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기저 간질환이 없는 환자에서 우연히 발견된 간외 문맥 동맥류 1예

Extrahepatic Portal Vein Aneurysm in a Non-cirrhotic Patient

  • 박성환 (동의대학교 한의과대학 동의의료원 내과학교실) ;
  • 박철우 (동의대학교 한의과대학 동의의료원 내과학교실) ;
  • 남원욱 (동의대학교 한의과대학 동의의료원 내과학교실) ;
  • 박정익 (동의대학교 한의과대학 동의의료원 내과학교실) ;
  • 김효종 (동의대학교 한의과대학 동의의료원 내과학교실) ;
  • 문성원 (동의대학교 한의과대학 동의의료원 내과학교실)
  • Park, Sung-Hwan (Department of Internal Medicine, Dong-Eui Medical Center, Dong-Eui University College of Oriental Medicine) ;
  • Park, Cheol-Woo (Department of Internal Medicine, Dong-Eui Medical Center, Dong-Eui University College of Oriental Medicine) ;
  • Nam, Oun-Ouk (Department of Internal Medicine, Dong-Eui Medical Center, Dong-Eui University College of Oriental Medicine) ;
  • Park, Jung-Ik (Department of Internal Medicine, Dong-Eui Medical Center, Dong-Eui University College of Oriental Medicine) ;
  • Kim, Hyo-Jong (Department of Internal Medicine, Dong-Eui Medical Center, Dong-Eui University College of Oriental Medicine) ;
  • Moon, Sung Won (Department of Internal Medicine, Dong-Eui Medical Center, Dong-Eui University College of Oriental Medicine)
  • 투고 : 2012.11.01
  • 심사 : 2013.03.19
  • 발행 : 2013.09.01

초록

간문맥 동맥류는 흔치 않은 질환으로 증상 없이 우연히 발견되는 경우가 많다. 정확한 원인은 아직 밝혀지지 않았으며 다양한 모양을 갖고 있다. 기저 간질환이나 문맥압 항진의 증거가 없는 간문맥 동맥류는 비교적 안정적인 경과를 보이는 것으로 알려져 있다. 따라서 조기 진단 후 추적검사를 통해 크기 변화와 합병증 발생 여부에 대한 관찰이 중요하다. 증상이나 합병증이 발생한 경우 중재적 시술이나 수술적 치료가 필요하다. 저자들은 비특이적인 복부 불편감을 주소로 내원한 환자에서 CT상 간외 간문맥 동맥류를 발견한 1예를 경험하였기에 문헌고찰과 함께 증례를 보고하고자 한다.

Portal venous aneurysm (PVA) is an unusual venous malformation and its etiology is not fully understood. Most PVAs are diagnosed incidentally by non-invasive abdominal imaging techniques; indeed, recently, PVAs have frequently been discovered in this way. Most PVAs remain stable, without complications, in patients with no clinical symptoms of portal hypertension or intrinsic liver disease. However, if PVA is discovered in these patients by chance, close imaging follow-up of portal vein aneurysms is recommended. In the case of aneurysm growth or the development of complications related to the aneurysm, medical or surgical approaches are advised but there is no consensus on the use of prophylactic antiplatelet or anticoagulation medications. We report a case of incidental PVA identification in a patient without underlying liver disease by routine investigation. A review of the literature is also provided.

키워드

참고문헌

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