The Korean Journal of Medicine

  • 제85권6호
  • /
  • Pages.604-608
  • /
  • 2013
  • /
  • 1738-9364(pISSN)
  • /
  • 2289-0769(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
권호 표지
DOI QR코드

DOI QR Code

보존적 치료로 호전된 장괴사를 동반한 급성 하장간막 동맥 혈전증 1예

A Case of Inferior Mesenteric Arterial Thrombosis with Bowel Infarction Successfully Treated by Conservative Treatment

  • 최윤식 (울산대학교 의과대학 내과학교실) ;
  • 양동훈 (울산대학교 의과대학 내과학교실) ;
  • 남광우 (울산대학교 의과대학 내과학교실) ;
  • 이신원 (울산대학교 의과대학 내과학교실) ;
  • 최영권 (울산대학교 의과대학 내과학교실) ;
  • 변정식 (울산대학교 의과대학 내과학교실) ;
  • 양석균 (울산대학교 의과대학 내과학교실)
  • Choi, Yun-Sik (Department of Internal Medicine, University of Ulsan College of Medicine) ;
  • Yang, Dong-Hoon (Department of Internal Medicine, University of Ulsan College of Medicine) ;
  • Nam, Kwang-Woo (Department of Internal Medicine, University of Ulsan College of Medicine) ;
  • Lee, Sin-Won (Department of Internal Medicine, University of Ulsan College of Medicine) ;
  • Choi, Young-Kwon (Department of Internal Medicine, University of Ulsan College of Medicine) ;
  • Byeon, Jeong-Sik (Department of Internal Medicine, University of Ulsan College of Medicine) ;
  • Yang, Suk-Kyun (Department of Internal Medicine, University of Ulsan College of Medicine)
  • 투고 : 2013.05.06
  • 심사 : 2013.07.25
  • 발행 : 2013.12.01
⟨ 이전 논문 다음 논문 ⟩

초록

급성 장간막 혈전증은 대부분 상장간막 동맥에 발생하므로 그 예후가 매우 불량하며 특히 장괴사를 동반한 경우에는 반드시 수술이 필요하다. 그러나 저자들은 비록 장괴사가 동반되었으나 하장간막 동맥에 부분적인 폐색을 유발한 혈전증을 보존적 치료만으로 성공적으로 치료하였기에 문헌고찰과 함께 보고하는 바이다.

Acute mesenteric thrombosis accounts for 25-30% of acute mesenteric ischemia and occurs usually alongside severe atherosclerotic disease. Acute mesenteric thrombosis primarily affects the superior mesenteric artery; thus, inferior mesenteric arterial thrombosis is an extremely rare form of the condition. Surgical treatment is mandatory to resolve impending or overt bowel infarction in acute mesenteric ischemia patients. However, here we report a case of colonic infarction caused by acute inferior mesenteric thrombosis successfully treated by conservative management.

키워드

참고문헌

  1. Oldenburg WA, Lau LL, Rodenberg TJ, Edmonds HJ, Burger CD. Acute mesenteric ischemia: a clinical review. Arch Intern Med 2004;164:1054-1062. https://doi.org/10.1001/archinte.164.10.1054
  2. Berland T, Oldenburg WA. Acute mesenteric ischemia. Curr Gastroenterol Rep 2008;10:341-346. https://doi.org/10.1007/s11894-008-0065-0
  3. Brandão D, Koullias GJ, Caparrelli DJ, Diethrich EB. Inferior mesenteric artery stenting: a solution for chronic mesenteric ischemia. Perspect Vasc Surg Endovasc Ther 2009;21:186-189. https://doi.org/10.1177/1531003509351096
  4. Lotun K, Shetty R, Topaz O. Atherosclerotic inferior mesenteric artery stenosis resulting in large intestinal hypoperfusion: a paradigm shift in the diagnosis and management of symptomatic chronic mesenteric ischemia. Catheter Cardiovasc Interv 2012;80:877-882. https://doi.org/10.1002/ccd.23365
  5. Huggard T, Herstein A. Thrombosis of the inferior mesenteric artery. Can Med Assoc J 1950;62:502-503.
  6. Karmody AM, Jordan FR, Zaman SN. Left colon gangrene after acute inferior mesenteric artery occlusion. Arch Surg 1976;111:972-975. https://doi.org/10.1001/archsurg.1976.01360270044008
  7. Sitges-Serra A, Mas X, Roqueta F, Figueras J, Sanz F. Mesenteric infarction: an analysis of 83 patients with prognostic studies in 44 cases undergoing a massive smallbowel resection. Br J Surg 1988;75:544-548. https://doi.org/10.1002/bjs.1800750614
  8. Cangemi JR, Picco MF. Intestinal ischemia in the elderly. Gastroenterol Clin North Am 2009;38:527-540. https://doi.org/10.1016/j.gtc.2009.06.002
  9. 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