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Case Report

[English]
Unusual Giant Arteriovenous Malformation in Jejunum: A Case Report
DongJa Kim, JaIl Goo
J Korean Assoc Pediatr Surg 2017;23(2):52-54.   Published online December 20, 2017
DOI: https://doi.org/10.13029/jkaps.2017.23.2.52

Polypoid or tumorous arteriovenous malformation (AVM) of small intestine is rare and can be misdiagnosed as other tumorous conditions. We experienced a rare case of giant jejunal AVM in a 15-year-old boy, who complained of intense abdominal pain. Ultrasonography and contrast-enhanced CT revealed a 13.5-cm-sized multiseptated cystic mass arising in small intestine, which was mimicking submucosal tumor. It was successfully treated by surgical resection. The specimen showed a multilobulated outbulging submucosal mass in jejunum. Histopathologic evalulation confirmed AVM located in the submucosa, muscularis propria and subserosa. This case is the largest AVM of small intestine among which has ever been reported.

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Original Articles

[English]
A Clinical Analysis of the Intestinal Atresia
Jinyoung Park
J Korean Assoc Pediatr Surg 2004;10(2):99-106.   Published online December 31, 2004
DOI: https://doi.org/10.13029/jkaps.2004.10.2.99

Intestinal atresia is a frequent cause of intestinal obstruction in the newborn. We reviewed the clinical presentation, associated anomalies, types of atresias, operative managements, and early postoperative complications in 36 cases of intestinal atresia treated at the Department of Surgery, Kyungpook National University Hospital between January 1994 and February 2003. Location of the lesion was duodenum in 17 patients, jejunum in 11 patients and ileum in 8 patients. The male to female ratio was 1:1.4 in duodenal atresia (DA), 2.7:1 in jejunal atresia (JA) and 7:1 in ileal atresia (IA). The most common type was type III (41.1 %) in DA, and type I (52.6 %) in JA and IA. The most common presenting symptoms was vomiting(88.2 %) in DA, but in jejunoileal atresia, vomiting(89.4 %) and abdominal distension(89.4 %) were the most common sign and symptom. All cases of DA were diagnosed by plain abdominal radiography. There were 6 cases of DA with congenital heart disease, 3 cases of DA with Down syndrome and 3 cases of JA with meconium peritonitis. Segmental resection was performed in 13 cases, duodenoduodenostomy in 11 cases, membrane excision in 7 cases, jejunojejunostomy in 2 cases, gastroduodenostomy in 2 cases and ileocolic anastomosis in 1 case. There were 9 postoperative complications including 3 each of anastomotic leakage, wound infection, and intestinal obstruction 3 cases. The mortality rate for DA was 11.8 %(2/17). Both deaths in DA were attributed to congenital heart disease. The mortality rate for JA was 18% (2/11). Both cases died with sepsis and short bowel syndrome.

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[English]
High Jejunal Atresia: Clinical Characteristics and Treatment
Jeon, Ho Jong , Ho, In Geol , Oh, Jung-Tak
Adv Pediatr Surg 2023;29(2):58-64.
DOI: https://doi.org/10.13029/aps.2023.29.2.58
Purpose
High jejunal atresia occurring near the ligament of Treitz is rare. It is a complicated type of small bowel atresia, and its treatment is challenging. Our study describes the clinical characteristics and proper management of high jejunal atresia.
Methods
We performed a retrospective review of seven neonates who underwent operations for high jejunal atresia between January 2000 and April 2021.
Results
The sex ratio showed a male predominance, and all patients were prenatally diagnosed with small bowel atresia. Six patients presented with a typical triple bubble appearance on the preoperative abdominal film. The location of the atresias were around the ligament of Treitz or less than 10 cm from the ligament of Treitz, and the types of atresia comprised three cases of type I, two of type IIIb, and two of type IV. Five of the seven patients underwent the operation without proximal enteroplasty. The median duration from operation to full feeding was 23 days, with three patients requiring more than a month to reach full feeding. There were no other operation-related complications. At the long-term follow-up, all patients tolerated oral feeding well.
Conclusion
This study indicates that high jejunal atresia close to the ligament of Treitz exhibits a high incidence of type I and complex types of atresia, and that primary anastomosis, without proximal enteroplasty, can be applied through surgical intervention.
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