Acute Appendicitis in Children under Age of 5 Years

PURPOSE: Acute appendicitis is one of the most common causes of abdominal emergency. Children, under age of 5 years, are unable to give an accurate history, but other nonspecific abdominal pain is more common at this age. Because diagnosis is often delayed and progression of appendicitis is faster, incidence and perforation rate is higher than those of adults. Abdominal US and CT are helpful in diagnosis of acute appendicitis. METHODS: Between July, 1997 and April, 2004, 39 patients below 5-year-old were participated, but 2 (Negative) patients were excluded. This study was done retrospectively based on medical charts. For statistical analysis, Chi-squre test was used. RESULTS: All patients undergone emergency operations, in which male to female ratio was 1.79: 1, with its mean age of 4.05. 19 patients (49%) were perforated and fever developed more frequently in perforating group, but leukocytosis was not significant. Delayed preoperative duration was associated with perforation rate significantly. All complications were occurred in perforating group. CONCLUSION: To decrease perforation rate and complications, early diagnosis and management are necessary to avoid delaying preoperative time.

Epigastric Hernia

An epigastric hernia is a protrusion of the extra-peritoneal fat to the linea alba, between the xiphoid process and the umbilicus. About 3~5% of people develop epigastric hernias. The authors have experienced a case of a 79 year-old woman who had an asymptomatic epigastric hernia, where an abdomen CT is helpful in its diagnosis. The size of the defect was large, and a hernia sac existed. The case of an epigastric hernia, which was treated by a primary repair, is reported, with a brief review of the literature.

Intestinal Obstruction Due to Incarcerated Hernia at CAPD Catheter Insertion Site

Patients who have undergone peritoneal dialysis can frequently experience abdominal wall complications, such as hernia due to increased intraabdominal pressure and peritoneal leakage. However, no case of incarcerated abdominal wall hernia through catheter insertion site of CAPD has yet been reported Recently the authors experienced a case of intestinal obstruction due to an incarcerated hernia at the catheter insertion site of CAPD. We report this case and present a literature review.

Duodenal Lymphangioma

A lymphangioma is comparatively rare in the elimentary tract, and is a benign tumor of the lymphatic system. A duodenal lymphangioma is especially rare, and has an obscure etiology. Clinically, and in the laboratory the are non-specific, and are incidentally found by endoscopy, and their treatment is total excision. Recently, the authors experienced a 45 year-old woman, who had a duodenal lymphangioma, but with no symptom. An endoscopic examination revealed a single, about 2 cm, polypoid lesion below the ampulla. The lesion was successfully excised after a duodenotomy.