Anisakiasis Induced Segmental Jejunum Obstruction / 대한소화기학회지

Human anisakiasis is a disease caused by an infestation of the third stage larvae of family anisakidae. The ingested larvae invade the gastrointestinal wall, causing clinical symptoms that include abdomen pain, nausea, and vomiting. Although enteric anisakiasis is extremely rare, it can induce intestinal obstruction. We report a case in which emergency surgery was needed due to intestinal obstruction that coincided with symptoms related to anisakiasis, along with a brief literature review.

Neuroendocrine Tumor of the Colon

Neuroendocrine tumor (NET) of the colon and rectum has been reported to have a low incidence and aggressive progression; it is frequently misdiagnosed and its treatment is not well documented. Four NET cases were collected at our hospital during the previous year of a colon cancer survey. Endoscopic mucosal biopsy of the colon was done for each case and all the cases proved to be adenocarcinomas. Curative surgery was conducted after the preoperative diagnostic and staging evaluation was completed. The locations of the primary lesions of the patients were all different; cecum, ascending colon, splenic flexure colon and sigmoid colon. The disease was advanced in all cases and the first postoperative diagnosis was poorly differentiated adenocarcinoma. Immunohistochemical tests followed and all the cases were positive for chromogranin A staining. A retrospective study was then conducted.

A Case of Non-immune Hydrops Fetalis due to Intraperitoneal Hemangioma

Hydrops describes the infant who has generalized edema due to accumulation of excess fluid. In severe case, massive edema with ascites and pleural and pericardial effusions are commonly combined. The main etiology of hydrops fetalis has been changed from immune type which is caused by fetomaternal blood group incompatibility to nonimmune type. Although cardiovascular diseases are the most common (23% to 38%) causes for nonimmune hydrops fetalis, fetal tumors still compromise 5% to 7% of the diseases. We report a case of nonimmune hydrops fetalis due to intraperitoneal hemangioma. The newborn infant was managed surgically and had excellent outcome.

Spontaneous Ileal Perforation in Very Low Birth Weight Infant without Evidence of Necrotizing Enterocolitis

Ongoing advances in the treatment of very-low-birth-weight infants have confronted us with a growing number of infants susceptible to acquired illnesses of the gastrointestinal tract. Although necrotizing enterocolitis has been regarded as the major cause of gastrointestinal perforation in preterm infants, the incidence of spontaneous perforation occurred in an apparently normal bowel is increasing. The risk factors for spontaneous intestinal perforation include prematurity, twin pregnancies, perinatal asphyxia, prior use of umbilical artery catheter, use of indomethacin and/or steroid, and bacterial or fungal sepsis. We report a case of spontaneous ileal perforation occurred in very low birth weight infant who was successfully treated with emergency operation.

Primary Plasmacytoma of the Sigmoid Colon

Plasmacytoma is a lymphoid neoplasm with the histological, immunological, and functional features of an immunoglobulin- secreting B cell proliferation. Intestinal involvement may be a manifestation of a diffuse multiple myeloma or less commonly, a primary tumor. Gastric plasmacytomas occur more frequently than intestinal plasmacytomas. We experienced a woman who had a primary extramedullary plasmacytoma that originated in the sigmoid colon. She had suffered from abdominal pain and diarrhea for 4 months and underwent a colonoscopy examination. A colonoscopic biopsy revealed it to be ulcerative colitis, and she underwent a total colectomy as a result. However, the permanent biopsy finding was a plasmacytoma. We review the clinical manifestations, as well as the radiological and histopathological findings of a plasmacytoma.

