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A Pediatric Case of Mixed Acinar-Neuroendocrine Carcinoma 小儿腺泡-神经内分泌混合性癌1例
Pub Date : 2016-06-01 DOI: 10.13029/JKAPS.2016.22.1.14
J. Youn, H. Son, Sung-Eun Jung, Hyun Young Kim
Mixed acinar-neuroendocrine carcinoma (MANEC) is a malignant pancreatic tumor that rarely occurs in children. It is diagnosed pathologically according to the proportion of neuroendocrine cells present, highlighting the need for surgical biopsy. A 13-year-old boy presented with a 10-cm palpable mass on CT. Surgical resection was performed, and the pathological diagnosis was MANEC. There were no postoperative complications, and the patient was discharged from the hospital 10 days after surgery. He is presently undergoing adjuvant chemotherapy. We reviewed historical MANEC cases published in the English literature. We concluded that pathological analysis of a surgically resected specimen is necessary for an accurate diagnosis of MANEC, and that publication of more cases is needed to determine the optimal management strategy for MANEC.
混合性腺泡-神经内分泌癌(MANEC)是一种少见的儿童胰腺恶性肿瘤。根据神经内分泌细胞的比例进行病理诊断,强调手术活检的必要性。一个13岁的男孩在CT上表现为一个10厘米可触及的肿块。手术切除,病理诊断为MANEC。术后无并发症,术后10天出院。他目前正在接受辅助化疗。我们回顾了在英语文献中发表的历史MANEC病例。我们的结论是,手术切除标本的病理分析对于准确诊断MANEC是必要的,需要发表更多的病例来确定MANEC的最佳治疗策略。
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引用次数: 1
Risk Factors for Surgical Procedure on Ileo-Colic Intussusception in Children 儿童回肠-结肠肠套叠手术的危险因素
Pub Date : 2016-06-01 DOI: 10.13029/JKAPS.2016.22.1.10
Sin Kim, Soo-Min Jung, Jong-In Lee
Purpose: The aim of this study was to analyze of the risk factors for surgical procedure on ileo-colic intussusception without leading point in children. Methods: We retrospectively reviewed medical records of patient treated for ileo-colic intussusception between January 2003 and December 2014. We exclude the patients who had leading point. Because of the large difference on patient’s numbers between non-operative group (cases of ileo-colic intussusceptions successfully reduced by air reduction) and operative group (cases underwent operation due to failed air reduction), we compared the data of operative group of patients without leading point between 2003 and 2014 with the data of non-operative group as control group from 2013 to 2014. Clinical features such as gender, age, body temperature, body weight in diagnosis, growth curves for age-gender-body weight, and laboratory data of blood test were compared. Results: In non-operative group, total 94 patients who were treated successfully by the non-operative air reduction. In operative group, total 21 patients treated by surgical procedure. The age under 12 months, weight over upper 75 percentile group, increased segment neutrophil count, decreased hemoglobin level and lymphocyte count were significantly associated with a requirement for surgical procedure. Conclusion: We conclude that younger age, higher weight percentile group, increased segment neutrophil, decreased hemoglobin and lymphocyte are the independent risk factors related to operative treatment for ileo-colic intussusception in children. If primary air reduction is failed in patients with such risk factors, operative treatment over ultrasonography or secondary reduction can prevent unnecessary effort and complications, thus emphasizing the consideration of operative treatment when selecting treatment methods.
