Pub Date : 2018-06-01DOI: 10.13029/JKAPS.2018.24.1.5
Ji-Won Han, J. Youn, Hee-Beom Yang, Chaeyoun Oh, Hyun Young Kim, Sung-Eun Jung
Purpose: Preoperative ultrasonography (USG) in pediatric inguinal hernia has controversy. In this study, we analyzed the cases of pediatric inguinal hernia with/without preoperative USG and discussed whether USG is necessary. Methods: We reviewed medical records of 1,441 patients who underwent inguinal hernia repair in Seoul National University Children’s Hospital between January 2011 and August 2016 retrospectively. Results: Male were 69.3% and age at operation was 37.8±36.5 months old. There were 150 patients (10.4%) performed USG preoperatively. The department ordered to perform USG included department of surgery (n=71), emergency medicine (n=42), pediatrics (n=26), urology (n=10) and outside hospital (n=1). The reasons of performing USG included evaluation for hernia laterality (n=82), incarceration (n=28), testis (n=15), request of parents (n=14), scrotal mass (n=6) and incidentally found during evaluation for another disease (n=5). Excepting 5 cases of incidental finding, of 145 cases with USG, 12 (8.3%) cases changed the surgical plan; change to bilateral repair from unilateral repair (n=5), emergency operation due to incarceration (n=4) which include 1 salpingo-oophorectomy, 1 open abdomen surgery and 2 hernia repair after reduction of ovary, change to co-operation of orchiopexy (n=2) and change to laparoscopic surgery from open surgery due to herniation of both ovaries into one inguinal canal (n=1). In group without USG (n=1,291), 5 patients (0.4%) had unexpected problems during operation; 2 co-operation of orchiopexy because of transverse testicular ectopia (n=1) and right undescended testis (n=1), 2 hypertrophy of major labia and 1 retroperitoneal lymphangioma at inguinal area misdiagnosed as inguinal hernia. Conclusion: It was difficult to interpret the meaning of preoperative USG because not all patients had performed it. In this study, 10.4% of patients performed USG and 8.3% of them changed surgical plan. About 0.4% of patients without preoperative USG would have benefited from it for surgery if they had performed it. Since the percentage is too low, it is unreasonable to conclude that USG has diagnostic utility in inguinal hernia in this study.
{"title":"Is Preoperative Ultrasonography Necessary in Pediatric Inguinal Hernia","authors":"Ji-Won Han, J. Youn, Hee-Beom Yang, Chaeyoun Oh, Hyun Young Kim, Sung-Eun Jung","doi":"10.13029/JKAPS.2018.24.1.5","DOIUrl":"https://doi.org/10.13029/JKAPS.2018.24.1.5","url":null,"abstract":"Purpose: Preoperative ultrasonography (USG) in pediatric inguinal hernia has controversy. In this study, we analyzed the cases of pediatric inguinal hernia with/without preoperative USG and discussed whether USG is necessary. Methods: We reviewed medical records of 1,441 patients who underwent inguinal hernia repair in Seoul National University Children’s Hospital between January 2011 and August 2016 retrospectively. Results: Male were 69.3% and age at operation was 37.8±36.5 months old. There were 150 patients (10.4%) performed USG preoperatively. The department ordered to perform USG included department of surgery (n=71), emergency medicine (n=42), pediatrics (n=26), urology (n=10) and outside hospital (n=1). The reasons of performing USG included evaluation for hernia laterality (n=82), incarceration (n=28), testis (n=15), request of parents (n=14), scrotal mass (n=6) and incidentally found during evaluation for another disease (n=5). Excepting 5 cases of incidental finding, of 145 cases with USG, 12 (8.3%) cases changed the surgical plan; change to bilateral repair from unilateral repair (n=5), emergency operation due to incarceration (n=4) which include 1 salpingo-oophorectomy, 1 open abdomen surgery and 2 hernia repair after reduction of ovary, change to co-operation of orchiopexy (n=2) and change to laparoscopic surgery from open surgery due to herniation of both ovaries into one inguinal canal (n=1). In group without USG (n=1,291), 5 patients (0.4%) had unexpected problems during operation; 2 co-operation of orchiopexy because of transverse testicular ectopia (n=1) and right undescended testis (n=1), 2 hypertrophy of major labia and 1 retroperitoneal lymphangioma at inguinal area misdiagnosed as inguinal hernia. Conclusion: It was difficult to interpret the meaning of preoperative USG because not all patients had performed it. In this study, 10.4% of patients performed USG and 8.3% of them changed surgical plan. About 0.4% of patients without preoperative USG would have benefited from it for surgery if they had performed it. Since the percentage is too low, it is unreasonable to conclude that USG has diagnostic utility in inguinal hernia in this study.","PeriodicalId":164943,"journal":{"name":"Journal of Korean Association of Pediatric Surgeons","volume":"56 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115987962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-06-01DOI: 10.13029/JKAPS.2018.24.1.20
K. Ihn, Eun-jung Koo, I. Ho, S. Han, J. Oh
Purpose: Santulli enterostomy has been used for various surgical abdominal conditions that require temporary diversion of bowel during a neonatal period. The aim of this study was to report clinical outcomes of Santulli enterostomy and to evaluate its usefulness. Methods: Between January 2000 and December 2016, 40 neonates who underwent Santulli enterostomy were enrolled; Santulli enterostomies were performed for 25 patients without previous laparotomy (primary Santulli group) and 15 patients with previous laparotomy (secondary Santulli group). Results: Small bowel atresia is the first common indication of Santulli enterostomy (22/40, 55.0%), and luminal discrepancy between proximal and distal bowel was the most common determinant factor of Santulli enterostomy (17/40, 42.5%). The median age at surgery and mean birth weight were 2 days and 2,480 g respectively in the primary group, and 71 days, 2,340 g respectively in the secondary group. Operation time was significantly longer in the secondary group than the primary group (156±48 minutes vs. 224±95 minutes, p=0.019), and there was no difference in the time taken to initiation of oral feeding between the two groups. Santulli enterostomy closure was performed at median 65 days after Santulli enterostomy for primary group and 70 days for secondary group. Six complications (15.0%) were found after Santulli enterostomy, and nine complications (24.3%) after Santulli enterostomy closure (p=0.302). The incidence of complications was significantly higher in secondary group than in primary group (4.5% vs. 53.3%, p=0.001), and the reoperation rate was also significantly higher in the secondary group (4.5% vs. 46.7%, p=0.004). Conclusion: Santulli enterostomy could be applied as a temporary enterostomy in neonatal patients with various surgical abdominal diseases. Considering the high complication rate after secondary Santulli enterostomy closure, decision making on the timing of enterostomy closure should be done with caution.
