대량출혈을 동반한 하행결장의 동정맥 기형 1예
A Case of Arteriovenous Malformation of the Descending Colon Presenting with Massive Bleeding
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초록
동정맥 기형은 50세 미만의 젊은 연령의 하부 위장관 출혈의 드문 원인이며 특별한 과거력이나 가족력 없이 재발하는 무통성의 대량 출혈 및 만성 빈혈이 특징이다. 호발 부위는 상행결장 및 소장이며 위나 하행결장에는 매우 드문 것으로 되어 있으며 지금까지 하행결장의 동정맥 기형에 대한 국내 보고는 1예 있었다. 저자들은 대량 출혈을 주소로 내원한 32세 남자 환자에서 대장 내시경검사 및 복부 조영증강 전산화단층촬영으로 하행결장에 국한된 동정맥 기형을 진단하고 보존적 치료에도 계속되는 출혈이 있어 좌측 결장 반절제술을 시행하여 치료한 1예를 경험하였기에 보고하는 바이다.
Abstract
Arteriovenous malformation is a rare cause of lower gastrointestinal bleeding in patients younger than 50 years of age and is characterized by recurrent, painless, massive bleeding and chronic anemia without a remarkable prior or family history. The most commonly sites involved are the ascending colon and small bowel. This condition rarely involves the stomach and descending colon. Until recently, there has been only one case report on arteriovenous malformation of the descending colon in Korea. We report a case of a 32 year old male patient who presented with massive lower gastrointestinal bleeding and had been diagnosed with arteriovenous malformation of the descending colon after undergoing colonoscopy and abdomen CT with contrast enhancement. The patient underwent left hemicolectomy because of persistent bleeding despite conservative management. (Korean J Gastrointest Endosc 2007; 35:351-354)
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