Clinical Endoscopy

  • 제42권4호
  • /
  • Pages.255-258
  • /
  • 2011
  • /
  • 2234-2400(pISSN)
  • /
  • 2234-2443(eISSN)
대한소화기내시경학회 (The Korean Society of Gastrointestinal Endoscopy)
권호 표지

위의 Dieulafoy 병변 출혈 때문에 발생한 허혈성 대장염 1예

A Case of Ischemic Colitis Results from the Bleeding on Gastric Dieulafoy Lesions

  • 박준석 (순천향대학교 의과대학 내과학교실, 소화기연) ;
  • 김진오 (순천향대학교 의과대학 내과학교실, 소화기연) ;
  • 김현건 (순천향대학교 의과대학 내과학교실, 소화기연) ;
  • 이태희 (순천향대학교 의과대학 내과학교실, 소화기연) ;
  • 홍성욱 (순천향대학교 의과대학 내과학교실, 소화기연) ;
  • 전성곤 (순천향대학교 의과대학 내과학교실, 소화기연) ;
  • 전성란 (순천향대학교 의과대학 내과학교실, 소화기연) ;
  • 김완중 (순천향대학교 의과대학 내과학교실, 소화기연)
  • Park, Jun-Seok (Department of Internal Medicine, Institute for Digestive Research, Digestive Disease Center, Soonchunhyang University College of Medicine) ;
  • Kim, Jin-Oh (Department of Internal Medicine, Institute for Digestive Research, Digestive Disease Center, Soonchunhyang University College of Medicine) ;
  • Kim, Hyun-Gun (Department of Internal Medicine, Institute for Digestive Research, Digestive Disease Center, Soonchunhyang University College of Medicine) ;
  • Lee, Tae-Hee (Department of Internal Medicine, Institute for Digestive Research, Digestive Disease Center, Soonchunhyang University College of Medicine) ;
  • Hong, Sung-Wook (Department of Internal Medicine, Institute for Digestive Research, Digestive Disease Center, Soonchunhyang University College of Medicine) ;
  • Jun, Sung-Gon (Department of Internal Medicine, Institute for Digestive Research, Digestive Disease Center, Soonchunhyang University College of Medicine) ;
  • Jeon, Seong-Ran (Department of Internal Medicine, Institute for Digestive Research, Digestive Disease Center, Soonchunhyang University College of Medicine) ;
  • Kim, Wan-Jung (Department of Internal Medicine, Institute for Digestive Research, Digestive Disease Center, Soonchunhyang University College of Medicine)
  • 발행 : 2011.04.30
⟨ 이전 논문 다음 논문 ⟩

초록

허혈성 대장염은 가장 흔한 허혈성 위장관 손상이다. 일과성허혈성 대장염은 장간막동맥의 관류저하에 의해 발생하며, 그 선행인자가 다양하여 정확한 인과관계를 밝히기 어렵다. 상부위장관 출혈도 하부 위장관의 관류 상태에 영향을 줄 수 있다. 또 서로 임상 양상이 유사하기 때문에 진단 및 치료에 주의할 점이 많다. 아직 상부위장관 출혈 때문에 발생한 허혈성 대장염이 보고된 적은 없다. 저자들은 의식 소실 및 흑색변을 주소로 내원한 63세 남자 환자에서 위의 Dieulafoy 병변 출혈을 치료한 후에 발생한 허혈성 대장염을 경험한 바 있어, 문헌고찰과 함께 보고하는 바이다.

Ischemic colitis is the most common ischemic injury of the gastrointestinal tract. It can result from ischemia caused by compromised blood flow to the mesenteric arteries. Colonic ischemia may be precipitated by several conditions, although a cause is not clearly identified in most cases. A 63-year-old man was admitted because of loss of consciousness with melena. After endoscopic bleeding control of Dieulafoy lesions of the stomach, hematochezia occurred during the in-hospital care period. A sigmoidoscopy and computed tomography scan were conducted to evaluate the hematochezia, and ischemic colitis was diagnosed. Here, we report a case of ischemic colitis associated with massive upper gastrointestinal bleeding.

키워드

참고문헌

  1. Toursarkissian B, Thompson RW. Ischemic colitis. Surg Clin North Am 1997;77:461-470. https://doi.org/10.1016/S0039-6109(05)70561-2
  2. Theodoropoulou A, Koutroubakis IE. Ischemic colitis: clinical practice in diagnosis and treatment. World J Gastroenterol 2008;14:7302-7308. https://doi.org/10.3748/wjg.14.7302
  3. Gandhi SK, Hanson MM, Vernava AM, Kaminski DL, Longo WE. Ischemic colitis. Dis Colon Rectum 1996;39:88-100. https://doi.org/10.1007/BF02048275
  4. Sreenarasimhaiah J. Diagnosis and management of intestinal ischaemic disorders. BMJ 2003;326:1372-1376. https://doi.org/10.1136/bmj.326.7403.1372
  5. Laine L. Chapter 42. Gastrointestinal bleeding. In: Fauci AS, Braunwald E, Kasper DL, et al, editors. Harrison's principles of internal medicine. 17th ed. New York: McGrawHill, 2008:257-260.
  6. Matsumoto T, Iida M, Kimura Y, Nanbu T, Fujishima M. Clinical features in young adult patients with ischaemic colitis. J Gastroenterol Hepatol 1994;9:572-575. https://doi.org/10.1111/j.1440-1746.1994.tb01563.x
  7. Habu Y, Tahashi Y, Kiyota K, et al. Reevaluation of clinical features of ischemic colitis. Analysis of 68 consecutive cases diagnosed by early colonoscopy. Scand J Gastroenterol 1996;31:881-886. https://doi.org/10.3109/00365529609051996
  8. Balthazar EJ, Yen BC, Gordon RB. Ischemic colitis: CT evaluation of 54 cases. Radiology 1999;211:381-388. https://doi.org/10.1148/radiology.211.2.r99ma28381
  9. Scholerich J, Messmann H. Chapter 42. Lower intestinal bleeding disorders. In: Classen M, Tytgat G, Lightdale C, editors. Gastroenterological endoscopy. 2nd ed. New York: Thieme, 2010:598-613.
  10. Oh YL, Park CK. Histopathological features of endoscopic biopsies in ischemic colitis. Korean J Patho 1999;33:490-496.
  11. Kobayashi G, Chandrasoma P. Chapter 10. Nonneoplastic disease of the colon. In: Chandrasoma P, editor. Gastrointestinal pathology. 1st ed. New York: McGrawHill, 1999:249-282.
  12. Zeitz M. Shock-associated nonocclusive ischemic colitis: a very rare event in young patients after trauma. Int J Colorectal Dis 2001;16:58-59. https://doi.org/10.1007/s003840000272
  13. Naidoo TD, Paruk N, Moodley J. Shock associated ischaemic colitis following massive obstetric haemorrhage. J Obstet Gynaecol 2007;27:320-321. https://doi.org/10.1080/01443610701241308
  14. Ludwig KA, Quebbeman EJ, Bergstein JM, Wallace JR, Wittmann DH, Aprahamian C. Shock-associated right colon ischemia and necrosis. J Trauma 1995;39:1171-1174. https://doi.org/10.1097/00005373-199512000-00029
  15. Lim SR, Kim HS, Ryu HS, et al. A case of non-occlusive ischemic colitis of the right colon after percutaneous coronary intervention. Korean J Gastrointest Endosc 2010;40:130-134.
  16. Yang HS, Kim HD, Kim SH, et al. A case of ischemic colitis after percutaneous coronary intervention. Chonnam Med J 2007;43:216-219.