目的:Santulli肠造口术已用于各种外科腹部条件，需要暂时转移肠在新生儿时期。本研究的目的是报告Santulli肠造口术的临床结果并评估其有效性。方法:2000年1月至2016年12月，选取40例接受Santulli肠造口术的新生儿;25例无剖腹手术史的患者(一次Santulli组)和15例有剖腹手术史的患者(二次Santulli组)行Santulli肠造口术。结果:小肠闭锁是Santulli肠造口术的第一个常见适应症(22/40,55.0%)，近端和远端肠管腔差异是Santulli肠造口术最常见的决定因素(17/40,42.5%)。第一组的中位手术年龄和平均出生体重分别为2天和2480 g，第二组分别为71天和2340 g。第二组手术时间明显长于第一组(156±48 min vs. 224±95 min, p=0.019)，两组开始口服喂养所需时间无差异。第一组Santulli肠造口术后中位时间为65天，第二组为70天。Santulli肠造口术后并发症6例(15.0%)，关闭Santulli肠造口术后并发症9例(24.3%)(p=0.302)。继发组并发症发生率显著高于原发性组(4.5%比53.3%，p=0.001)，再手术率显著高于原发性组(4.5%比46.7%，p=0.004)。结论:Santulli肠造口术可作为新生儿各种腹部外科疾病的临时肠造口术。考虑到二次Santulli肠造口术后并发症发生率高，应慎重选择肠造口闭合时机。
{"title":"Santulli Enterostomy: A Considerable Method for Patients Who Require Proximal Enterostomy","authors":"K. Ihn, Eun-jung Koo, I. Ho, S. Han, J. Oh","doi":"10.13029/JKAPS.2018.24.1.20","DOIUrl":"https://doi.org/10.13029/JKAPS.2018.24.1.20","url":null,"abstract":"Purpose: Santulli enterostomy has been used for various surgical abdominal conditions that require temporary diversion of bowel during a neonatal period. The aim of this study was to report clinical outcomes of Santulli enterostomy and to evaluate its usefulness. Methods: Between January 2000 and December 2016, 40 neonates who underwent Santulli enterostomy were enrolled; Santulli enterostomies were performed for 25 patients without previous laparotomy (primary Santulli group) and 15 patients with previous laparotomy (secondary Santulli group). Results: Small bowel atresia is the first common indication of Santulli enterostomy (22/40, 55.0%), and luminal discrepancy between proximal and distal bowel was the most common determinant factor of Santulli enterostomy (17/40, 42.5%). The median age at surgery and mean birth weight were 2 days and 2,480 g respectively in the primary group, and 71 days, 2,340 g respectively in the secondary group. Operation time was significantly longer in the secondary group than the primary group (156±48 minutes vs. 224±95 minutes, p=0.019), and there was no difference in the time taken to initiation of oral feeding between the two groups. Santulli enterostomy closure was performed at median 65 days after Santulli enterostomy for primary group and 70 days for secondary group. Six complications (15.0%) were found after Santulli enterostomy, and nine complications (24.3%) after Santulli enterostomy closure (p=0.302). The incidence of complications was significantly higher in secondary group than in primary group (4.5% vs. 53.3%, p=0.001), and the reoperation rate was also significantly higher in the secondary group (4.5% vs. 46.7%, p=0.004). Conclusion: Santulli enterostomy could be applied as a temporary enterostomy in neonatal patients with various surgical abdominal diseases. Considering the high complication rate after secondary Santulli enterostomy closure, decision making on the timing of enterostomy closure should be done with caution.","PeriodicalId":164943,"journal":{"name":"Journal of Korean Association of Pediatric Surgeons","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131202323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-06-01DOI: 10.13029/JKAPS.2018.24.1.26
Y. Kang, J. Youn, Ji-Won Han, Chaeyoun Oh, Sung-Eun Jung, Hyun Young Kim
An 18-year-old male patient with cerebral palsy and scoliokyphosis came to the emergency department with abdominal distension and vomiting. He was a situs inversus patient with a feeding gastrostomy tube. Sigmoid volvulus was initially suspected, so rectal tube insertion and endoscopic decompression were attempted, but failed. So he went through explorative laparotomy, and transverse colonic adhesion and twisting around the gastrostomy tube and gastric wall was identified. Adhesiolysis and resection with redundant transverse colon and end-to-end colocolic anastomosis was performed. He discharged with symptom free. Suspecting transverse colonic volvulus is important when the patient has anatomical anomalies and feeding gastrostomy tube. Timely diagnosis with proper radiologic imaging should be made. Surgical resection of the redundant colon is needed for successful management of transverse colonic volvulus.
