A case of colonoscopy-induced right-sided ischemic colitis in a patient with no risk factor

위험인자가 없는 환자에게 발생한 대장 내시경에 의한 우측 허혈성 대장염 1예

  • Lee, Eun-Mi (Department of Internal Medicine, Kosin University College of Medicine) ;
  • Park, Seun-Ja (Department of Internal Medicine, Kosin University College of Medicine) ;
  • Song, Sung-Eun (Department of Internal Medicine, Kosin University College of Medicine) ;
  • Kim, Jae-Hyun (Department of Internal Medicine, Kosin University College of Medicine) ;
  • Kim, Kyu-Jong (Department of Internal Medicine, Kosin University College of Medicine) ;
  • Park, Moo-In (Department of Internal Medicine, Kosin University College of Medicine) ;
  • Park, Dong-Yang (Department of Internal Medicine, Kosin University College of Medicine)
  • 이은미 (고신대학교 의과대학 내과학교실) ;
  • 박선자 (고신대학교 의과대학 내과학교실) ;
  • 송성은 (고신대학교 의과대학 내과학교실) ;
  • 김재현 (고신대학교 의과대학 내과학교실) ;
  • 김규종 (고신대학교 의과대학 내과학교실) ;
  • 박무인 (고신대학교 의과대학 내과학교실) ;
  • 박동양 (고신대학교 의과대학 내과학교실)
  • Received : 2009.04.13
  • Accepted : 2009.09.22
  • Published : 2010.09.01

Abstract

Ischemic colitis is the most common form of intestinal ischemia. Although there are a variety of causes, the most common mechanism is acute, self-limited compromise in intestinal blood flow. Most cases of ischemic colitis are transient and resolve spontaneously, but right colon involvement is associated with poor outcome. Colonoscopy is the gold standard for the identification of colonic ischemia; however, very rarely, colonoscopy itself may induce ischemic colitis in patients with underlying predisposing factors, such as connective tissue disorders. We experienced a case of ischemic colitis of the right colon, following colonoscopy in a patient without risk factors.

저자 등은 평소 특별한 위험인자가 없었던 41세 여자 환자로 대장 내시경 시행 후 갑자기 발생한 혈변 및 우하복부 통증을 주소로 응급실에 내원하여 대장 내시경 및 복부 CT를 통해 대장 내시경에 의해 발생한 우측 대장의 허혈성 대장염으로 진단하고 금식 및 수액 공급 등의 보존적 치료로 회복된 예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Keywords

References

  1. Green BT, Trendler DA. Ischemic colitis: a clinical review. South Med J 98:217-222, 2005 https://doi.org/10.1097/01.SMJ.0000145399.35851.10
  2. 이병오, 최황, 강인중, 김기영, 이호일, 김정표, 이보인, 김병욱, 조세현, 최규용, 정인식, 차상복. 대장 내시경에 의해 발생한 허혈성 대장염 1예. 대한소화기내시경학회지 27:162-165, 2003
  3. Cremers MI, Oliveira AP, Freitas J. Ischemic colitis as a complication of colonoscopy. Endoscopy 30:S54, 1998
  4. Arahan M, Onal IK, Odemis B, Ibis M, Sasmaz N. Colonosocpy-induced ischemic colitis in a young patient with no risk factor. Am J Gastroenterol 104:250-251, 2009 https://doi.org/10.1038/ajg.2008.28
  5. Yuksel O, Bolat AD, Koklu S, Altiparmak E, Albayrak K, Caner S. Ischemic colitis, an unusual complication of colonoscopy. South Med J 101:972-973, 2008
  6. Grandihi SK, Hanson MM, Vernava AM, Kaminski DL, Longo WE. Ischemic colitis. Dis Colon Rectum 39:88-100, 1996 https://doi.org/10.1007/BF02048275
  7. Sotiriadis J, Brandt LJ, Behin DS, Southern WN. Ischemic colitis has a worse prognosis when isolated to the right side of the colon. Am J Gastroenterol 102:2247-2252, 2007 https://doi.org/10.1111/j.1572-0241.2007.01341.x
  8. 남상우, 윤현정, 이승옥, 이수택. 대장 내시경후 합병된 허혈성 대장염 1예. 대한소화기내시경학회지 25:220-223, 2002
  9. Versaci A, Macri A, Scuderi G, Bartolone S, Familiari L, Lupattelli T, Famulari C. Ischemic colitis following colonoscopy in a systemic lupus erythematosus patient: report of a case. Dis Colon Rectum 48:866-869, 2005 https://doi.org/10.1007/s10350-004-0837-z
  10. Wheeldon NM, Grundman MJ. Ischaemic colitis as a complication of colonoscopy. BMJ 301:1080-1801, 1990 https://doi.org/10.1136/bmj.301.6760.1080
  11. Nozawa H, Akiyama Y, Sunaga S, Tsurita G. Ischemic colitis following colonoscopy in an elderly patient on cardiovascular medication. Endoscopy 39(Supple 1):E344-E345, 2007
  12. Theodoropoulou A, Koutroubakis IE. Ischemic colitis: clinical practice in diagnosis and treatment. World J Gastroenterol 14:7302-7308, 2008 https://doi.org/10.3748/wjg.14.7302
  13. Medina C, Vilaseca J, Videla S, Fabra R, Armengol-Miro JR, Malagelada JR. Outcome of patients with ischemic colitis: review of fifty-three cases. Dis Colon Rectum 47:180-184, 2004 https://doi.org/10.1007/s10350-003-0033-6
  14. Hass DJ, Kozuch P, Brandt LJ. Pharmacologically mediated colon ischemia. Am J Gastroenterl 102:1765-1780, 2007 https://doi.org/10.1111/j.1572-0241.2007.01260.x
  15. Saegesser F, Loosli H, Robinson JW, Roenspies U. Ischemic disease of the large intestine. Int Surg 66:103-117, 1981