Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
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Cytomegalovirus Colitis Causing Cecal Perforation and Massive Lower Gastrointestinal Bleeding

맹장 천공과 하부위장관 출혈로 발현한 거대세포바이러스 대장염 1예

  • Jeon, Jung-Won (Department of Internal Medicine, Gang Dong Kyung Hee University Hospital, Kyunghee University College of Medicine) ;
  • Cha, Jae-Myung (Department of Internal Medicine, Gang Dong Kyung Hee University Hospital, Kyunghee University College of Medicine) ;
  • Lee, Joung-Il (Department of Internal Medicine, Gang Dong Kyung Hee University Hospital, Kyunghee University College of Medicine) ;
  • Joo, Kwang-Ro (Department of Internal Medicine, Gang Dong Kyung Hee University Hospital, Kyunghee University College of Medicine) ;
  • Shin, Hyun-Phil (Department of Internal Medicine, Gang Dong Kyung Hee University Hospital, Kyunghee University College of Medicine) ;
  • Park, Jae-Jun (Department of Internal Medicine, Gang Dong Kyung Hee University Hospital, Kyunghee University College of Medicine) ;
  • Pack, Kwan-Mi (Department of Internal Medicine, Gang Dong Kyung Hee University Hospital, Kyunghee University College of Medicine) ;
  • Lim, Jun-Uk (Department of Internal Medicine, Gang Dong Kyung Hee University Hospital, Kyunghee University College of Medicine)
  • 전정원 (경희대학교 의과대학 강동경희대학교병원 내과학교실) ;
  • 차재명 (경희대학교 의과대학 강동경희대학교병원 내과학교실) ;
  • 이정일 (경희대학교 의과대학 강동경희대학교병원 내과학교실) ;
  • 주광로 (경희대학교 의과대학 강동경희대학교병원 내과학교실) ;
  • 신현필 (경희대학교 의과대학 강동경희대학교병원 내과학교실) ;
  • 박재준 (경희대학교 의과대학 강동경희대학교병원 내과학교실) ;
  • 백관미 (경희대학교 의과대학 강동경희대학교병원 내과학교실) ;
  • 임준욱 (경희대학교 의과대학 강동경희대학교병원 내과학교실)
  • Published : 2011.01.30
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Abstract

Cytomegalovirus (CMV) infection is associated with significant morbidity and mortality in immunocompromised patients. It may cause serious illness including bleeding, ulceration and perforation of the gastrointestinal tract. However, bowel perforation, toxic megacolon, and massive lower gastrointestinal bleeding caused by CMV in one patient is not common. In this report, we present a case of CMV colitis causing cecal perforation and massive lower gastrointestinal bleeding in a patient with lupus nephritis. In our case, severe lower gastrointestinal bleeding developed during successful treatment of CMV infection with ganciclovir. Even though the outcome of CMV colitis has improved since ganciclovir has been available for immunocompromised patients, reductions in gastrointestinal bleeding from colonic ulcers of CMV colitis may be possible during successful treatment with ganciclovir. This case suggests the possibility of lower gastrointestinal bleeding from a colon ulcer of CMV colitis should be considered during successful treatment with ganciclovir in immunocompromised patients.

거대세포바이러스 감염은 면역이 저하된 환자에서 이환율과 사망률을 높이며, 위장관을 침범하는 경우 궤양, 출혈 그리고 천공을 포함하는 심각한 상태를 야기한다. 그러나 한 환자에서 위장관 출혈, 궤양, 거대 결장 그리고 천공이 함께 동반되는 경우는 흔하지 않다. 저자들은 루푸스 신염 환자에서 거대세포바이러스 장염에 의해 발생한 맹장의 천공을 수술적 방법으로 치료한 후, 적절한 항 바이러스 치료를 하는 과정에서 환자의 기저 전신 상태의 저하로 인하여, 이전에 발생한 대장 궤양이 원인이 되어 하부 위장관 출혈이 발생한 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

Keywords

References

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