{"title":"Transverse Colon Volvulus around the Gastrostomy Tube in a Pediatric Situs Inversus Patient","authors":"Y. Kang, J. Youn, Ji-Won Han, Chaeyoun Oh, Sung-Eun Jung, Hyun Young Kim","doi":"10.13029/JKAPS.2018.24.1.26","DOIUrl":"https://doi.org/10.13029/JKAPS.2018.24.1.26","url":null,"abstract":"An 18-year-old male patient with cerebral palsy and scoliokyphosis came to the emergency department with abdominal distension and vomiting. He was a situs inversus patient with a feeding gastrostomy tube. Sigmoid volvulus was initially suspected, so rectal tube insertion and endoscopic decompression were attempted, but failed. So he went through explorative laparotomy, and transverse colonic adhesion and twisting around the gastrostomy tube and gastric wall was identified. Adhesiolysis and resection with redundant transverse colon and end-to-end colocolic anastomosis was performed. He discharged with symptom free. Suspecting transverse colonic volvulus is important when the patient has anatomical anomalies and feeding gastrostomy tube. Timely diagnosis with proper radiologic imaging should be made. Surgical resection of the redundant colon is needed for successful management of transverse colonic volvulus.","PeriodicalId":164943,"journal":{"name":"Journal of Korean Association of Pediatric Surgeons","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132540649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-06-01DOI: 10.13029/JKAPS.2018.24.1.1
Soo-Hong Kim, Hyun Young Kim
Congenital esophageal stenosis (CES) is a rare disease that has been reported to occur once in every 25,000 to 50,000 births. According to its etiology, CES is divided into 3 subtypes, tracheobronchial remnants (TBR), fibromuscular hypertrophy (FMH) and membranous diaphragm (MD). Symptoms begin at the weaning period and the introduction of solid food around 6 months with dysphagia and vomiting. Esophagography is first screening test and endoscopic ultrasonography plays important roles to diagnose subtypes deciding therapeutic plan. TBRs were generally treated with surgical resection and end-to-end anasotomosis, whereas FMH and MD had good response rate to endoscopic or radiologic guided dilatation. This article reviews the literature on the etiology, clinical course, diagnosis and management of CES including recent opinion.
{"title":"Congenital Esophageal Stenosis in Children: From Etiology to Prognosis","authors":"Soo-Hong Kim, Hyun Young Kim","doi":"10.13029/JKAPS.2018.24.1.1","DOIUrl":"https://doi.org/10.13029/JKAPS.2018.24.1.1","url":null,"abstract":"Congenital esophageal stenosis (CES) is a rare disease that has been reported to occur once in every 25,000 to 50,000 births. According to its etiology, CES is divided into 3 subtypes, tracheobronchial remnants (TBR), fibromuscular hypertrophy (FMH) and membranous diaphragm (MD). Symptoms begin at the weaning period and the introduction of solid food around 6 months with dysphagia and vomiting. Esophagography is first screening test and endoscopic ultrasonography plays important roles to diagnose subtypes deciding therapeutic plan. TBRs were generally treated with surgical resection and end-to-end anasotomosis, whereas FMH and MD had good response rate to endoscopic or radiologic guided dilatation. This article reviews the literature on the etiology, clinical course, diagnosis and management of CES including recent opinion.","PeriodicalId":164943,"journal":{"name":"Journal of Korean Association of Pediatric Surgeons","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116240255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-06-01DOI: 10.13029/JKAPS.2018.24.1.10
Ju Yeon Lee, D. Kim, Jeong Rye Kim, J. Namgoong, S. Kim
Is Barium Enema Reliable for the Diagnosis of Total Colonic Aganglionosis? Ju Yeon Lee, Dae Yeon Kim, Jeong Rye Kim, Jung-Man Namgoong, Seong Chul Kim Department of Pediatric Surgery, Chonnam National University Children’s Hospital, Chonnam National University School of Medicine, Gwangju, Department of Pediatric Surgery, Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, Seoul, Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
{"title":"Is Barium Enema Reliable for the Diagnosis of Total Colonic Aganglionosis","authors":"Ju Yeon Lee, D. Kim, Jeong Rye Kim, J. Namgoong, S. Kim","doi":"10.13029/JKAPS.2018.24.1.10","DOIUrl":"https://doi.org/10.13029/JKAPS.2018.24.1.10","url":null,"abstract":"Is Barium Enema Reliable for the Diagnosis of Total Colonic Aganglionosis? Ju Yeon Lee, Dae Yeon Kim, Jeong Rye Kim, Jung-Man Namgoong, Seong Chul Kim Department of Pediatric Surgery, Chonnam National University Children’s Hospital, Chonnam National University School of Medicine, Gwangju, Department of Pediatric Surgery, Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, Seoul, Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea","PeriodicalId":164943,"journal":{"name":"Journal of Korean Association of Pediatric Surgeons","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132497409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-06-01DOI: 10.13029/JKAPS.2018.24.1.14
