벌침에 의한 인후부 부종 2예

Two Cases of Oropharyngeal Edema Caused by a Bee Sting

  • Oh, Wang-Guk (Department of Internal Medicine, Presbyterian Medical Center) ;
  • Kim, Ji-Woong (Department of Internal Medicine, Presbyterian Medical Center) ;
  • Kim, Ki-Hoe (Department of Internal Medicine, Presbyterian Medical Center) ;
  • Kim, Jeong-Gwan (Department of Internal Medicine, Presbyterian Medical Center) ;
  • Song, Ji-Eun (Department of Internal Medicine, Presbyterian Medical Center) ;
  • Gil, So-Hyun (Department of Internal Medicine, Presbyterian Medical Center) ;
  • Park, Sang-Hoon (Department of Internal Medicine, Presbyterian Medical Center) ;
  • Cho, Jin-Woong (Department of Internal Medicine, Presbyterian Medical Center)
  • 투고 : 2010.04.15
  • 심사 : 2010.08.04
  • 발행 : 2010.09.30

초록

벌침은 다양한 독성 물질과 알러지 물질을 함유하여 다양한 국소 및 전신 증상을 유발하며 대부분 후유증을 남기지 않으나 과민반응이 발생하면 매우 위험해 벌침으로 인한 사망의 원인으로 생각된다. 구강 내 벌침에 의한 쏘임은 흔하지 않으나 국소부종 및 과민반응에 의한 호흡부전 등 위험한 상황이 올 수 있어 즉각적인 에피네프린, 항히스타민제 및 스테로이드 등의 치료가 필요하며 수일간의 경과관찰이 필요하다. 특히 상부위장관내시경상피열 연골 등 인후부의 정밀한 관찰이 요구된다. 응급내시경 검사상 피열 연골의 부종이 있는지 확인 해야 하며 벌침의 유무를 확인한다. 저자들은 여름철 뚜껑을 열어놓은 음료수에 들어간 벌을 잘못 마셔 구강 내 피열 연골의 부종이 발생하여 이물감 및 통증을 호소하는 환자 2예를 경험하여 보고한다.

Hymenoptera stings can result in local and systematic symptoms due to their toxic and allergic contents. Although serious sequela are rare, the occurrence of an anaphylactic reaction is considered to be very dangerous and can potentially cause death. Oropharyngeal stings, though infrequent, can cause local edema and airway obstruction due to an anaphylactic reaction and requires immediate epinephrine, antihistamine, steroid treatment and close observation over several days. Careful observation of the oropharyngeal and laryngopharyngeal area using upper gastrointestinal endoscopy is highly recommended, especially for detection of possible edematous swelling in the arytenoid cartilage area. Here we report two cases of patients complaining pain due to edematous swelling in the arytenoid cartilage area caused by hymenoptera stings after accidentally drinking water with a bee in it.

키워드

참고문헌

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