The Korean Journal of Medicine

  • 제81권6호
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  • Pages.759-763
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  • 2011
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  • 1738-9364(pISSN)
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  • 2289-0769(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
권호 표지

내시경 조직 생검 후 발생한 점막하 식도 박리 1예

A Case of Esophageal Submucosal Dissection that Developed after Endoscopic Biopsy

  • Kim, Dong-Hyun (Department of Internal Medicine, Good Samsun Hospital) ;
  • Yoon, Jeong-Bin (Department of Internal Medicine, Good Samsun Hospital) ;
  • Kim, Dong-Wan (Department of Internal Medicine, Good Samsun Hospital) ;
  • Jang, Se-Won (Department of Internal Medicine, Good Samsun Hospital) ;
  • Yoon, Jong-Min (Department of Internal Medicine, Good Samsun Hospital) ;
  • Kim, Min-Jung (Department of Internal Medicine, Good Samsun Hospital) ;
  • Kim, Sang-Hyun (Department of Internal Medicine, Good Samsun Hospital)
  • 발행 : 2011.12.01
⟨ 이전 논문 다음 논문 ⟩

초록

점막하 식도 박리 발생의 위험인자는 혈소판감소증, 혈우병, 내시경 경화요법, 심부 정맥 혈전증으로 항응고치료를 받는 환자, 이물, 약물, 내시경 등의 기계적 손상 또는 자발적으로 발생한 점막하 출혈 및 혈종이 있다. 하지만 조직검사로 인한 증례는 아직 발표된 바가 없다. 저자들은 식도 조직검사 후 발생한 흉골하 통증을 주증상으로 내원한 환자에서 상부위장관 내시경 검사를 시행하여서 점막하 식도 박리증을 진단하였다. 금식 및 수액요법 등의 보존 치료로 증상이 호전된 드문 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

The incidence of gastrointestinal complications has increased as endoscopic biopsy has become a standard diagnostic technique. However, esophageal dissection is a rare complication. A 71-year-old man suffered retrosternal pain for 15 days. Fifteen days previously, he had undergone an endoscopic gastrointestinal examination at a local clinic and an esophageal biopsy to obtain microscopic confirmation of esophageal candidiasis. The patient then underwent a subsequent endoscopic examination, which showed features specific to esophageal submucosal dissection. The predisposing conditions for esophageal dissection are coagulopathy, iatrogenic trauma (variceal sclerotherapy), drugs (thrombolytic agents, aspirin), foreign bodies/certain foods (fish, chicken bones), and emesis. However, endoscopic biopsy is a rare predisposing condition. Here, we report a case of esophageal submucosal dissection that developed after esophageal biopsy. We observed the healing process of this lesion with a series of endoscopies as part of a conservative treatment plan.

키워드

참고문헌

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