The Korean Journal of Medicine

  • 제86권4호
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  • Pages.472-477
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  • 2014
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  • 1738-9364(pISSN)
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  • 2289-0769(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
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알코올 간경변 환자에서 발생한 자발성 근육 내 혈종 3예

Three Cases of Spontaneous Muscle Hematoma in Alcoholic Liver Cirrhosis

  • 유동훈 (경상대학교 의학전문대학원 경상대학교병원 내과) ;
  • 최자윤 (경상대학교 의학전문대학원 경상대학교병원 내과) ;
  • 차라리 (경상대학교 의학전문대학원 경상대학교병원 내과) ;
  • 오혜원 (경상대학교 의학전문대학원 경상대학교병원 내과) ;
  • 조윤원 (경상대학교 의학전문대학원 경상대학교병원 내과) ;
  • 민현주 (경상대학교 의학전문대학원 경상대학교병원 내과) ;
  • 이옥재 (경상대학교 의학전문대학원 경상대학교병원 내과)
  • Lew, Dong Hoon (Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine) ;
  • Choi, Ja Yoon (Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine) ;
  • Cha, Ra Ri (Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine) ;
  • Oh, Hye Won (Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine) ;
  • Jo, Yun Won (Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine) ;
  • Min, Hyun Ju (Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine) ;
  • Lee, Ok Jae (Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine)
  • 투고 : 2013.07.17
  • 심사 : 2013.09.02
  • 발행 : 2014.04.01
⟨ 이전 논문 다음 논문 ⟩

초록

자발성 근육 내 혈종은 간경변 환자에서 드물지만 치명적인 합병증이다. 저자들은 알코올 간경변 환자에서 자발적으로 발생한 근육 내 혈종 3예를 경험하여 보고하는 바이다. 출혈 혈관에 대하여 반복적인 경동맥 색전술을 시행하였음에도 불구하고 지속되는 출혈과 간부전으로 모두 사망하였다. 현재까지 보고된 간경변 환자에서 발생한 자발성 근육내 혈종 14증례에서 알코올 간경변 환자에서 가장 많이 발생하였으며 빠른 진단과 치료에도 불구하고 사망률이 높았다. 따라서 간경변 환자에서 발생하는 자발성 근육 내 혈종은 드물지만 예후가 매우 불량하여 이의 발생과 치료에 주의를 요한다.

Liver cirrhosis is commonly associated with bleeding complications due to portal hypertension or coagulopathy. Spontaneous muscle hematoma is a rare but potentially lethal complication of liver cirrhosis. Here we report three cases of spontaneous muscle hematoma diagnosed in patients with alcoholic liver cirrhosis. All three patients died due to recurrent bleeding and liver failure although they had undergone repeated transcatheter arterial embolization of the actively bleeding vessels. We reviewed 14 cases of spontaneous muscle hematoma that were associated with liver cirrhosis, including our cases, and found that the mortality rate was 86%, despite early diagnosis and treatment. Cirrhosis-associated spontaneous muscle hematoma occurred more frequently in patients with alcoholic liver cirrhosis, who accounted for -93% of cases. Thus, spontaneous muscle hematoma should be considered a life-threatening complication in patients with alcoholic liver cirrhosis, and abstinence from alcohol may help to prevent the occurrence of this deadly condition.

키워드

참고문헌

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피인용 문헌

  1. Alcohol Abuse and Alcoholic Liver Cirrhosis Leading to Spontaneous Muscle Hematoma: An Event Fraught with Danger vol.9, pp.1, 2014, https://doi.org/10.1159/000381305