질 성형을 위한 실리콘 액 주입 후 발생한 급성 호흡 곤란 증후군 1예

A Case of Acute Respiratory Distress Syndrome Induced by Injection of Silicone Fluid for Colpoplasty

  • 정창욱 (성균관대학교 의과대학 내과학교실, 마산삼성병원 호흡기내과) ;
  • 전익수 (성균관대학교 의과대학 내과학교실, 마산삼성병원 호흡기내과) ;
  • 장재영 (성균관대학교 의과대학 내과학교실, 마산삼성병원 호흡기내과) ;
  • 박지은 (성균관대학교 의과대학 내과학교실, 마산삼성병원 호흡기내과) ;
  • 송춘영 (성균관대학교 의과대학 내과학교실, 마산삼성병원 호흡기내과) ;
  • 김성헌 (성균관대학교 의과대학 내과학교실, 마산삼성병원 호흡기내과) ;
  • 강경우 (성균관대학교 의과대학 내과학교실, 마산삼성병원 호흡기내과)
  • Jung, Chang Wook (Division of Pulmonary and Critical Care Medicine, Department of Medicine, Masan Samsung Hospital Sungkyunkwan University School of Medicine) ;
  • Jeon, Ik Soo (Division of Pulmonary and Critical Care Medicine, Department of Medicine, Masan Samsung Hospital Sungkyunkwan University School of Medicine) ;
  • Jang, Jae Young (Division of Pulmonary and Critical Care Medicine, Department of Medicine, Masan Samsung Hospital Sungkyunkwan University School of Medicine) ;
  • Park, Jee Eun (Division of Pulmonary and Critical Care Medicine, Department of Medicine, Masan Samsung Hospital Sungkyunkwan University School of Medicine) ;
  • Song, Chun Young (Division of Pulmonary and Critical Care Medicine, Department of Medicine, Masan Samsung Hospital Sungkyunkwan University School of Medicine) ;
  • Kim, Sung Hun (Division of Pulmonary and Critical Care Medicine, Department of Medicine, Masan Samsung Hospital Sungkyunkwan University School of Medicine) ;
  • Kang, Kyung Woo (Division of Pulmonary and Critical Care Medicine, Department of Medicine, Masan Samsung Hospital Sungkyunkwan University School of Medicine)
  • 투고 : 2004.06.15
  • 심사 : 2004.07.15
  • 발행 : 2004.08.30

초록

저자들은 실리콘 액을 이용한 질 성형술 후에 급성호흡 곤란 증후군을 보인 환자에서 경기관지 폐생검으로 실리콘에 의한 것으로 생각되는 폐포 대식세포내의 봉입체를 확인하고 대증적인 치료로 호전된 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Acute respiratory distress syndrome after silicone fluid injection is uncommon. Reasons that organic silicone is inactive in the human body and has low surface tension and is not affected by physical factors such as time or temperature make this material to be widely used as a medical product. However, lately some of its side effects have been noted and also cause respiratory problems in rare occasions. The mechanism is not clear but silicone injection cause one to cough, produce hemoptysis, fever, pleuritic chest pain, and dyspnea, and may even lead to acute respiratory failure. In other countries, these side effects were reported from 1970s and several cases started to appear in Korea from 1990s. We report a 58 years-old female who recovered from acute respiratory distress syndrome after injection of silicone fluid into vaginal wall by a conservative therapy.

키워드

참고문헌

  1. Rees TD, Platt J, Ballantyne DL Jr. An investigation of cutaneous response to dimethylpolysiloxane(silicone liquid) in animals and humans A preliminary report. Plast Reconstr Surg 1965;35:131-9
  2. Symmers WS. Silicone mastitis in 'topless' waitresses and some other varieties of foreign-body mastitis. Br Med J 1968;3:19-22
  3. Ellenbogen R, Rubin L. Injectable fluid silicone therapy. Human morbidity and mortality. JAMA 1975;234:308-9
  4. Celli B, Textor S, Kovnat DM. Adult respiratory distress syndrome following mammary augmentation. Am J Med Sci 1978;275:81-5
  5. Kim CH, Chung DH, Yoo CG, Lee CT, Han SK, Shim YS, et al. A case of acute pneumonitis induced by injection of silicone for colpoplasty. Respiration 2003;70:104-6
  6. Kang SE, Yong SJ, Lee WY, Shin PJ, Kim MH, Park HC, et al. Two cases of acute respiratory distress syndrome with pulmonary hemorrhage induced by injection of silicone at perineum. Tuberc Respir Dis 2001;51:166-72
  7. Kang MB, Kim ST, Lee JG, Seo CJ, Lee HE, Jeong JB, et al. A case of acute respiratory distress syndrome with pulmonary embolism induced by injection of silicone at vaginal wall. Tbc and Resp Dis 1999;46:414-9
  8. Jung BH, Suh YI, Lee JM, Song SH, Kim HJ, Lee MG, et al. Two cases of silicone-induced pulmonary embolism. Tuberc Respir Dis 1993;40:610-5
  9. Chastre J, Basset F, Viau F, Dournovo P, Bouchama A, Akesbi A, et al. Acute pneumonitis after subcutaneous injections of silicone in transsexual men. N Engl J Med 1983;308;764-7
  10. Chastre J, Brun P, Soler P, Basset F, Trouillet JL, Fagon JY, et al. Acute and latent pneumonitis after subcutaneous injections of silicone in transsexual men. Am Rev Respir Dis 1987;135:236-40
  11. Editorial: Silicone pneumonitis. Lancet 1983;ii:833
  12. Lai YF, Chao TY, Wong SL. Acute pneumonitis after subcutaneous injections of silicone for augmentation mammaplasty. Chest 1994;106:1152-5
  13. Matsuba T, Sujiura T, Irei M, Kyan Y, Kunishima N, Uchima H, et al. Acute pneumonitis presumed to be silicone embolism. Intern Med 1994;33:481-3