Clinical Analysis of Abdominal Actinomycosis: 8 Cases

PURPOSE: Actinomycosis is still a relatively rare infection, characterized by multiple abscesses, draining sinuses and the appearance of sulfur granules, which are valuable in aiding the diagnosing the discharge of involved tissues. In most instances, the onset of an abdominal disease is preceded by inflammatory or a traumatic incident resulting in the perforation of the mucosa of the gastrointestinal tract. Intensive and prolonged antimicrobial therapy, and wide surgical excision of involved tissues are the two general principles of therapy. METHODS: We experienced 8 cases of abdominal actinomycosis after a laparotomy between March 1997 and February 2002. RESULTS: The results were as follows: 1) There was a 1: 1 male to female ratio of abdominal actinomycosis, and a mean age of 47 years. 2) The clinical features were different for each involved organ, -but, most of the clinical symptoms were nonspecific to suspect actinomycosis. 3) The frequently involved organs were mainly located lower abdomen, such as the appendix and cecum, sigmoid colon and small bowel. 4) In 60% of the patients, the predisposing factors were identifiable, these being: a previous abdominal operation, IUD and abdominal injury. 5) The preoperative diagnoses included: acute appendicitis, and periappendiceal and intra-abdominal abscesses. The pre-exploratory diagnoses were made by ultrasound and abdominal CT. 6) Explorations were performed in all patients, depending on their diagnosis, to afford the proper surgical treatment and correct diagnosis. After the operation, all the patients were treated with oral antibiotics for long period. CONCLUSION: The authors conclude that pre-exploratory cytological or culture studies, with careful history taking, for low abdominal tumors or abscesses may increase the rate of correct diagnosis, as could proper explorations.

Review of the Pathology and Differential Diagnosis of Acute Appendicitis

PURPOSE: Multiple methods are used to diagnose acute appendicitis. However, with the current practice, the negative laparotomy rate for acute appendicitis is from 15% up to 30%. This study was designed to evaluate various pathologies of the appendix and other intraabdominal organs of patients preoperatively diagnosed with acute appendicitis and to analyze clinically the difference between acute appendicitis and other intraabdominal inflammatory diseases. METHODS: We reviewed the pathologic reports of 833 patients who underwent laparotomies for acute appendicitis from January 1997 to December 2001. We grouped these patients by pathology. Group I included patients with a negative appendectomy and no other intraabdominal pathology, group II included those with lesions within the appendix, and group III, those with intraabdominal lesions other than in the appendix. We also analyzed the age, sex distributions, the typical symptoms of appendicitis, the duration of symptoms, fever, and leukocytosis of 100 patients with typical appendicitis by random sampling to find the clinical differences that existed between pelvic inflammatory disease and cecal diverticular disease presented as appendicitis. RESULTS: The diagnostic accuracy for acute appendicitis was 79.7%, and the negative appendectomy and negative laparotomy rates were 17.4% and 15.5%, respectively. The percents of patients in group I, II, and III were 10.4%, 82.6%, and 7.0%, respectively. CONCLUSIONS: It is important to consider the possibility of various pathologies during diagnostic and operative procedures for an acute abdomen, especially one occurring in the right lower quadrant.

Inflammatory Response of Secretoneurin -Immunoreactive Nerves in the Rat Uterus after Formalin Exposure / 체질인류학회지

It is known that there are numerous chemotatic secretoneurin -immunoreactive nerve fibers and movable MHC class II -immunoreactive dendritic cells in the normal uterine cervix. And the relationships between them are not fully understood. The aim of this study is to reveal that secretoneurin could give to chemotatic influence to dendritic cells in inflammational state. Virgin female Sprague -Dawley rats (n = 20; approximately 2 months old; 200 ~250 g body weight) were used in this study. Animals (n = 10) were injected with 5% formalin (0.5 ml/day, 5 days) in experiment group. Animals were deeply anesthetized with 3.5% chloral hydrate (100 mg/kg, i.p.) and uterine cervix were removed. Immunostaining was done according to standard methods used routinely. In brief, tissue sections were incubated with primary antibodies generated in mouse anti -rat MHC class II antibody and mouse or rabbit anti -rat secretoneurin antibody for single and double immunostains. FITC for secretoneurin and rhodamine for MHC class II were used as secondary antibodies in double stains. Tissue sections were observed by using light and confocal laser scanning microscopes. The results were as follows; 1. Numerous secretoneurin -immunoreactive nerve fibers were located in the lamina propria and those were not found in the epithelium of normal rat uterine cervix. 2. MHC class II -immunoreactive dendritic cells were mainly located in the epithelium and the lamina propria of normal rat uterine cervix. 3. On the inflammation state, MHC class II -immunoreactive dendritic cells were mainly located in the lamina propria and those were not found in the epithelium of rat uterine cervix. According to above results, it is suggested that secretoneurin can give to chemotatic influence to dendritic cells in inflammational state. Therefore, secretoneurin is considered to be used for dendritic cell immunotheraphy.