目的:本研究的目的是分析无导点的儿童回肠-结肠肠套叠手术的危险因素。方法:回顾性分析2003年1月至2014年12月收治的回肠-结肠肠套叠患者病历。我们排除了有领先优势的病人。由于非手术组(空气复位成功的回肠-结肠套叠病例)与手术组(空气复位失败的手术病例)患者数量差异较大,我们将2003 - 2014年无导点手术组患者的数据与2013 - 2014年非手术组作为对照组的数据进行比较。比较诊断时的性别、年龄、体温、体重等临床特征、年龄-性别-体重的生长曲线和血检实验室数据。结果:非手术组94例患者均成功行空气复位术。手术组共21例患者行手术治疗。年龄在12个月以下、体重超过75%以上组、节段中性粒细胞计数增加、血红蛋白水平和淋巴细胞计数降低与手术需求显著相关。结论:年龄小、体重百分位数组高、节段中性粒细胞增多、血红蛋白和淋巴细胞减少是儿童回肠-结肠肠套叠手术治疗的独立危险因素。有这些危险因素的患者,如果一次空气复位失败,手术治疗优于超声检查或二次复位,可以避免不必要的努力和并发症,因此在选择治疗方法时强调手术治疗的考虑。
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引用次数: 1
Newborns Surgery with Congenital Anomalies: A National Survey of Its Members by Korean Association of Pediatric Surgeons 新生儿手术与先天性异常:由韩国儿科外科医师协会其成员的全国调查
Pub Date : 2016-06-01 DOI: 10.13029/JKAPS.2016.22.1.1
Doe-Young Kim, S. C. Kim, Sung-Hoon Kim, Hye-Sun Kim, S. Nam, K. Park, J. B. Park, J. Y. Park, Taejin Park, Jeong-Meen Seo, J. Seol, J. Shin, J. Oh, M. D. Lee, Sangkyu Lee, S. C. Lee, E. Jang, H. Jang, S. Y. Jung, S. Jung, S. Jung, Y. Jung, Eunyoung Jung, Min-Jeong Cho, S. J. Choi, So Choi, Sh Choi, Y. M. Choi, S. Han, T. Heo
National survey for newborns surgery with congenital anomalies by Korean Association of Pediatric Surgeons (KAPS) was done. A questionnaire was sent to all members of the KAPS on March 2014. The current survey is to review three years status of the newborn surgery from 2012 to 2013. Thirty-four members (27.9%) took part in the survey that included data for the diagnosis, number and procedures of neonatal surgical cases. The result was discussed at the Topic Discussion section of the 30th Annual Congress of KAPS, 2014.
韩国儿科外科医师协会(KAPS)对新生儿先天性畸形手术进行了全国调查。2014年3月,向KAPS的所有成员发送了一份调查问卷。本次调查是回顾2012 - 2013年三年来新生儿外科手术的现状。34名成员(27.9%)参加了调查,包括新生儿手术病例的诊断、数量和程序数据。该结果在2014年第30届KAPS年会的主题讨论部分进行了讨论。
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引用次数: 2
Panperitonitis due to Perforation of Meckel Diverticulum in Infant Period 婴儿期梅克尔憩室穿孔所致腹膜炎
Pub Date : 2015-12-01 DOI: 10.13029/JKAPS.2015.21.2.38
Dong Won Lee, Sung-woo Cho, Seung Hyun Lee, D. Kang, S. Yu
The perforation and subsequent panperitonitis as one of the complications of a Meckel diverticulum is a rare complication, especially in infants. Complication of Meckel diverticulum, preoperative and operative patient’s mean age is about 5 years old. A 13-month-old male infant presented at our emergency room with currant jelly stool of about 24 hours duration. Intussusception or bacterial enteritis was initially suspected. Gastrointestinal ultrasonography showed no evidence of intussusception or appendicitis. On the 3rd hospital day, he suddenly showed high fever and irritability. Abdominal CT suggested intraperitoneal and retroperitoneal abscess with air collection due to possible bowel perforation. The final diagnosis of perforation of Meckel diverticulum was made by laparoscopy and biopsy. We report a very rare case with perforation of Meckel diverticulum in infant period.