J. H. Park, S. Nam
Purpose: The management of lymphatic malformation (LM) in pediatric patients is challenging. Complete excision of LM is difficult to achieve in some cases. We reviewed our experience how to manage LM. Methods: We retrospectively reviewed the patients who were treated for LM between 2010 and 2017. Medical records were reviewed about age of diagnosis, age of treatment age, gender, symptom, location of tumor, treatment modality, response and complication. Results: Sixty-three patients (39 boys and 24 girls) were included. Mean age at diagnosis was 14.5±28.0 months (range, neonate-10 years). The involved lesion were head and neck in 27 patients (42.9%), abdominal cavity in 7 patients (11.1%), chest wall and abdominal wall in 11 patients (17.5%), buttock in 7 patients (11.1%), and extremities in 11 patients (17.5%). The treatment options were including surgical resection in 32 patients, sclerotherapy in 7 patients, surgical resection combined sclerotherapy in 19 patients, and close observation in 5 patients. We achieved complete remission in 39 patients. Fourteen patients showed partial remission and 6 showed recurrences. Conclusion: Despite surgical difficulty, meticulous excision with supportive treatment, and adjuvant sclerotherapy could get a favorable outcome without fatal complication. Decision should be based on surgeon’s experience, location of LM, related symptoms, and consultation with patient’s parents.
{"title":"The Treatment Experience of Lymphatic Malformations in Pediatric Patients","authors":"J. H. Park, S. Nam","doi":"10.13029/JKAPS.2018.24.1.14","DOIUrl":"https://doi.org/10.13029/JKAPS.2018.24.1.14","url":null,"abstract":"Purpose: The management of lymphatic malformation (LM) in pediatric patients is challenging. Complete excision of LM is difficult to achieve in some cases. We reviewed our experience how to manage LM. Methods: We retrospectively reviewed the patients who were treated for LM between 2010 and 2017. Medical records were reviewed about age of diagnosis, age of treatment age, gender, symptom, location of tumor, treatment modality, response and complication. Results: Sixty-three patients (39 boys and 24 girls) were included. Mean age at diagnosis was 14.5±28.0 months (range, neonate-10 years). The involved lesion were head and neck in 27 patients (42.9%), abdominal cavity in 7 patients (11.1%), chest wall and abdominal wall in 11 patients (17.5%), buttock in 7 patients (11.1%), and extremities in 11 patients (17.5%). The treatment options were including surgical resection in 32 patients, sclerotherapy in 7 patients, surgical resection combined sclerotherapy in 19 patients, and close observation in 5 patients. We achieved complete remission in 39 patients. Fourteen patients showed partial remission and 6 showed recurrences. Conclusion: Despite surgical difficulty, meticulous excision with supportive treatment, and adjuvant sclerotherapy could get a favorable outcome without fatal complication. Decision should be based on surgeon’s experience, location of LM, related symptoms, and consultation with patient’s parents.","PeriodicalId":164943,"journal":{"name":"Journal of Korean Association of Pediatric Surgeons","volume":"145 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133766694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-06-01DOI: 10.13029/JKAPS.2018.24.1.30
K. Ihn, Eun-jung Koo, I. Ho, Dongeun Lee, S. Han
A 6-year-old male who lived with a mother in a single-parent family was referred to the emergency room with multiple traumas. There was no specific finding on CT scan of the other hospital performed 55 days before admission. However, CT scan at the time of admission showed common bile duct (CBD) stenosis, proximal biliary dilatation and bile lake formation at the segment II and III. Endoscopic retrograde biliary drainage was performed, but the tube had slipped off spontaneously 36 days later, and follow-up CT scan showed aggravated proximal biliary dilatation above the stricture site. He underwent excision of the CBD including the stricture site, and the bile duct was reconstructed with Roux-en-Y hepaticojejunostomy. Pathologic report of the resected specimen revealed that the evidence of trauma as a cause of bile duct stricture. While non-iatrogenic extrahepatic biliary trauma is uncommon, a level of suspicion is necessary to identify injuries to the extrahepatic bile duct. The role of the physicians who treat the abused children should encompass being suspicious for potential abdominal injury as well as identifying visible injuries.
