대장내시경 검사에서 진단된 편충감염 2예
Two Cases of Trichuris Trichiura Infection Diagnosed by Colonoscopy
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편충은 토양매개성 기생충으로 전세계적으로 널리 분포하며 위생상태가 불량한 지역에서 감염률이 높다. 주로 식품이나 식수를 통해 감염성의 편충란을 구강으로 섭취함으로써감염되며, 성인에서의 감염은 대개 무증상으로 나타나지만심한 감염의 경우 빈혈, 설사, 오심, 구토, 복통, 체중 감소 등의증상을 나타낼 수 있으며 장폐쇄, 장천공을 일으킨 예도 보고되고 있다. 진단을 위해 도움이 되는 검사로는 대변 편충 충란검사 및 혈액중 호산구 수치검사 등이 있으며, 대장내시경검사도 일반적이지는 않지만 편충감염의 확진 및 치료에 도움이 될 수 있다. 저자들은 북한 탈북자로서 수년간 만성복통 증상으로 고통을 받은 환자와 복통 및 무른 변 증상이 있었으나증상이 심하지 않아 특별한 치료를 받지 않고 있던 지내던 환자에게 있어 대장내시경 검사를 시행하여 편충감염을 확진하여 치료 후 증상이 호전되었던 2예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.
Abstract
Trichuris trichiura (T. trichiura) is soil-transmitted parasite and widely spreads all over the world. High infection rates occur especially in the poor hygiene area. T. trichiura is transmitted by the water and food contaminated with T. trichiura eggs. Most of mildly infected individuals could be asymptomatic, whereas heavily infected patients manifest with anemia,diarrhea, nausea, vomiting, abdominal pain, and weight loss. Serious manifestations such as intestinal obstruction and perforation were reported to be caused by Trichuriasis. Diagnostic methods are stool examination of T. trichiura eggs and eosinophil count in blood. Sometimes, colonoscopy can be useful diagnostic tool and treatment. We observed that the North Korean refugee with chronic abdominal pain and the patient with abdominal pain and loose stool have been diagnosed as T. trichiura infection confirmed by colonoscopy. After treatment, the patient's symptom has improved. Therefore we report two cases of trichuriasis with literature review.
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