자발성 벽내성 식도 혈종 1예

A Case of Spontaneous Intramural Hematoma of the Esophagus

  • 이창헌 (왈레스기념 침례병원 내과) ;
  • 정현광 (왈레스기념 침례병원 내과) ;
  • 김도형 (왈레스기념 침례병원 내과)
  • Lee, Chang-Hun (Department of Internal Medicine, Wallace Memorial Baptist Hospital) ;
  • Jung, Hyun-Gwang (Department of Internal Medicine, Wallace Memorial Baptist Hospital) ;
  • Kim, Do-Hyeong (Department of Internal Medicine, Wallace Memorial Baptist Hospital)
  • 투고 : 2010.01.19
  • 심사 : 2010.04.13
  • 발행 : 2010.05.30

초록

식도의 혈종은 자발적이거나 또는 손상 후 이차적인 원인으로 발생하는 드문 질환이다. 병인론에 대해서는 아직 모호한 면이 있으나, 환자의 응고 능력이나 혈종의 위치, 그리고 선행하는 구토의 병력 등에 의해 발생하게 된다. 본 증례는 항응고제를 복용중인 환자에서 구토 및 구역질에 의해 발생한 자발성 벽내성 식도 혈종을 내시경으로 진단하였고, 금식 및 보존적 치료를 시행하였다. 그 후 추적 관찰한 상부위장관내시경 검사에서는 식도 혈종이 완전하게 제거 되고 정상 점막의 소견을 보인 증례를 경험하여 저자들은 문헌 고찰과 함께 보고한다.

Spontaneous intramural hematoma of the esophagus is a very rare disease. Varying degrees of submucosal rupture of the esophagus are caused by intramural hematoma of the esophagus. The causative factors include vomiting, an esophageal foreign body, endoscopic sclerotherapy for esophageal varices, equipment manipulation, drugs (e.g., warfarin and aspirin) and full-body disease (e.g., chronic renal failure, hemophilia and leukemia), and idiopathic causes have also been described. A 68-year-old male taking aspirin, clopidogrel and cilostazol was admitted to our hospital complaining of hematemesis. Spontaneous intramural hematoma of the esophagus was diagnosed by endoscopy. We report here on a case of spontaneous intramural hematoma of the esophagus that occurred after vomiting and the patient showed spontaneous improvement. We also review the relevant literature.

키워드

참고문헌

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