Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
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An Intramural Gastric Hematoma after Epinephrine Injection for Gastric Ulcer Bleeding in Patient with Liver Cirrhosis

간경변 환자에서 위궤양 출혈의 에피네프린 주입술 후 발생한 위벽 내 혈종 1예

  • Cheong, Hyeong-Cheol (Department of Internal Medicine, Wonkwang University Hospital, Wonkwang University College of Medicine) ;
  • Kim, Tae-Hyeon (Department of Internal Medicine, Wonkwang University Hospital, Wonkwang University College of Medicine) ;
  • Chung, Jin-Soo (Department of Internal Medicine, Wonkwang University Hospital, Wonkwang University College of Medicine) ;
  • Kim, Tae-Hyun (Department of Internal Medicine, Wonkwang University Hospital, Wonkwang University College of Medicine) ;
  • Yang, Bong-Jun (Department of Internal Medicine, Wonkwang University Hospital, Wonkwang University College of Medicine) ;
  • Oh, Hyo-Jung (Department of Internal Medicine, Wonkwang University Hospital, Wonkwang University College of Medicine) ;
  • Sohn, Yong-Woo (Department of Internal Medicine, Wonkwang University Hospital, Wonkwang University College of Medicine)
  • 정형철 (원광대학교 의과대학 원광대학병원 내과학교실) ;
  • 김태현 (원광대학교 의과대학 원광대학병원 내과학교실) ;
  • 정진수 (원광대학교 의과대학 원광대학병원 내과학교실) ;
  • 김태현 (원광대학교 의과대학 원광대학병원 내과학교실) ;
  • 양봉준 (원광대학교 의과대학 원광대학병원 내과학교실) ;
  • 오효정 (원광대학교 의과대학 원광대학병원 내과학교실) ;
  • 손영우 (원광대학교 의과대학 원광대학병원 내과학교실)
  • Received : 2010.01.22
  • Accepted : 2010.05.18
  • Published : 2010.06.30
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Abstract

Intramural hematoma of the gastrointestinal tract is an uncommon occurrence with the majority being localized to the esophagus or duodenum. Hematoma of the gastric wall is very rare, and has been reported most commonly in association with coagulopathy, trauma, hematologic disease, and therapeutic endoscopy. Here we describe a case of intramural gastric hematoma after epinephrine injection therapy for a gastric ulcer with underlying liver cirrhosis that was successfully managed with conservative therapy.

위궤양의 상부위장관 내시경 후 발생하는 위벽 내 혈종은 매우 드문 질환으로 만성신부전, 간경화, 혈우병 등의 혈액응고 장애가 있는 환자들에서 주로 발생한다. 혈종의 정확한 기전은 밝혀지지 않았지만 희석된 에피네프린이 과도하게 주입되었거나 기저 혈관이 손상되는 경우가 원인으로 추정된다. 따라서 혈액응고장애가 있는 환자들에서는 각종 내시경적 지혈제를 주입할 때 많은 주의가 필요하다. 본 증례에서는 간경변 환자에서 출혈성 위궤양의 재출혈을 예방하기 위해 시행한 내시경적 지혈치료 후에 위벽 내 혈종이 발생하였고, 금식 및 산분비 억제제 치료 등 보존적 치료 후 특별한 합병증 없이 호전된 1예를 경험하였기에 문헌고찰과 함께 보고한다.

Keywords

References

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