All issues
Volume 49, Issue 4
Displaying 1-15 of 15 articles from this issue
- |<
- <
- 1
- >
- >|
-
[in Japanese]2013 Volume 49 Issue 4 Pages 001-009
Published: June 20, 2013
Released on J-STAGE: June 20, 2013
JOURNAL FREE ACCESSDownload PDF (278K)
Originals
-
Miki Toma, Seiichi Hirobe, Mari Arai, Koji Komori, Yuki Yamamoto, Keii ...2013 Volume 49 Issue 4 Pages 897-903
Published: June 20, 2013
Released on J-STAGE: June 20, 2013
JOURNAL FREE ACCESSPurpose: The long-term outcome of urogenital functions with cloacal anomalies has been challenging, particularly in a high-confluence group. We developed a partial urogenital mobilization (PUM) procedure with modification from the total urogenital mobilization (TUM) method. We evaluated the short-term complications and long-term urogenital functions from our cumulative data.
Methods: We reviewed patients with cloacal anomaly in a high-confluence group. We defined patients with an anatomical confluence-point located above the PC line as the high-confluence group. We evaluated the complications and functional outcomes after operation, and performed a historical comparison between the procedures.
Results: Seven cases were categorized as belonging to the high-confluence group. The age of the patients ranged from 2 to 31 years. Four patients, who had undergone operations that included separation of vagina from the urinary tract, indicated short-term complications of urethral injury, vaginourethral fistula and vaginal stenosis. Long-term clean intermittent catheterization (CIC) was required for all cases. As we explored for an alternative procedure, we developed PUM and performed in 3 patients. Although long-term outcomes of PUM are still under evaluation, the short-term outcomes have been favorbale, since the patients were free of the post-surgical complications and had better bladder function.
Conclusion: Patients with cloacal anomaly in the highconfluence group may have benefited from the PUM procedure with less short-term complications and better bladder function. Evaluations of the long-term outcomes of urogenital functions are under progress, and will be reported on completion in future.View full abstractDownload PDF (827K) -
Yoshiaki Takahashi, Ryota Souzaki, Kouji Nagata, Makoto Hayashida, Tom ...2013 Volume 49 Issue 4 Pages 904-908
Published: June 20, 2013
Released on J-STAGE: June 20, 2013
JOURNAL FREE ACCESSPurpose: Intussusception is one of the most common diseases of the acute abdomen in children. The purpose of this study was to review the clinical features of intussusception in children.
Method: The clinical records of 105 cases with intussusception treated at Kyushu University Hospital from January 2001 to December 2010 were retrospectively reviewed.
Results: Patients consisted of 51 males and 54 females; 83 of them (80%) were under 3 years old. Hematochezia was the commonest symptom in 57 cases (54.3%), followed by stomachache. Only 9 cases (8.5%) had triad-containing stomachache, vomiting, and hematochezia. However, all cases have at least one of the three symptoms. Eight cases were associated with a causal organic lesion; and 2 of them had malignancy. Surgical treatment was performed in 16 cases (15%), and most of them were treated after 24 hours from the onset. Comparing cases over 3 years old with those under 3 years old, the percentages of cases with an organic lesion and cases requiring surgery in the former were higher than those in the latter. In addition, 2 of 8 cases with an organic lesion presented with malignant lymphoma.
Conclusion: In current study, about 2% of children with intussusception showed malignant disease. Therefore, it was highly recommended that further examinations should be performed to detect organic lesions such as malignant lymphoma or polyps.View full abstractDownload PDF (409K) -
Kazuhiko Yoshimoto, Hirotsugu Terakura, Hiromi Koyama, Seiichi Kawabat ...2013 Volume 49 Issue 4 Pages 909-915
Published: June 20, 2013
Released on J-STAGE: June 20, 2013
JOURNAL FREE ACCESSPurpose: We aimed to clarify the current state of pediatric trauma care in Kyushu.
Methods: A questionnaire survey was performed at member institutions of the Kyushu Pediatric Surgical Congress; 22 institutions participated in the survey.
Results: At 12 institutions, primary treatment of pediatric trauma patients was directed by pediatric surgeons. Two institutions had a pediatric trauma team. From May 2007 to April 2012 (5-year period), there have been 9 cases of major organ injuries (involving the liver, spleen, pancreas, and small/large bowel): i.e. 1.8 cases/year.
Conclusions: Pediatric surgeons at none of the institutions had conducted sufficient experiments for creating a database of pediatric trauma cases. Pediatric trauma care in the future will be greatly influenced by current research.View full abstractDownload PDF (499K)
Case Reports
-
Hisako Kuyama, Hiroo Takehara, Akira Nii, Hiroki Mori2013 Volume 49 Issue 4 Pages 916-919
Published: June 20, 2013
Released on J-STAGE: June 20, 2013
JOURNAL FREE ACCESSHemorrhagic colitis due to Escherichia coli O-157 infection causes intestinal edema. In these cases, an abdominal ultrasonography shows findings similar to intussusception, and secondary intussusception may occur.