Effects of c -Fos Immunoreactivity on Central Nervous System after Administration of Aspirin / 체질인류학회지

Aspirin is one of the popular non -steroid anti -inflammatory drugs used in the management of pain. This study was performed to investigate the effects of aspirin on c -Fos expression in rat CNS after inducing somatic pain with formalin. Male S.D. rats were injected subcutaneously with 0.1 ml of 5% formalin in the plantar surface of right hindpaw. For experimental group, aspirin was administered orally before injection of formalin. Asprin -untreated group was utilized as the control group. Rats were sacrificed at 0.5, 1, 2, 6 and 24 hours after formalin injection. Rat brains were removed and sliced in rat brain matrix. Brain slices were coronally sectioned at interaural 5.70 ~6.70 mm. Serial sections were immunohisto-chemically reacted with polyclonal c -Fos antibody. The numbers of c -Fos protein immunoreactive neurons in the cingulate cortex, primary somatosensory area, and hippocampus were counted and analyzed statistically with Mann - Whitney U test. Results were as follows: 1. Higher numbers of c -Fos immunoreactive neurons were found in the cingulate cortex, primary somatosensory area and hippocampus. 2. Both aspirin -treated and -untreated groups, numbers of c -Fos immunoreactive neurons were significantly higher all time points than formalin -untreated group, which peacked at 2 hours. 3. The numbers of c -Fos immunoreactive neuron of the aspirin -treated group were less compared to the aspirin - untreated group at each time point. In conclusion, these results provide some basic knowledge in understanding the mechanism and control of formalin - induced somatic pain.

A Case of Postpartum Small Bowel Obstruction Following Vaginal Delivery / 대한산부인과학회잡지

Intestinal obstruction is a rare but important complication of pregnancy and puerperium leading to increased maternal and fetal motality. Diagnosis is often delayed or missed because many of the manifestations of intestinal obstruction such as nausea, vomiting and abdominal pain can be interpreted as pregnancy related symptoms. This delay in diagnosis or misdiagnosis, reluctance to surgery during pregnancy are thought to be responsible for the high maternal and fetal death rate. So we report a case of postpartum small bowel obstruction following vaginal delivery with a review of the literature.

A Case of Solitary Cecal Diverticulitis Misdiagnosed as a Cecal Tumor / 대한소화기내시경학회지

Cecal diverticulitis is a rare entity and remains a difficult diagnostic problem. Most patients are presented with an acute pain in the abdomen, which is nearly indistinguishable from that of appendicitis. Preoperative diagnostic studies are not helpful. Even with an operation, the correct diagnosis may be difficult to predict with certainty. The differential diagnosis between a cecal malignant tumor and a mass caused by inflammation due to cecal diverticulitis is difficult. Suspicion of a neoplastic process continues to prompt colectomy in an emergency setting. If diagnosed preoperatively, it can be treated effectively with a broad spectruum of antibiotics without surgical intervention. The physician must be aware this condition and be prepared to choose the most apropriate treatmetn. A case was experienced involving of solitary cecal diverticulitis misdiagnosed as a cecal tumor in a 61-year-o0ld female. This unique form of diverticulitis is herein reported with literature review.

Reoperation for benign biliary tract disease

No abstract available.