The Korean Journal of Medicine

  • 제93권5호
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  • Pages.477-481
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  • 2018
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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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식도종격동누공을 형성한 결핵 종격동 림프절염 1예

Esophago-Mediastinal Fistula Due to Tuberculous Mediastinal Lymphadenitis

  • 김진영 (울산대학교 의과대학 서울아산병원 내과) ;
  • 김호연 (울산대학교 의과대학 서울아산병원 내과) ;
  • 이형경 (울산대학교 의과대학 서울아산병원 내과) ;
  • 정민선 (울산대학교 의과대학 서울아산병원 내과) ;
  • 형례창 (울산대학교 의과대학 서울아산병원 내과) ;
  • 김도훈 (울산대학교 의과대학 서울아산병원 소화기내과) ;
  • 정훈용 (울산대학교 의과대학 서울아산병원 소화기내과)
  • Kim, Jinyoung (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Hoyun (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Lee, Hyeungkyeung (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Cheong, Minseon (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Hsing, Li Chang (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Do Hoon (Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Jung, Hwoon-Yong (Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine)
  • 투고 : 2017.04.12
  • 심사 : 2017.09.04
  • 발행 : 2018.10.01
⟨ 이전 논문 다음 논문 ⟩

초록

결핵의 식도 침범 및 이의 합병증인 식도종격동누공 형성은 매우 드물고 국내 보고가 거의 없다. 대부분 종격동 림프절염에서 식도 침범이 이루어지고 이러한 경우 식도종격동누공을 형성할 수 있다. 저자들은 식도종격동누공 치료에 내시경적 클립 결찰술을 먼저 시도하였으나 누공 폐쇄에 실패하였고, 경피적 내시경 위루술을 통한 항결핵제 치료만으로 누공 폐쇄를 경험하였기에 보고한다.

Tuberculosis rarely involves the esophagus, and most esophageal tuberculosis occurs secondary to adjacent tuberculous lymphadenitis. An esophago-mediastinal fistula is a very unusual complication of tuberculous lymphadenitis. Herein, we report a case of an esophago-mediastinal fistula due to tuberculous lymphadenitis. A 28-year-old woman who had dysphagia was assessed by chest computed tomography, endoscopy, esophagogram, and a lymph node biopsy. An esophago-mediastinal fistula was found and an antituberculous agent was considered initially. However, because of her severe dysphagia, she managed with endoscopic clipping as an alternative. However, the fistula remained on follow-up esophagography. A gastrostomy was eventually performed, and she was treated with an antituberculous agent. The fistula had closed after 4 weeks of medication. Antituberculous agents are the mainstay treatment for esophago-mediastinal fistula due to tuberculous lymphadenitis; endoscopic clipping may be a complementary treatment.

키워드

참고문헌

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