梅克尔憩室穿孔及继发的腹膜炎是一种罕见的并发症,尤其是在婴儿中。梅克尔憩室并发症,术前及手术患者平均年龄约5岁。一个13个月大的男婴以持续约24小时的醋栗果冻大便出现在我们的急诊室。最初怀疑为肠套叠或细菌性肠炎。胃肠超声检查未见肠套叠或阑尾炎。在住院的第三天,他突然出现高烧和烦躁。腹部CT提示腹膜内及腹膜后脓肿伴积气,可能为肠穿孔。最终诊断为梅克尔憩室穿孔是通过腹腔镜和活检。我们报告一例非常罕见的婴儿时期梅克尔憩室穿孔。
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引用次数: 1
Surgical Treatment of Difficult Cervicofacial Lymphangioma in Children 小儿颈面淋巴管瘤的外科治疗
Pub Date : 2015-12-01 DOI: 10.13029/JKAPS.2015.21.2.17
D. Hwang, S. H. Lee, S. Lim, S. Lee, Jeong-Meen Seo
Purpose: Cervical lymphangiomas are rare lymphovascular malformations arising in the neck, which form huge fluid-containing cysts. Treatment of the malformation consists of surgery and sclerotherapy. However, the optimal approach is still controversial. Here, we describe a series of cervical lymphangiomas which have been treated with surgical approaches. Methods: We retrospectively investigated the medical records of 82 patients who had been diagnosed with cervicofacial lymphangioma from 2001 to 2012 in our center. A closed suction drainage with negative pressure was placed on the operative lesion following excision to prevent reaccumulation of lymphatic fluid and the drainage tube was removed after injecting OK-432 through the tube. Results: Twelve patients underwent surgical excision of cervical lymphangioma. The median patient age was 3 months at the time of the operation. The patients have been followed-up over a period of 34 months. When lesions were located near vital organs such as the trachea or carotid artery or did not respond to repetitive OK-432 injections, surgical treatment might bring good outcomes. However, swallowing difficulty, lip palsy, or dyslalia due to adjacent nerve damage temporarily appeared as postoperative complications. Five children had tracheostomy due to tracheal or subglottic stenosis and 2 patients had gastrostomy due to aspiration while they eat after surgery. Conclusion: Surgery for cervicofacial lymphangioma should be conducted carefully in selective cases. A well thought-out surgical plan with a multidisciplinary surgical team approach and placement of closed suction drainage tube after surgery and adjuvant OK-432 sclerotherapy through drainage tube seem to be helpful for good outcome.
目的:颈淋巴管瘤是发生于颈部的罕见淋巴血管畸形,可形成巨大的含液囊肿。畸形的治疗包括手术和硬化疗法。然而,最佳方法仍然存在争议。在这里,我们描述了一系列的颈部淋巴管瘤已被治疗的手术途径。方法:回顾性分析2001 ~ 2012年本院诊断为颈面淋巴管瘤的82例患者的病历资料。切除后在手术病灶处放置负压封闭吸引引流管,防止淋巴液再积聚,通过引流管注射OK-432后拔出引流管。结果:12例患者行颈部淋巴管瘤手术切除。手术时患者的中位年龄为3个月。对患者进行了为期34个月的随访。当病变位于气管或颈动脉等重要器官附近或反复注射OK-432无效时,手术治疗可能会带来良好的效果。然而,由于邻近神经损伤引起的吞咽困难、唇部麻痹或发音障碍暂时出现为术后并发症。5例患儿因气管或声门下狭窄行气管造口术,2例患儿术后进食时误吸行胃造口术。结论:颈面部淋巴管瘤的手术治疗应慎重选择。一个经过深思熟虑的多学科外科团队的手术方案,术后放置闭合吸引引流管和通过引流管辅助OK-432硬化治疗似乎有助于获得良好的结果。
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引用次数: 4
A Natural Course of an Infantile Hypertrophic Pyloric Stenosis without Adequate Surgical Procedure 没有适当外科手术的婴儿肥厚性幽门狭窄的自然病程
Pub Date : 2015-12-01 DOI: 10.13029/JKAPS.2015.21.2.46
C. Lim, H. Park, J. Yeom, Taejin Park, J. Park, E. Park, J. Seo, Jae-Young Lim, C. Park, H. Woo, H. Youn
Infantile hypertrophic pyloric stenosis (IHPS) is one of the common surgical abdomen in infancy, characterized by progressive non-bilious vomiting. The etiology is unknown, but it likely develops after birth. The pylorus of the stomach becomes thick and triggers progressive vomiting. Abdominal ultrasonography (US) is widely used as a diagnostic tool. Currently, there is a rare IHPS patient with severe metabolic derangement because of general use of abdominal US and its accuracy. We experienced a natural course of a 62- day-old male infant with IHPS who was suffering from intermittent vomiting, loss of weight but had not been properly treated for 1 month. It is needed to make an effort to diagnose differentially in recurrent vomiting infant and check-up regularly, and also educate parents properly.
