DOI QR코드

DOI QR Code

말단 회장의 게실염에 동반된 혈전정맥염: 증례 보고

Superior Mesenteric Venous Thrombophlebitis with Terminal Ileal Diverticulitis: A Case Report

  • 박양일 (한국원자력의학원 원자력병원 영상의학과) ;
  • 김영한 (한국원자력의학원 원자력병원 영상의학과) ;
  • 이병희 (한국원자력의학원 원자력병원 영상의학과)
  • Yang Il Park (Department of Radiology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences) ;
  • Young Han Kim (Department of Radiology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences) ;
  • Byung Hee Lee (Department of Radiology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences)
  • 투고 : 2020.02.18
  • 심사 : 2020.04.24
  • 발행 : 2020.11.01

초록

장간막 혈전정맥염은 장의 허혈 및 경색을 일으킬 수 있는 드문 질환으로, 게실염이나 충수돌기염 등의 염증성 장질환으로 인해 이차적으로 발생한다. 게실 질환에 의해 발생한 장간막 혈전정맥염의 빈도는 매우 낮고 증상이 비특이적이므로 영상학적 진단이 매우 중요하다. 저자들은 61세 여성의 전산화단층촬영에서 말단 회장의 게실염에 동반된 상장간막 혈전정맥염으로 진단받고 항생제, 경구 항응고제 치료 및 우반 결장 절제술 후 혈전정맥염이 소실된 증례를 경험하여 보고한다.

Mesenteric venous thrombophlebitis secondary to inflammatory processes such as diverticulitis and appendicitis is a rare disease; however, it can nonetheless cause bowel ischemia and infarctions. Radiologic diagnosis is vital for mesenteric venous thrombophlebitis complicated with diverticulitis due to its non-specific clinical presentation and very low incidence. We report a case of a 61-year-old woman with superior mesenteric vein thrombosis and ileocecal diverticulitis on CT, which was resolved after treatment with a combination of antibiotic therapy and right hemicolectomy.

키워드

참고문헌

  1. Belhassen-Garcia M, Gomez-Munuera M, Pardo-Lledias J, Velasco-Tirado V, Perez-Persona E, Galindo-Perez I, et al. Pylephlebitis: incidence and prognosis in a tertiary hospital. Enferm Infecc Microbiol Clin 2014;32:350-354
  2. De Raet J, Brugman T, Geukens A. Non-Meckel's ileal diverticulitis with perforation: a rare cause of acute right lower quadrant pain. Acta Chir Belg 2010;110:90-92
  3. Lee BK, Ryu HH. A case of pylephlebitis secondary to cecal diverticulitis. J Emerg Med 2012;42:e81-e85
  4. Abraham MN, Mathiason MA, Kallies KJ, Cogbill TH, Shapiro SB. Portomesenteric venous thrombosis: a community hospital experience with 103 consecutive patients. Am J Surg 2011;202:759-763
  5. Choudhry AJ, Baghdadi YM, Amr MA, Alzghari MJ, Jenkins DH, Zielinski MD. Pylephlebitis: a review of 95 cases. J Gastrointest Surg 2016;20:656-661
  6. Kanellopoulou T, Alexopoulou A, Theodossiades G, Koskinas J, Archimandritis AJ. Pylephlebitis: an overview of non-cirrhotic cases and factors related to outcome. Scand J Infect Dis 2010;42:804-811
  7. Falkowski AL, Cathomas G, Zerz A, Rasch H, Tarr PE. Pylephlebitis of a variant mesenteric vein complicating sigmoid diverticulitis. J Radiol Case Rep 2014;8:37-45
  8. Lee JS, Hong CK, Kim KC, Hong SP, Hwang SG, Park PW, et al. A case of portal and mesenteric venous gas and thrombosis in sigmoid diverticulitis. Korean J Gastroenterol 2000;36:408-412
  9. Balthazar EJ, Gollapudi P. Septic thrombophlebitis of the mesenteric and portal veins: CT imaging. J Comput Assist Tomogr 2000;24:755-760
  10. Harada RN, Whelan TJ Jr. Surgical management of cecal diverticulitis. Am J Surg 1993;166:666-669