{"title":"Bile Duct Stricture and Intrahepatic Cystic Formation after Abdominal Injury due to Child Abuse: A Case Report","authors":"K. Ihn, Eun-jung Koo, I. Ho, Dongeun Lee, S. Han","doi":"10.13029/JKAPS.2018.24.1.30","DOIUrl":"https://doi.org/10.13029/JKAPS.2018.24.1.30","url":null,"abstract":"A 6-year-old male who lived with a mother in a single-parent family was referred to the emergency room with multiple traumas. There was no specific finding on CT scan of the other hospital performed 55 days before admission. However, CT scan at the time of admission showed common bile duct (CBD) stenosis, proximal biliary dilatation and bile lake formation at the segment II and III. Endoscopic retrograde biliary drainage was performed, but the tube had slipped off spontaneously 36 days later, and follow-up CT scan showed aggravated proximal biliary dilatation above the stricture site. He underwent excision of the CBD including the stricture site, and the bile duct was reconstructed with Roux-en-Y hepaticojejunostomy. Pathologic report of the resected specimen revealed that the evidence of trauma as a cause of bile duct stricture. While non-iatrogenic extrahepatic biliary trauma is uncommon, a level of suspicion is necessary to identify injuries to the extrahepatic bile duct. The role of the physicians who treat the abused children should encompass being suspicious for potential abdominal injury as well as identifying visible injuries.","PeriodicalId":164943,"journal":{"name":"Journal of Korean Association of Pediatric Surgeons","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130198359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-12-01DOI: 10.13029/JKAPS.2017.23.2.19
J. Youn, D. Jung, Soo-Hong Kim, Sung-Eun Jung, K. Park, Hyun Young Kim
Soft Tissue Hemangioendothelioma in Children Joong Kee Youn, Do-Hyun Jung, Soo-Hong Kim, Sung-Eun Jung, Kwi-Won Park, Hyun-Young Kim Department of Pediatric Surgery, Seoul National University College of Medicine, Department of Surgery, Korea University Guro Hospital, Seoul, Department of Pediatric Surgery, Pusan National University Yangsan Hospital, Yangsan, Department of Surgery, Chung-Ang University Hospital, Seoul, Korea
{"title":"Soft Tissue Hemangioendothelioma in Children","authors":"J. Youn, D. Jung, Soo-Hong Kim, Sung-Eun Jung, K. Park, Hyun Young Kim","doi":"10.13029/JKAPS.2017.23.2.19","DOIUrl":"https://doi.org/10.13029/JKAPS.2017.23.2.19","url":null,"abstract":"Soft Tissue Hemangioendothelioma in Children Joong Kee Youn, Do-Hyun Jung, Soo-Hong Kim, Sung-Eun Jung, Kwi-Won Park, Hyun-Young Kim Department of Pediatric Surgery, Seoul National University College of Medicine, Department of Surgery, Korea University Guro Hospital, Seoul, Department of Pediatric Surgery, Pusan National University Yangsan Hospital, Yangsan, Department of Surgery, Chung-Ang University Hospital, Seoul, Korea","PeriodicalId":164943,"journal":{"name":"Journal of Korean Association of Pediatric Surgeons","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114680665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-12-01DOI: 10.13029/JKAPS.2017.23.2.48
Y. Cho, D. Kim
Purpose: Inguinal hernia in early infant is a challenging surgical condition. This study aims to evaluate the efficacy and safety of laparoscopic inguinal hernia repair (LH) for small babies in corrected age 3 months compared with the traditional open inguinal hernia repair (OH). Methods: Medical records were retrospectively reviewed in 232 pediatric patients under corrected age 3 months who underwent inguinal hernia repair from January 1, 2013 to December 31, 2015. The chi-squared and Fisher’s exact test were used to analyze the results of the study. Results: As for operative time, in unilateral/bilateral inguinal hernia repair, OH is faster than LH (p<0.05 vs. p=0.06). But operation time gap is shorter in bilateral hernia than unilateral hernia. As for operation site, bilateral inguinal hernia case was more performed in LH than OH (p<0.05). For comparison with the spontaneous breathing recovery time, there was no statistical difference between the two techniques (p=0.96). As for the recurrence rate, no significant difference was observed between the two techniques (p=0.36), whereas the relative risk of recurrence was higher for OH compared with LH (OR=1.56). Conclusion: LH is also feasible and safe procedure as OH for small babies in corrected age 3 months for experienced pediatric surgeons.