婴儿肥厚性幽门狭窄(IHPS)是婴儿期常见的外科腹部疾病之一,以进行性非胆汁性呕吐为特征。病因不明,但很可能在出生后发病。胃幽门变厚,引发进行性呕吐。腹部超声(US)被广泛用作诊断工具。由于腹部US的普遍使用和准确性,目前有一例罕见的IHPS患者存在严重的代谢紊乱。我们经历了一个62天的IHPS男婴儿的自然病程,他患有间歇性呕吐,体重减轻,但没有得到适当的治疗1个月。对反复呕吐的婴儿应努力鉴别诊断,定期检查,并对家长进行正确的教育。
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引用次数: 1
Mature Cystic Gastric Teratoma in an Infant: A Case Presenting with a Gastrointestinal Bleeding 婴儿成熟囊性胃畸胎瘤1例:表现为消化道出血
Pub Date : 2015-12-01 DOI: 10.13029/JKAPS.2015.21.2.42
Soo-Hong Kim, Y. Cho, Hae-Young Kim, Y. Lee, J. Park
Gastric teratoma is an extremely rare tumor that accounts for less than 1% of all teratomas. Gastric teratoma is mostly presented as a palpable abdominal mass, and is rarely accompanied with gastrointestinal bleeding such as melena or hematemesis. A 5-month-old male infant was brought with a history of pale facial color and dark-colored stool. The hemoglobin level was at 6.1 g/dL, with melena having begun 1 month previous. Upper gastrointestinal endoscopy revealed a polypoid mass with bleeding at the upper body and lesser curvature of the stomach. Wedge resection of the stomach was performed and histopathological analysis confirmed the mass to be a mature cystic teratoma. There was no recurrence after the operation during follow-up.
胃畸胎瘤是一种极为罕见的肿瘤,占所有畸胎瘤的不到1%。胃畸胎瘤主要表现为可触及的腹部肿块,很少伴有消化道出血,如黑黑或呕血。送来1例5个月大男婴,面部颜色苍白,大便颜色深。血红蛋白水平为6.1 g/dL,黑黑症开始于1个月前。上消化道内窥镜检查发现一个息肉样肿块,上半身和胃小弯出血。行胃楔形切除术,组织病理学分析证实肿块为成熟囊性畸胎瘤。术后随访无复发。
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引用次数: 2
Postoperative Monotherapy with Piperacillin-Tazobactam versus Multidrug Therapy with Cefotaxime and Metronidazole for Perforated Appendicitis in Children: A Case-Control Study 术后哌拉西林-他唑巴坦单药治疗与头孢噻肟和甲硝唑联合多药治疗儿童穿孔阑尾炎:病例对照研究
Pub Date : 2015-12-01 DOI: 10.13029/JKAPS.2015.21.2.28
S. Chun, D. Kim, S. Kim, J. Namgoong
Purpose: Recent data suggest that monotherapy with a broad-spectrum antibiotic may be as efficacious as, and potentially less costly than, standard multi-drug therapy. We compared mono-therapy with intravenous piperacillin-tazobactam (PT) with multi-drug therapy with cefotaxime and metronidazole (CM) in aspect of postoperative complications and hospital stay. Methods: We reviewed the hospital records and medical costs of the pediatric patients who were managed for perforated appendicitis between April 2013 and May 2014 retrospectively. Results: Forty-six patients with laparoscopic appendectomy for perforated appendicitis were included in our study. PT group was 20 and CM group was 26 patients. On admission, there were no significance in sex distribution, duration of symptoms, leukocyte count, and CRP levels. At postoperative third, fifth, and seventh day of each regimen, PT group have no statistical difference with CM group in leukocyte count, percentage of neutrophil, and CRP. There was no difference in abscess formation rate, wound infections, and hospital stay between two groups. There was only one patient who was readmitted with elevation of CRP and leukocyte count in CM group. Conclusion: Daily dosing with the mono-therapy of PT offers as efficient as multi-drug therapy of CM. To evaluate the efficacy of broad-spectrum antibiotics monotherapy in perforated appendicitis children, the cohort included more patients should be needed.
