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17세까지 천식으로 오인된 식도이완불능증

A Patient with Achalasia Misdiagnosed as Asthma Until Age 17

  • 김혜진 (순천향대학교 의과대학 구미병원 호흡기내과학교실) ;
  • 김명신 (순천향대학교 의과대학 구미병원 호흡기내과학교실) ;
  • 임건일 (순천향대학교 의과대학 구미병원 호흡기내과학교실) ;
  • 박윤선 (순천향대학교 의과대학 구미병원 소화기내과학교실) ;
  • 임한혁 (순천향대학교 의과대학 구미병원 영상의학과학교실) ;
  • 황헌규 (순천향대학교 의과대학 구미병원 호흡기내과학교실)
  • Kim, Hye Jin (Division of Pulmonology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Gumi Hospital) ;
  • Kim, Myung Shin (Division of Pulmonology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Gumi Hospital) ;
  • Lim, Gune Il (Division of Pulmonology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Gumi Hospital) ;
  • Park, Youn Sun (Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Gumi Hospital) ;
  • Im, Han Hyeok (Department of Radiology, Soonchunhyang University College of Medicine, Gumi Hospital) ;
  • Hwang, Hun Gyu (Division of Pulmonology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Gumi Hospital)
  • 투고 : 2013.01.25
  • 심사 : 2013.03.20
  • 발행 : 2013.09.01

초록

식도이완불능증은 하부식도괄약근의 이완장애 및 식도체부의 연하운동부전을 특징으로 하는 식도운동장애질환으로 연하장애를 동반한다. 소아 및 청소년에서 가장 흔한 증상은 구토, 연하곤란, 체중감소, 반복적인 폐렴, 야간기침, 흉통 등이 발생할 수 있다. 4세경부터 운동시 유발되는 호흡곤란과 기침증세를 보였으며, 치료에 반응을 잘 보이지 않는 천식의 과거력이 있는 17세 환아가 내원 1주 전부터 발생한 기침, 객담, 발열을 주소로 내원하여 마침내 식도이완불능증과 식도하부확장, 폐렴, 기관지확장증으로 진단되어 풍선확장술을 시행 받고 호흡기 증세의 호전을 보여 문헌고찰과 함께 보고하는 바이다.

Achalasia is a primary esophageal motility disorder characterized by functional obstruction of the distal esophagus and subsequent dilation of the proximal esophagus. The most common symptoms in children and adolescents are vomiting, progressive dysphagia, weight loss, recurrent pneumonia, nocturnal cough, and chest pain. A girl who had been diagnosed with asthma poorly responsive to inhaled steroids until age 17, presented at the hospital with cough, sputum, and fever. Finally, she was diagnosed with achalasia and underwent esophageal balloon dilatation, which relieved her GI and pulmonary symptoms. We report this case with a literature review.

키워드

참고문헌

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