目的:婴儿早期腹股沟疝是一种具有挑战性的手术条件。本研究旨在评价腹腔镜腹股沟疝修补术(LH)与传统开放式腹股沟疝修补术(OH)对矫正3月龄小婴儿的疗效和安全性。方法:回顾性分析2013年1月1日至2015年12月31日232例矫正年龄小于3个月的小儿腹股沟疝修补术的病历。采用卡方检验和Fisher精确检验对研究结果进行分析。结果:手术时间方面，在单侧/双侧腹股沟疝修补中，OH比LH快(p<0.05 vs. p=0.06)。但双侧疝手术时间比单侧疝短。在手术部位上，双侧腹股沟疝患者LH组多于OH组(p<0.05)。两种方法的自主呼吸恢复时间比较，差异无统计学意义(p=0.96)。两种方法的复发率差异无统计学意义(p=0.36)，而OH的相对复发率高于LH (OR=1.56)。结论:对于经验丰富的儿科医生来说，对于矫正3月龄的小婴儿，LH也是可行且安全的手术。
{"title":"Laparoscopic versus Open Herniorrhapy in Corrected Age 3 Months","authors":"Y. Cho, D. Kim","doi":"10.13029/JKAPS.2017.23.2.48","DOIUrl":"https://doi.org/10.13029/JKAPS.2017.23.2.48","url":null,"abstract":"Purpose: Inguinal hernia in early infant is a challenging surgical condition. This study aims to evaluate the efficacy and safety of laparoscopic inguinal hernia repair (LH) for small babies in corrected age 3 months compared with the traditional open inguinal hernia repair (OH). Methods: Medical records were retrospectively reviewed in 232 pediatric patients under corrected age 3 months who underwent inguinal hernia repair from January 1, 2013 to December 31, 2015. The chi-squared and Fisher’s exact test were used to analyze the results of the study. Results: As for operative time, in unilateral/bilateral inguinal hernia repair, OH is faster than LH (p<0.05 vs. p=0.06). But operation time gap is shorter in bilateral hernia than unilateral hernia. As for operation site, bilateral inguinal hernia case was more performed in LH than OH (p<0.05). For comparison with the spontaneous breathing recovery time, there was no statistical difference between the two techniques (p=0.96). As for the recurrence rate, no significant difference was observed between the two techniques (p=0.36), whereas the relative risk of recurrence was higher for OH compared with LH (OR=1.56). Conclusion: LH is also feasible and safe procedure as OH for small babies in corrected age 3 months for experienced pediatric surgeons.","PeriodicalId":164943,"journal":{"name":"Journal of Korean Association of Pediatric Surgeons","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129643081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-12-01DOI: 10.13029/JKAPS.2017.23.2.37
Hyunhee Kwon, Ju Yeon Lee, Jung-Man Namgung, D. Kim, S. Kim
Purpose: Spontaneous neonatal gastric perforation is a rare but fatal disease with unclear etiology. In this study, we reviewed its clinical manifestations, outcomes, and discussed the etiology and prognostic factors. Methods: There were 12 neonates with gastric perforation in our hospital from 1989 to 2015. Their medical records were reviewed retro-spectively including birth record, associated disease, site and size of perforation, type of surgical management, clinical outcome. Also, the prognostic factors were analyzed. Results: The median gestational age and birth weight was 32 weeks (range, 26-43 weeks; preterm birth rate, 66.7%) and 1,883 g (range, 470-4,400 g), respectively. Five patients had associated gastrointestinal anomalies including esophageal atresia and tracheoesophageal fistula (two patients), midgut volvulus, non-rotation and microcolon, and meconium plug syndrome. The median age at surgery was six days after birth (range, 2-13 days), and the median weight at surgery was 1,620 g (range, 510-3,240 g). Upper third part of stomach was the most frequently involved location of perforation. The size of perforation varied from pin