Clinical Endoscopy

  • 제41권6호
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  • Pages.329-337
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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

원인불명의 위장관 출혈에서 내시경의 역할

The Role of Endoscopy in Obscure Gastrointestinal Bleeding

  • 은창수 (한양대학교 의과대학 내과학교실)
  • Eun, Chang-Soo (Department of Internal Medicine, Hanyang University College of Medicine)
  • 투고 : 2010.12.06
  • 심사 : 2010.12.22
  • 발행 : 2010.12.30
⟨ 이전 논문 다음 논문 ⟩

초록

원인불명의 위장관 출혈은 상부위장관내시경과 대장내시경에서 원인을 알 수 없었던 출혈이나 철 결핍성 빈혈이 반복되거나 지속되는 상태를 말한다. 원인불명의 위장관 출혈은 소화기의사가 종종 접하는 질환으로 전체 위장관 출혈의 약 5%를 차지하는데, 대부분은 소장 병변에서 발생한다. 그동안 원인불명의 위장관 출혈의 진단을 위해서 밀기식 소장내시경을 비롯한 몇몇 소장내시경들이 사용되어 왔지만 근위부 공장까지만 관찰할 수 있다는 문제점 등으로 제한적인 역할만을 하였다. 최근 캡슐내시경과 이중풍선 소장내시경이 도입됨에 따라 전체 소장의 관찰이 가능하게 되어 원인불명의 위장관 출혈의 진단과 치료에 커다란 발전을 이루게 되었다. 이 글에서는 원인불명의 위장관 출혈에서 캡슐내시경과 이중풍선 소장내시경 중심으로 내시경의 역할을 정리하였다.

Obscure gastrointestinal bleeding (OGIB) is defined as occult or overt bleeding of unknown origin that persists or recurs after an initial negative endoscopic evaluation by gastroscopy or colonoscopy. Most of these problems occur in the small bowel, and it is not an uncommon condition encountered by gastroenterologists, accounting for approximately 5% of all GIB. Traditional endoscopic techniques, including push enteroscopy, have a limited role in diagnosing patients with OGIB because of the inaccessibility of a large part of the small bowel using an endoscopic procedure. The recent introduction of new enteroscopic modalities including capsule endoscopy (CE) and double balloon enteroscopy have allowed mucosal visualization of the entire small bowel, revolutionizing the diagnosis and treatment of patients with OGIB. The respective roles of CE and deep enteroscopy in patients with OGIB are discussed in this review.

키워드

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