is preferred whenever possible.