目的:最近的数据表明,使用广谱抗生素的单药治疗可能与标准的多药治疗一样有效,而且可能比多药治疗更便宜。我们比较了静脉注射哌拉西林-他唑巴坦(PT)单药治疗与头孢噻肟、甲硝唑(CM)多药治疗的术后并发症和住院时间。方法:回顾性分析2013年4月至2014年5月收治的小儿穿孔性阑尾炎患者的住院记录和医疗费用。结果:我们的研究包括46例腹腔镜阑尾切除术治疗穿孔性阑尾炎。PT组20例,CM组26例。入院时,性别分布、症状持续时间、白细胞计数和CRP水平无显著性差异。术后第3、5、7天,PT组与CM组白细胞计数、中性粒细胞百分比、CRP差异无统计学意义。两组患者的脓肿形成率、伤口感染、住院时间均无差异。CM组仅1例因CRP及白细胞计数升高再次入院。结论:每日给药单药治疗与多药治疗CM疗效相当。为了评估广谱抗生素单药治疗儿童穿孔阑尾炎的疗效,需要纳入更多的患者。
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引用次数: 0
Inguinal Ectopic Scrotum, Anorectal Malformation with Sacral Agenesis and Limb Defects: An Unusual Presentation 腹股沟异位阴囊,肛门直肠畸形伴骶骨发育不全及肢体缺损:一个不寻常的表现
Pub Date : 2015-12-01 DOI: 10.13029/JKAPS.2015.21.2.32
M. Bawa, S. Garge, V. Sekhon, Kln Rao
A case of congenital ectopic scrotum in neonatal period is described. The ectopic scrotum was located in the right inguinal area and the left hemiscrotum was found in normal location and each hemi-scrotum contained their testis. The neonate also had imperforate anus as low anorectal malformation with spinal abnormalities (hemi-sacrum and hemi-pelvis), right knee flexion contracture and right club foot. The embryological explanation in the literature of ectopic scrotum and its associated anomalies is discussed.
报告一例新生儿期先天性异位阴囊。异位阴囊位于右侧腹股沟区,左侧半阴囊位于正常位置,各半阴囊均包含睾丸。新生儿也有肛门闭锁,低肛门直肠畸形,脊柱异常(半骶骨和半骨盆),右膝屈曲挛缩和右内翻足。本文讨论了异位阴囊及其相关异常的胚胎学解释。
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引用次数: 3
Median Raphe Cyst in a 2-Year-Old Boy 2岁男童中缝囊肿一例
Pub Date : 2015-12-01 DOI: 10.13029/JKAPS.2015.21.2.35
Jihoon Jang, Jinyoung Park
Median raphe cyst (MRC) of the perineum is rare congenital midline cyst of the male genitalia. MRC is thought to be caused by congenital alterations in the embryologic development of the male genitalia during fetal life. MRC can be found on the midline position between the urethral meatus and the anus. The lesion can be cystic, but sometimes it looks like an elongated configuration called a raphe canal. Diagnosis in childhood is particularly rare because they are usually asymptomatic, but some cases have reportedly been identified after infection. Although conservative treatment can be possible in small asymptomatic lesions, the treatment of choice is simple excision followed by primary closure in symptomatic cases. We describe here the case of 2-year-old boy presented at our institution with a 10-month history of anomaly of the perineal median raphe, which was treated by surgical excision.
会阴中缝囊肿(MRC)是一种罕见的先天性男性生殖器中线囊肿。MRC被认为是由胎儿期男性生殖器胚胎学发育的先天性改变引起的。MRC可见于尿道道与肛门之间的中线位置。病变可以是囊性的,但有时它看起来像一个细长的结构,称为中缝管。儿童期的诊断尤其罕见,因为它们通常无症状,但据报道,有些病例在感染后被发现。虽然在小的无症状病变中保守治疗是可能的,但治疗的选择是简单的切除,然后在有症状的病例中进行初步闭合。我们在这里描述一个2岁的男孩,在我们的机构提出了一个10个月的历史的会阴中缝异常,这是通过手术切除治疗。
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引用次数: 1
期刊
Journal of Korean Association of Pediatric Surgeons
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