point to involving the whole greater curvature. Primary repairs were done in seven cases, and in five cases, resections of necrotic portion were needed. Mortality rate was 33.3% (n=4), morbidity (re-operation) rate was 16.7% (n=2). The causes of death were sepsis (n=3), and heart failure from Ebstein anomaly (n=1). The median hospital stay was 92.5 days (range, 1-176 days). The factors mentioned as prognostic factors in previous studies showed no significant relations to the mortality and morbidity in our study. Conclusion: There were improvements of outcomes in patients with large size perforation. As previous studies, we assume these improvements were possible due to the improvements of critical care medicine. Given that rare incidence, a multi-center study can help us get a better understanding of this disease, and a better outcome.
{"title":"Clinical Review of Spontaneous Neonatal Gastric Perforation","authors":"Hyunhee Kwon, Ju Yeon Lee, Jung-Man Namgung, D. Kim, S. Kim","doi":"10.13029/JKAPS.2017.23.2.37","DOIUrl":"https://doi.org/10.13029/JKAPS.2017.23.2.37","url":null,"abstract":"Purpose: Spontaneous neonatal gastric perforation is a rare but fatal disease with unclear etiology. In this study, we reviewed its clinical manifestations, outcomes, and discussed the etiology and prognostic factors. Methods: There were 12 neonates with gastric perforation in our hospital from 1989 to 2015. Their medical records were reviewed retro-spectively including birth record, associated disease, site and size of perforation, type of surgical management, clinical outcome. Also, the prognostic factors were analyzed. Results: The median gestational age and birth weight was 32 weeks (range, 26-43 weeks; preterm birth rate, 66.7%) and 1,883 g (range, 470-4,400 g), respectively. Five patients had associated gastrointestinal anomalies including esophageal atresia and tracheoesophageal fistula (two patients), midgut volvulus, non-rotation and microcolon, and meconium plug syndrome. The median age at surgery was six days after birth (range, 2-13 days), and the median weight at surgery was 1,620 g (range, 510-3,240 g). Upper third part of stomach was the most frequently involved location of perforation. The size of perforation varied from pin point to involving the whole greater curvature. Primary repairs were done in seven cases, and in five cases, resections of necrotic portion were needed. Mortality rate was 33.3% (n=4), morbidity (re-operation) rate was 16.7% (n=2). The causes of death were sepsis (n=3), and heart failure from Ebstein anomaly (n=1). The median hospital stay was 92.5 days (range, 1-176 days). The factors mentioned as prognostic factors in previous studies showed no significant relations to the mortality and morbidity in our study. Conclusion: There were improvements of outcomes in patients with large size perforation. As previous studies, we assume these improvements were possible due to the improvements of critical care medicine. Given that rare incidence, a multi-center study can help us get a better understanding of this disease, and a better outcome.","PeriodicalId":164943,"journal":{"name":"Journal of Korean Association of Pediatric Surgeons","volume":"225 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123247237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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