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논문KCI 등재

위공장 경관식이(Gastrojejunal Tube Feeding) 환아에서 동반된 덤핑 증후군(Dumping Syndrome) 1례

Dumping Syndrome in a Child with Gastrojejunal Tube Feeding

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참고문헌

키워드

주제분류소아과학

초록

덤핑 증후군은 소아의 위공장 경관식이의 합병증으로 발생할 수 있는 질환으로, 19개월된 여아에서 식후 나타나는 특징적인 임상증상과 당부하 검사상 조기 고혈당 후 나타나는 후기 저혈당으로 진단할 수 있었으며, 생옥수수 전분을 포함한 식이요법만으로도 증상의 호전과 영양상태의 호전을 보일 수 있었다.

Abstract

Dumping syndrome is a known complication of gastric surgery in adults, but a very rare disease in the pediatric population. We report on a case of dumping syndrome in a 19-month-old child, who underwent gastrojejunal feeding tube insertion for the treatment and prevention of gastroesophageal reflux and frequent aspiration pneumonia. At 17 months of age, 2 months after the beginning of gastrojejunal tube feeding, postprandial diaphoresis, palpitation, lethargy, bloating, and diarrhea occurred, and a single episode of convulsion with hypoglycemia were noted. Early and late dumping syndrome was confirmed by an abnormal oral glucose tolerance test with early onset hyperglycemia followed by delayed onset hypoglycemia. Diet therapy including uncooked corn starch then improved the postprandial diaphoresis, abnormal glucose levels, and her nutritional status. We conclude that dumping syndrome may be considered as a complication of gastrojejunal tube feeding in a child.

참고문헌 (13)

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  3. 문진수, "^위저추벽성형술^Nissen fundoplication^시행 후 발생한 덤핑", 4, pp.92~8 (2001)
  4. Peters JM, "Experience with gastrojejunal feeding tubes in children", 92, pp.476~80 (1997)
  5. Godbole P, "Limitations and uses of gastrojejunal feeding tubes", 86, pp.134~7 (2002)
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  7. Mathus-Vliegen LM, "Percutaneous endoscopic gastrostomy and gastrojejunostomy:a critical reappraisal of patient selection,tube function and the feasibility of nutritional support during extended follow-up", 50, pp.746~54 (1999)
  8. Rivkees SA, "Hypoglycemia pathogenesis in children with dumping syndrome", 80, pp.947~2 (1987)
  9. Borovoy J, "Benefit of uncooked constarch in the management of children with dumping syndrome fed exclusively by gastrostomy", 93, pp.814~8 (1998)
  10. Samuk I, "Dumping syndrome following Nissen fundoplication,diagnosis and treatment", 23, pp.235~40 (1996)
  11. 홍종민, "저혈당성 쇼크로 발현된 덤핑 증후군에서의 Octreotide 치료 효과 1예", 대한내과학회지, 63(5), pp.15~571 (2002), 대한내과학회
  12. Ng DD, "Acarbose treatment of postprandial hypoglycemia in children after Nissen fun-doplication", 139, pp.877~9 (2001)
  13. Khoshoo V, "Nutritional management of dumping syndrome associated with antireflux surgery", 29, pp.1452~4 (1994)

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