Short Bowel Syndrome Due to Infarction of the Superior Mesenteric Artery

The syndrome of mesenteric ischemia remains clinically challenging despite decades of surgical experience, and occlusive disease involving the arteries to the viscera is associated with the life-threatening complications of intestinal infarction. Total parenteral nutrition has been shown to be an excellent treatment modality that has allowed many patients with intestinal failure to survive with a reasonable quality of life. However, only with the development of successful intestinal transplantation of the gut will the short bowel syndrome be cured. If intestinal transplantation could be performed with acceptable morbidity and mortality rates, it would offer a more physiologic and economic approach to the problem of short bowel syndrome. We report a case of short bowel syndrome due to infarction of the superior mesenteric artery along with a review of the literature.

Current problems and perspectives of liver transplantation in Pittsburgh: Retransplantation and Split, Reduced size liver transplantation / 한국간담췌외과학회지

No abstract available.

Pancreas-Intestinal Transplantation in Familial Adenomatous Polyposis Patients

Familial adenomatous poliposis is autosomal, predominantly inherited, premalignant disease, which is caused by a mutation in adenomatous poliposis coli gene in chromosome 5q21. Intestinal transplantation is an evolving procedure and has become a lifesaving procedure for pediatrics and adults with intestinal failure who cannot be managed by conventional therapies. Long-term outcome and cost effectiveness continue to improve and will be comparable to those of total parenteral nutrition. The short gut syndrome is the most common indication. Pancreas transplantation, as a solid organ, vascularized graft, has im proved the quality of life for diabetic patients by establishing an insulin-independent, constant normo glycemic state and is a well-established treatment for patients with insulin-dependent diabetes. The bene ficial effect is the maintenance of normoglycemia and possibly the reversal of diabetic complications, such as vasculopathy, neuropathy, and nephropathy. We report a case of pancreas-intestinal transplantation in a familial adenomatous polyposis patient along with a review of the literature.

An Experience of Axillary-Subclavian Vein Thrombosis after Left Subclavian Vein Catheterization in Polycythemia Vera

Deep venous thrombosis (DVT) of the upper extremity has been recently been recognized as being more common than previously reported (probably because of the increasingly frequent use of subclavian venous access). Since the initial descriptions of axillary-subclavian vein thrombosis more than 100 years ago, studies cites a 1.3% to 2.1% incidence of all DVT that occurs in the axillary or subclavian veins. Axillary-subclavian vein thrombosis is commonly associated with significant morbidity. The most serious aspect of morbidity and mortality is pulmonary embolization. Venography or digital subtraction studies are most reliable in allowing detection of thrombosis and Duplex imaging of vein is useful in following the course and assessing the effect of treatment. Early diagnosis and initiation of treatment before thrombus organization are important for successful outcome. Polycythemia vera are at an especially high risk for both thrombotic and hemorrhghic events and postoperative complications. We report a case of axillary-subclavian vein thrombosis after left subclavian vein catheterization in polycythemia vera.

Retroperitoneal, Mesenteric and Omental Cysts

Retroperitoneal, mesenteric, and omental cysts are rare intra-abdominal tumors. The most common symptom and physical finding is abdominal pain and a smooth, nontender, mobile, palpable mass. With increasing availability of ultrasound and computed tomography, the preoperative diagnosis of intra-abdominal cyst is being made more frequently. The upper gastrointestinal(GI) series, barium enema, and intravenous pyelogram exclude GI and genitourinary cysts and tumors. However, in the past, the correct preoperative diagnosis was made in only 25% of the other previously reported cases. Complete enucleation of the cyst, including a bowel resection, if necessary, is the treatment of choice and it has excellent postoperative results. In this study, the records of 15 patients with retroperitoneal, mesenteric, and omental cysts who underwent surgery at Chonbuk National University Hospital between January 1975 and July 1997 were retrospectively reviewed. The results are as follows: 1) The peak age was past the 4th decade (53.3%), and sex ratio of females to males was 6.5 : 1. 2) An abdominal palpable mass and abdominal pain existed in 10 cases (66.6%) and 5 cases (33.3%), respectively. Other clinical symptoms were abdominal distention, nausea, vomiting, constipation, diarrhea, fever, urinary frequeny. 3) The cyst was located on small bowel mesentey in 5 cases (33.3%), transverse colon mesentery in 4 cases (27%), retroperitoneurn in 2 cases (13%), and omentum in 2 cases (13%), and most cases were single. 4) Ultrasonography and computed tomography were helpful to know the presence of intra-abdominal mass and its location and relationship to adjacent organs. 5) The most common operation methods was complete enucleation of the cyst and next best alternative would be excion of the cyst with the resection of a portion of the adjacent bowel.

Mesenteric Cysts Report on three cases and review of the literature

A mesenteric cyst is an uncommon cause of a palpable abdominal mass. Such cysts occur along the Gastrointestinal(G-I) tract, from the duodenum to the rectum and are commonly found in the mesentery of small bowel rather than in the mesocolon. They can present themselves as chronic abdominal pain, an abdominal mass, and abdominal pain, and the most common physical finding is an abdominal mass which is movable transversely but not longitudinally. Diagnostic aids include abdominal computed tomography and ultrasound. An upper gastrointestinal series, barium enema, and intravenous pyelogram exclude GI and genitourinary cysts and tumors. Complete excision of the cyst, including a bowel resection, if necessary, is the treatment of choice and it has excellent postoperative results. The authors experienced three new cases of mesenteric cysts from March 1986 to July 1997 in Chonbuk National University Hospital. These cases are reported in this paper, along with a review of the literature on mesenteric cysts.