Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Petersen's Hernia after Subtotal Gastrectomy with Billroth II Gastrojejunostomy for Gastric Cancer: A Specific CT Finding

위암으로 Billroth II 위공장문합술을 통한 위아전절제술을 받고 난 후 발생한 Petersen 탈장: 특징적인 CT 소견

  • Kim, Hwan (Yonsei University College of Medicine) ;
  • Chung, Yong Eun (Department of Radiology, Severance Hospital, Yonsei University College of Medicine) ;
  • Hyung, Woo Jin (Department of Surgery, Severance Hospital, Yonsei University College of Medicine) ;
  • Lim, Joon Seok (Department of Radiology, Severance Hospital, Yonsei University College of Medicine)
  • 김환 (연세대학교 의과대학) ;
  • 정용은 (연세대학교 의과대학 세브란스병원 영상의학과) ;
  • 형우진 (연세대학교 의과대학 세브란스병원 외과) ;
  • 임준석 (연세대학교 의과대학 세브란스병원 영상의학과)
  • Received : 2017.10.13
  • Accepted : 2018.03.16
  • Published : 2018.08.01
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Abstract

Petersen's hernia is a rare internal hernia occurring after any type of gastrojejunal anastomosis. This type of internal hernia after laparoscopic gastrectomy with Rouxen-Y reconstruction for obesity treatment has been reported frequently. However, reports about Petersen's hernia after gastrectomy with Billroth II gastrojejunostomy for gastric cancer are relatively rare. To diagnose internal hernia, whirl sign has been reported to be a sensitive predictor of internal hernia. However, it is hard to diagnose a specific type of internal hernia. We report a case of Petersen's hernia after radical subtotal gastrectomy with Billroth II gastrojejunostomy for gastric cancer with an unreported specific computed tomography finding that suggests Petersen's hernia.

Petersen 탈장은 위공장문합술 후에 드물게 발생하는 내탈장이다. 비만의 치료를 위해 Roux-en-Y 위우회술을 시행한 후에 발생한 Petersen 탈장은 상대적으로 빈번하게 보고되었으나, 위암으로 Billroth II 위공장문합술을 통한 위아전절제술을 받고 난 후에 발생한 경우는 거의 보고되지 않았다. 컴퓨터단층촬영에서 whirl sign이 내탈장을 진단할 수 있는 가장 민감한 소견으로 보고되어 있다. 그러나 이러한 소견이 보이더라도, 구체적인 내탈장 타입을 진단하는 것은 어려운 경우가 많다. 저자들은 위암으로 Billroth II 위공장문합술을 통한 위아전절제술을 받고 난 후에 발생한 Petersen 탈장을 보고하며, 내탈장 중에서도 Petersen 탈장을 나타내는 이전에 보고되지 않았던 특징적인 영상소견을 보고한다.

Keywords

References

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