We report on two children who underwent laparoscopic examination because of possible intussusception. Case 1: A 15-year-old boy was subjected to laparoscopic examination due to failure of barium enema reduction for intussusception. Case 2: A 6-year-old girl was similarly examined because of recurrence of intussusception after two times of barium enema reduction.
In both cases, the cecum and ascending colon were edematous without intussusception; i.e. possible causes of intussusception. Postoperatively, E. coli O-157 were detected in stool sample. Therefore, medical treatments were performed in both patients.
In elder children with suspected intussusception, we should always be reminded of possible infection from E. coli O-157 colitis to avoid unnecessary surgery.View full abstractDownload PDF (910K) -
Akihide Tanano, Minoru Horisawa2013 Volume 49 Issue 4 Pages 920-924
Published: June 20, 2013
Released on J-STAGE: June 20, 2013
JOURNAL FREE ACCESSWe report a patient with an ectopic cyst of the salivary gland, and where an etiological factor for multiple recurrent median cervical cysts could be histopathologically verified.
The patient was a 5-year-old boy. At the age of 2 years, a cystic region measuring about 5 mm in diameter was noted in the right mandibule. He was referred to our hospital because the cystic region had enlarged over the last few months. Detailed examination led to diagnosis of an ectopic cyst of the mucous gland which was then scheduled for resection. During surgery, mucus elimination from the cyst was confirmed. Furthermore, a cordlike substance connecting the cyst to the median anterior surface of the hyoid bone was observed. These findings suggested an ectopic mucous cyst was connected to the thyroglossal duct, and for which cystectomy and Sistrunk's operation were performed.
Histopathologically, cordlike connective tissue, involving the cyst to median hyoid bone, and a duct in the connective tissue were noted. The duct partially showed atrophy, and an occlusive site was present. However, it was connected to the thyroglossal duct of the median hyoid bone.
Based on these findings, the patient was diagnosed with ectopic salivary gland cyst draining into the thyroglossal duct cyst.
The present case may provide information/data useful for understanding the etiology of multiple recurrent thyroglossal duct cyst.View full abstractDownload PDF (921K) -
Nobuo Shinkai, Kazuyuki Nishinaka, Naoya Masumori, Taiji Tsukamoto2013 Volume 49 Issue 4 Pages 925-928
Published: June 20, 2013
Released on J-STAGE: June 20, 2013
JOURNAL FREE ACCESSWe report a 13-year old boy with left renal cell carcinoma. The patient presented with macrohematuria, left flank pain, and fever as primary symptom. Computed tomography (CT) findings led to diagnosis of a left infected renal cyst. The symptoms rapidly improved with antibiotic therapy: however, microhematuria persisted. A cystic mass with a thin wall enhanced by contrast medium was still found by CT after 2-month treatment, although the mass was reduced in size. Because image diagnosis did not exclude the the possibility of a malignant neoplasm in the kidney, he underwent left laparoscopic nephrectomy. He was histologically diagnosed as having renal cell carcinoma. Xp11 gene translocation was not detected. Renal cell carcinoma in children is rare, and infectious symptoms as the primary presentation are also uncommon. When image diagnosis suggests a spaceoccupying lesion of the kidney in a child having urinary tract infection, careful follow-up is needed to monitor changes of the lesion even after the infection has been improved.View full abstractDownload PDF (651K) -
Kumiko Suzuki, Tetsuo Katayama, Hideaki Iwama, Satoru Chujo2013 Volume 49 Issue 4 Pages 929-933
Published: June 20, 2013
Released on J-STAGE: June 20, 2013
JOURNAL FREE ACCESSWe report a case of cecal volvulus in a 9-year-old boy. The patient was referred to our hospital for abdominal pain and vomiting, and plain abdominal X-ray showed a giant colonic gas shadow with air-fluid level. The abdominal computed tomography showed the whirl sign. On diagnosis of a small intestinal volvulus, emergency laparotomy was performed. His cecum was twisted 720 degrees clockwise. Since the intestinal wall had become necrotic, an ileocecal excision was performed. We recognized that his cecum was mobile. When abdominal images were retrospectively reviewed, the plain abdominal X-ray portrayals revealed a markedly dilated loop of the large bowel located in the left half, and the small intestine located in the right. These images were typical findings of cecal volvulus. Although cecal volvulus is rare as a cause of intestinal obstruction in children, it should be considered as a differential diagnosis of the ileus.View full abstractDownload PDF (406K) -
Yuki Muta, Sadashige Uemura, Atsushi Yoshida, Mayumi Yamamoto, Hisako ...2013 Volume 49 Issue 4 Pages 934-938
Published: June 20, 2013
Released on J-STAGE: June 20, 2013
JOURNAL FREE ACCESSLow-grade fibromyxoid sarcoma (LGFMS) is characterized by an uncommon and slow-growing malignant tumor, and mostly occurs in deep soft tissues. We report on a 3-year-old boy with subcutaneous LGFMS. A mass was located in the suprapubic area at medical checkup. An ultrasound examination showed a 1-cm mass suspected to be a dermoid cyst; he underwent tumor excision. The tumor did not adhere to the surrounding tissues. The pathological diagnosis was LGFMS. Because the resected margin was close to the tumor, we performed additional surgery to remove a margin 1 cm from the border of the previous resection, 2 months after the initial surgery. Residual tumor cells were pathologically observed in the resected subcutaneous tissue. The patient is currently followed up, and has presented no signs of recurrence to date. Although LGFMS is a rare tumor, it should be considered as a differential diagnosis for soft tissue tumors. Long-term observations are required.View full abstractDownload PDF (624K) -
Makoto Suzuki, Mariko Aoki, Akihiro Igarashi, Masahiro Hatanaka, Junko ...2013 Volume 49 Issue 4 Pages 939-947
Published: June 20, 2013
Released on J-STAGE: June 20, 2013
JOURNAL FREE ACCESSWe report two children (4 y and 1 y-6 m old boys) with esophageal stenosis due to corrosive esophagitis in whom orthotopic jejunal pedicled graft reconstructions of the esophagus had been carried out. Conservative treatments with balloon dilatation had no effect and esophageal replacement was done 6 and 11 months after the injury, respectively. Postoperative anastomotic strictures in both patients were successfully dilated with balloon dilatation, and both patients recovered to the normal diet 3 and 5 months after reconstruction, respectively.
