DOI QR코드

DOI QR Code

위점막밑 병변으로 나타난 부비장 1예

Subepithelial Lesion of the Gastric Fundus Caused by an Accessory Spleen

  • 박명옥 (강원대학교 의학전문대학원 내과학교실) ;
  • 이성원 (강원대학교 의학전문대학원 내과학교실) ;
  • 김희정 (강원대학교 의학전문대학원 내과학교실) ;
  • 최대희 (강원대학교 의학전문대학원 내과학교실) ;
  • 박성철 (강원대학교 의학전문대학원 내과학교실) ;
  • 이성준 (강원대학교 의학전문대학원 내과학교실) ;
  • 강창돈 (강원대학교 의학전문대학원 내과학교실)
  • Park, Myoung-Ok (Department of Internal Medicine, Kangwon National University School of Medicine) ;
  • Lee, Sung-Won (Department of Internal Medicine, Kangwon National University School of Medicine) ;
  • Kim, Hee-Jung (Department of Internal Medicine, Kangwon National University School of Medicine) ;
  • Choi, Dae-Hee (Department of Internal Medicine, Kangwon National University School of Medicine) ;
  • Park, Sung-Chul (Department of Internal Medicine, Kangwon National University School of Medicine) ;
  • Lee, Sung-Joon (Department of Internal Medicine, Kangwon National University School of Medicine) ;
  • Kang, Chang-Don (Department of Internal Medicine, Kangwon National University School of Medicine)
  • 발행 : 2012.02.01

초록

위는 복부 중앙에 위치하여 주변의 장기로 인한 눌림이 흔하게 나타나며, 이는 종종 점막밑종양과 감별이 필요하다. 특히 위 바닥은 흔하게 정상적인 해부학적 구조물인 비장이나 비장동맥으로 인한 벽외성 압박이 관찰되는 경우가 많다. 저자들은 외상으로 인한 신장 및 비장절제술을 받은 환자가 속쓰림과 소화불량이 심하여 시행한 위내시경 검사에서 위바닥의 점막밑종양이 의심되었던 증례로 수술 후 부비장으로 확인되어 보고하는 바이다.

When a submucosal lesion is discovered at the gastric fundus by gastroscopy, it may be difficult to distinguish a gastric external compression from a true submucosal tumor (SMT). The stomach is a hollow organ centrally placed in the upper abdomen, and it is possible to have a protruding external compression at the fundus, particularly from an enlarged spleen or splenic artery. An accessory spleen or splenosis is not a very unusual finding but may rarely produce such external compression at the gastric fundus. We experienced a case of an accessory spleen mimicking a gastric SMT diagnosed through a gastroscopy after a splenectomy.

키워드

참고문헌

  1. Kim YW, Kim GH, Kim DU, et al. The clinical significance of extraluminal compressions according to the site of the stomach. Korean J Gastrointest Endosc 2009;39:125-130.
  2. Movitz D. Accessory spleens and experimental splenosis: principles of growth. Chic Med Sch Q 1967;26:183-187.
  3. Böhm N, Wybitul K. Autotransplantation of spleen tissue after traumatic spleen rupture (traumatic splenosis): a report of 4 cases. Chirurg 1980;51:158-162.
  4. Woo JH, Park SH, Park YK, et al. Postsplenectomy recurrence of thrombocytopenia with an accessory spleen. Korean J Intern Med 2004;19:199-201. https://doi.org/10.3904/kjim.2004.19.3.199
  5. Halpert B, Gyorkey F. Lesions observed in accessory spleens of 311 patients. Am J Clin Pathol 1959;32:165-168. https://doi.org/10.1093/ajcp/32.2.165
  6. Beahrs JR, Stephens DH. Enlarged accessory spleens: CT appearance in postsplenectomy patients. AJR Am J Roentgenol 1980;135:483-486. https://doi.org/10.2214/ajr.135.3.483
  7. Chin S, Isomoto H, Mizuta Y, Wen CY, Shikuwa S, Kohno S. Enlarged accessory spleen presenting stomach submucosal tumor. World J Gastroenterol 2007;13:1752-1754. https://doi.org/10.3748/wjg.v13.i11.1752
  8. Chen CH, Wu HC, Chang CH. An accessory spleen mimics a left adrenal carcinoma. MedGenMed 2005;7:9.
  9. Gayer G, Zissin R, Apter S, Atar E, Portnoy O, Itzchak Y. CT findings in congenital anomalies of the spleen. Br J Radiol 2001;74:767-772. https://doi.org/10.1259/bjr.74.884.740767