The Korean Journal of Medicine

  • 제84권4호
  • /
  • Pages.551-555
  • /
  • 2013
  • /
  • 1738-9364(pISSN)
  • /
  • 2289-0769(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
권호 표지
DOI QR코드

DOI QR Code

급성 담석 췌장염의 합병증으로 발생한 십이지장 벽내 혈종 1예

Intramural Duodenal Hematoma Caused by Acute Gallstone Pancreatitis

  • 권혁희 (울산대학교 의과대학 서울아산병원 내과학교실) ;
  • 최효인 (울산대학교 의과대학 서울아산병원 내과학교실) ;
  • 전민지 (울산대학교 의과대학 서울아산병원 내과학교실) ;
  • 송호준 (울산대학교 의과대학 서울아산병원 내과학교실) ;
  • 이상수 (울산대학교 의과대학 서울아산병원 내과학교실) ;
  • 정훈용 (울산대학교 의과대학 서울아산병원 내과학교실) ;
  • 김진호 (울산대학교 의과대학 서울아산병원 내과학교실)
  • Kwon, Hyuk Hee (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Choi, Hyo In (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Jeon, Min Ji (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Song, Ho June (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Lee, Sang Soo (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Jung, Hwoon Yong (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Jin Ho (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine)
  • 투고 : 2012.06.26
  • 심사 : 2012.08.16
  • 발행 : 2013.04.01
⟨ 이전 논문 다음 논문 ⟩

초록

췌장 기원의 십이지장 벽내 혈종은 드문 질환으로서 저자들은 담석에 의한 급성 췌장염 환자에서 십이지장 벽내 혈종이 발생한 1예를 경험하였다. 급성 췌장염에서 복통과 장관 폐쇄의 악화, 위장관 출혈이 병발한 경우에는 합병증으로서 십이지장 벽내 혈종을 의심할 수 있다. 본 증례에서는 췌장과 십이지장 절제 없이 내과적인 방법으로 췌장염과 십이지장 벽내 혈종을 치료하였다.

Intramural duodenal hematoma (IDH) is a rare complication of pancreatitis. We report a unique case of IDH caused by acute gallstone pancreatitis in a 37-year-old man. The patient presented with hematemesis and sudden exacerbation of upper abdominal pancreatic pain. An abdominal computed tomography scan showed an intramural hyperdense hematoma and symmetric thickening of the duodenal wall along with peripancreatic inflammation and gallbladder stones. A duodenoscopy also revealed a bloody edematous duodenal wall with a narrow lumen due to IDH. The patient recovered fully from the acute pancreatitis and IDH without pancreaticoduodenectomy using conservative management and a subsequent cholecystectomy.

키워드

참고문헌

  1. Dubois J, Guy F, Porcheron J. A pancreatic-induced intramural duodenal hematoma: a case report and literature review. Hepatogastroenterology 2003;50:1689-1692.
  2. Fukunaga N, Ishikawa M, Yamamura Y, Ichimori T, Sakata A. Spontaneous intramural duodenal hematoma complicating acute pancreatitis. Surgery 2011;149:143-144. https://doi.org/10.1016/j.surg.2009.06.014
  3. Park BD, Lee DH, Jeong S, et al. A case of duodenal intramural hematoma complicated with chronic pancreatitis. Korean J Gastrointest Endosc 2008;37:207-211.
  4. Jones WR, Hardin WJ, Davis JT, Hardy JD. Intramural hematoma of the duodenum: a review of the literature and case report. Ann Surg 1971;173:534-544. https://doi.org/10.1097/00000658-197104000-00009
  5. Bellens L, Van Hee R, Vanderstighelen Y, Vanderputte S. Intramural duodenal hematoma of pancreatic origin. Hepatogastroenterology 1999;46:930-932.
  6. Kwon CI, Ko KH, Kim HY, et al. Bowel obstruction caused by an intramural duodenal hematoma: a case report of endoscopic incision and drainage. J Korean Med Sci 2009; 24:179-183. https://doi.org/10.3346/jkms.2009.24.1.179
  7. Ma JK, Ng KK, Poon RT, Fan ST. Pancreatic-induced intramural duodenal haematoma. Asian J Surg 2008;31: 83-86. https://doi.org/10.1016/S1015-9584(08)60063-9
  8. Van Spreeuwel JP, van Gorp LH, Bast TJ, Nadorp JH. Intramural hematoma of the duodenum in a patient with chronic pancreatitis. Endoscopy 1981;13:246-248. https://doi.org/10.1055/s-2007-1021697
  9. Abbas MA, Collins JM, Olden KW. Spontaneous intramural small-bowel hematoma: imaging findings and outcome. AJR Am J Roentgenol 2002;179:1389-1394. https://doi.org/10.2214/ajr.179.6.1791389
  10. Linsenmaier U, Wirth S, Reiser M, Körner M. Diagnosis and classification of pancreatic and duodenal injuries in emergency radiology. Radiographics 2008;28:1591-1602. https://doi.org/10.1148/rg.286085524
  11. Dugernier TL, Breuskin FM. Duodenal air dissection secondary to intramural hematoma in necrotizing pancreatitis. Endoscopy 2002;34:1024. https://doi.org/10.1055/s-2002-35833

피인용 문헌

  1. A Case of Duodenal Intramural Hematoma Caused by Acute Alcoholic Pancreatitis vol.19, pp.3, 2013, https://doi.org/10.15279/kpba.2014.19.3.132
  2. Acute Cholecystitis and Obstructive Jaundice by Nontraumatic Duodenal Intramural Hematoma at Ampulla of Vater vol.21, pp.1, 2013, https://doi.org/10.15279/kpba.2016.21.1.50
  3. Intramural Duodenal Hematoma after Transpancreatic Septotomy during ERCP: A Case Report and Literature Review vol.21, pp.1, 2013, https://doi.org/10.15279/kpba.2016.21.1.55