Although esophageal reconstruction with a pedicled jejunal graft is a good and ideal operation for replacement of the esophagus, certain considerations (anastomotic site, gaining enough length with a sufficiently long vascular pedicle, and postoperative treatment of anastomotic strictures) are needed to make it successful.View full abstractDownload PDF (1306K) -
Takahiro Saito, Kazuya Ise, Michitoshi Yamashita, Yoshinori Kawahara, ...2013 Volume 49 Issue 4 Pages 948-953
Published: June 20, 2013
Released on J-STAGE: June 20, 2013
JOURNAL FREE ACCESSAlthough appendicitis is a common disease in children, it is extremely rare in neonates. We experienced a neonatal case of appendicitis with an abdominal tumor. A 22-dayold boy was admitted to our hospital with fever, vomiting and abdominal distention. He was given a diagnosis for infectious enteritis and treated with some antibiotics. His condition, however, was not improved. CT scan revealed abdominal dilatation and an ileocecal tumor was located. We suspected ileus due to intestinal duplication, and performed a laparotomy at the age of 36 days. Laparotomy revealed a retroperitoneal abscess in the ileocecal region, and the appendix had been molten and vanished. We performed a sutural repair of the appendix root, followed by intraperitoneal irrigation and abdominal drainage. The postoperative course was non-eventful. Appendicitis has the potential to occur in neonates, and 41 cases including ours have been reported from 1925 to 2013 in Japan. Because the typical symptoms of appendicitis do not usually appear, preoperative diagnosis is very difficult. Therefore, recognition of neonatal appendicitis is required, and depending on the situation, surgical management should be done before the condition becomes too severe. We need to realize that appendicitis may also occur in neonates. Depending on the situation, surgical management should be done before they become life-threatening.View full abstractDownload PDF (554K) -
Masahiro Kawasaki, Tsutomu Kanagawa2013 Volume 49 Issue 4 Pages 954-958
Published: June 20, 2013
Released on J-STAGE: June 20, 2013
JOURNAL FREE ACCESSThis report describes successful medical treatment of recurrent intestinal bleeding secondary to portal hypertension. The patient had previously had a Kasai's operation for biliary atresia (IIIb1ν), with an uneventful postoperative course. At one year and ten months of age, she developed massive melena which recurred frequently at short intervals. Upper endoscopic examination and scintigraphy did not show any bleeding. CT portography demonstrated a dilated mesenteric vein around the Roux-en-Y anastomosis. Laparotomy was performed for the purpose of identifying bleeding site of the intestine and resecting any congested bowel. However bleeding sites were not found, and the congested segment of the jejunum was too long to resect. Therefore, jejunectomy was not attempted, and she was subsequently started on spironolactone and propranolol. Since then, over two years of follow-up, she has not had any recurrence of melena.
Intestinal bleeding due to portal hypertension is relatively rare, and the diagnosis and treatment of intestinal bleeding have not been established due to the variety of clinical features it presents. However, medical treatment can prevent intestinal bleeding over the long-term, as in our case. Medical therapy is effective against intestinal bleeding secondary to portal hypertension, and hence medical treatment may be recommended prior to surgical treatment.View full abstractDownload PDF (370K)
-
[in Japanese]2013 Volume 49 Issue 4 Pages 959-960
Published: June 20, 2013
Released on J-STAGE: June 20, 2013
JOURNAL FREE ACCESSDownload PDF (321K)
-
[in Japanese]2013 Volume 49 Issue 4 Pages 961-968
Published: June 20, 2013
Released on J-STAGE: June 20, 2013
JOURNAL FREE ACCESSDownload PDF (565K)
-
[in Japanese]2013 Volume 49 Issue 4 Pages 9999
Published: June 20, 2013
Released on J-STAGE: June 20, 2013
JOURNAL FREE ACCESSDownload PDF (159K)
- |<
- <
- 1
- >
- >|