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김민성(Min Sung Kim),홍부환(Boo Hwan Hong),김동희(Dong Hee Kim) 대한외과학회 2007 Annals of Surgical Treatment and Research(ASRT) Vol.73 No.2
Purpose: Because of the difficulties in making the preoperative diagnosis of diverticulitis, most patients with cecal diverticulitis have been operated on under the preoperative diagnosis of acute appendicitis. However, controversy about the treatment exists when physicians are confronted with a cecal diverticulitis. The purpose of this study is to investigate the proper treatment of cecal diverticulitis that’s misdiagnosed as acute appendicitis. Methods: We reviewed 58 cases of cecal diverticulitis that underwent emergency operation as acute appendicitis, according to classified option of treatment. Results: Of the 58 patients (82.8%), 48 were treated by appendectomy without manipulation of the cecal diverticulitis (conservative treatment, CT group), and 10 cases (17.2%) were treated by surgical resection (diverticulectomy or segmental resection of bowel) of the cecal diverticulitis (operative treatment, OT group). The difference of demographic figures was not significant between the CT and OT groups (P>0.05). However, the length of the postoperative hospital stay and the rate of complications were statistically superior for the CT group (mean hospital stay: 7.5±2.1 days; rate of complications: n=2/48; 4.2%) compared to the OT group (mean hospital stay: 14.0±7.5 days, rate of complication: n=3/10; 30.0%) (P<0.05). Moreover, the symptomatic relapse of the CT group was not statistically higher than that of the OT group (CT, n=8/48; 16.7% and OT, n=2/10; 20.0%)(P>0.05). Conclusion: Given the above clinical results, we could suggest that appendectomy with postoperative antibiotic therapy is an effective management strategy for cecal diverticulitis that’s misdiagnosed as acute appendicitis.
유연화 ( Yeon Hwa Yu ),손병관 ( Byoung Kwan Son ),전대원 ( Dae Won Jun ),김성환 ( Seong Hwan Kim ),조윤주 ( Yun Ju Jo ),박영숙 ( Young Sook Park ),홍부환 ( Boo Whan Hong ),주종은 ( Jong Eun Joo ) 대한소화기학회 2009 대한소화기학회지 Vol.53 No.5
Desmoid tumor is a rare benign tumor derived from fibrous sheath or musculoaponeurotic structure. The tumor is benign histologically but considered as malignant clinically because it has high propensity on infiltrative growth with local invasion and tendency to recurrence after local excision. Especially, when this tumor happens to be in the intra-abdomen, the prognosis is worse because it can cause intestinal obstruction, ureter obstruction and, fistula formation. It also can invade major vessels in abdomen. This tumor occurs more frequently in patients with familial adenomatous polyposis (FAP), in post-partume women, and at old surgical incision site. However, in this case, the patient had neither previous surgery nor a FAP history. We report a rare case of the young male patient who presented with an acute abdomen and underwent laparotomy and was found to have an intra-abdominal desmoid tumor with abscess formation. (Korean J Gastroenterol 2009;53:315-319)
Yersinia enterocolitica의 급성 충수염에서 원인균으로서 가능성
손태준(Tae Joon Son),김동희(Dong Hee Kim),조윤주(Yun Ju Jo),채정돈(Jeong Don Chae),홍부환(Boo Hwan Hong),강재희(Jae Hee Kang),이태석(Tae Seok Lee),한준길(Jun Gil Han) 대한외과학회 2009 Annals of Surgical Treatment and Research(ASRT) Vol.76 No.4
Purpose: With increasing frequency, Yersinia enterocolitica is being recognized as an important bacterial cause of acute gastrointestinal infection with abdominal pain. In addition, the association of Y. enterocolitica infections with acute appendicitis has been suggested. This study was undertaken to ascertain whether Y. enterocolitica is a possible infectious agent in acute appendicitis. Methods: Between December 2007 and April 2008, 162 patients who underwent appendectomy for presumed appendicitis, enrolled in this prospective study. After surgical excision of appendix, a portion of each specimen was cultured for Y. enterocolitica with highly selective media (Cefsulodin-Irgasan-Novobiocin agar). Results: Pathologically, 150 of the patients had appendicitis and 12 patients had normal appendices. Only one of the 150 patients (0.7%) with appendicitis was found to be culture positive for Y. enterocolitica, while it was not detected from normal appendices. Conclusion: The authors were unable to implicate Y. enterocolitica as a major pathogen in acute appendicitis within the Seoul area. However, we thought there to be more need for investigation for association of Y. enterocolitica with acute appendicitis over a broader area and season.