Clinical Endoscopy

  • 제40권5호
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  • Pages.321-324
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  • 2010
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  • 2234-2400(pISSN)
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  • 2234-2443(eISSN)
대한소화기내시경학회 (The Korean Society of Gastrointestinal Endoscopy)
권호 표지

상부위장관 내시경 검사 중 발생한 거대 위점막 열상

Extensive Gastric Mucosal Laceration During Endoscopic Examination

  • 전한별 (한림대학교 의과대학 강남성심병원 내과학교실) ;
  • 백일현 (한림대학교 의과대학 강남성심병원 내과학교실) ;
  • 신수린 (한림대학교 의과대학 강남성심병원 내과학교실) ;
  • 김효정 (한림대학교 의과대학 강남성심병원 내과학교실) ;
  • 김진배 (한림대학교 의과대학 강남성심병원 내과학교실) ;
  • 이명석 (한림대학교 의과대학 강남성심병원 내과학교실)
  • Chun, Han-Byul (Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Baek, Il-Hyun (Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Shin, Su-Rin (Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Kim, Hyo-Jung (Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Kim, Jin-Bae (Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Lee, Myung-Seok (Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine)
  • 투고 : 2009.12.24
  • 심사 : 2010.04.03
  • 발행 : 2010.05.30
⟨ 이전 논문 다음 논문 ⟩

초록

상부위장관 내시경 검사 중 발생하는 거대 위점막 열상의 빈도는 매우 드물다. 열상의 위치나 범위로 보아 일반적인 Mallory-Weiss 열상과는 차이가 있으나 그 발병기전은 유사하다. Mallory-Weiss 열상의 선행인자로 식도 열공, 위축성 위염, 고령 등이 있다. 고령의 환자에서 상부위장관 내시경 검사 중 발생한 위점막 열상 중 위식도 접합부에서 위각부에 이르는 거대 위점막 열상에 대한 보고는 국내에 1예가 있을 뿐이다. 저자들은 체표면적과 위가 매우 작은 82세 여자에서 내시경 시행 중 거대 위점막 열상이 발생하였고 금속클립으로 치유한 것을 경험하였기에 문헌 고찰과 함께 보고한다.

Gastric mucosal lacerations occurring during the course of upper gastroduodenal endoscopy are apparently rare. The location and extent of the lesion are little different from the usual one found in the Mallory-Weiss tear. But the pathogenesis of the gastric mucosal tear is similar to that of Mallory-Weiss tear. Hiatal hernia, atrophic gastritis, and old age are predisposing factors for Mallory-Weiss tear. There is currently only one report about extensive gastric mucosal laceration during performance of endoscopy in an elderly patient. During a standard diagnostic endoscopic procedure, we experienced extensive gastric mucosal laceration that ranged from the gastroesophageal junction to the gastric angle in an elderly woman Furthermore, her body surface area and stomach size were very small. The patient was treated successfully with hemoclip application for the laceration. We report on the case along with a review of the relevant literature.

키워드

참고문헌

  1. Penston JG, Boyd EJ, Wormsley KG. Mallory-Weiss tears occurring during endoscopy: a report of seven cases. Endoscopy 1992;24:262-265. https://doi.org/10.1055/s-2007-1009122
  2. Montalvo RD, Lee M. Retrospective analysis of iatrogenic Mallory-Weiss tears occurring during upper gastrointestinal endoscopy. Hepatogastroenterology 1996;43:174-177.
  3. Pitman ER, Javdan P. Gastric mucosal tears with acute hemorrhage: a possible varient of the Mallory-Weiss syndrome. Am J Dig Dis 1974;19:736-739. https://doi.org/10.1007/BF01844943
  4. Choi PR, Moon W, Park CB, et al. A gigantic gastric mucosal rupture when performing endoscopy under conscious sedation in a patient with hiatal hernia. Korean J Gastrointest Endosc 2009;38:137-141.
  5. Atkinson M, Bottrill MB, Edwards AT, Mitchell W, Peet BG, Williams RE. Mucosal tears at the oesophagogastric junction (the Mallory-Weiss syndrome). Gut 1961;2:1-11. https://doi.org/10.1136/gut.2.1.1
  6. Santoro MJ, Chen YK, Collen MJ. Polyethylene glycol electrolyte lavage solution-induced Mallory-Weiss tears. Am J Gastroenterol 1993;88:1292-1293.
  7. De Vries AJ, van der Maaten JM, Laurens RR. Mallory-Weiss tear following cardiac surgery: transoesophageal echoprobe or nasogastric tube? Br J Anaesth 2000;84:646-649. https://doi.org/10.1093/bja/84.5.646
  8. Fujii H, Suehiro S, Shibata T, Aoyama T, Ikuta T. Mallory - weiss tear complicating intraoperative transesophageal echocardiography. Circ J 2003;67:357-358. https://doi.org/10.1253/circj.67.357
  9. Gilbert DA, Silverstein FE, Tedesco FJ. National ASGE survey on upper gastrointestinal bleeding complications of endoscopy. Dig Dis Sci 1981;26(suppl):55S-59S.
  10. Decker JP, Zamcheck N, Mallory GK. Mallory-Weiss syndrome: hemorrhage from gastroesophageal lacerations at the cardiac orifice of the stomach. New Eng J Med 1953;249:957-963. https://doi.org/10.1056/NEJM195312102492401
  11. Myung SJ, Kim HR, Moon YS. Severe Mallory-Weiss tear after endoscopy treated by endoscopic band ligation. Gastrointestinal Endoscopy 2000;52:99-101. https://doi.org/10.1067/mge.2000.105071
  12. Sugawa C, Benishek D, Walt A. Mallory-Weiss syndrome. A study of 224 patients. Am J Surg 1983;145:30-33. https://doi.org/10.1016/0002-9610(83)90162-9
  13. Bharucha AE, Gostout CJ, Balm RK. Clinical and endoscopic risk factors in the Mallory-Weiss syndrome. Am J Gastroenterol 1997;92:805-808.
  14. Walmsley RS, Montgomery SM. Factors affecting patient tolerance of upper gastrointestinal endoscopy. J Clinical Gastroenterol 1998;26:253-255. https://doi.org/10.1097/00004836-199806000-00006
  15. Lee SY, Son HJ, Lee JM, et al. Identification of factors that influence conscious sedation in gastrointestinal endoscopy. J Korean Med Sci 2004;19:536-540. https://doi.org/10.3346/jkms.2004.19.4.536
  16. Farhadi A, Fields JZ, Hoseini SH. The assessment of esophagogastroduodenoscopy tolerance a prospective study of 300 cases. Diag Ther Endosc 2001;7:141-147. https://doi.org/10.1155/DTE.7.141