내시경 조직 생검 후 발생한 점막하 식도 박리 1예
A Case of Esophageal Submucosal Dissection that Developed after Endoscopic Biopsy
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초록
점막하 식도 박리 발생의 위험인자는 혈소판감소증, 혈우병, 내시경 경화요법, 심부 정맥 혈전증으로 항응고치료를 받는 환자, 이물, 약물, 내시경 등의 기계적 손상 또는 자발적으로 발생한 점막하 출혈 및 혈종이 있다. 하지만 조직검사로 인한 증례는 아직 발표된 바가 없다. 저자들은 식도 조직검사 후 발생한 흉골하 통증을 주증상으로 내원한 환자에서 상부위장관 내시경 검사를 시행하여서 점막하 식도 박리증을 진단하였다. 금식 및 수액요법 등의 보존 치료로 증상이 호전된 드문 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.
Abstract
The incidence of gastrointestinal complications has increased as endoscopic biopsy has become a standard diagnostic technique. However, esophageal dissection is a rare complication. A 71-year-old man suffered retrosternal pain for 15 days. Fifteen days previously, he had undergone an endoscopic gastrointestinal examination at a local clinic and an esophageal biopsy to obtain microscopic confirmation of esophageal candidiasis. The patient then underwent a subsequent endoscopic examination, which showed features specific to esophageal submucosal dissection. The predisposing conditions for esophageal dissection are coagulopathy, iatrogenic trauma (variceal sclerotherapy), drugs (thrombolytic agents, aspirin), foreign bodies/certain foods (fish, chicken bones), and emesis. However, endoscopic biopsy is a rare predisposing condition. Here, we report a case of esophageal submucosal dissection that developed after esophageal biopsy. We observed the healing process of this lesion with a series of endoscopies as part of a conservative treatment plan. (Korean J Med 2011;81:759-763)
참고문헌 (15)
- 유홍준, "수면 내시경검사 도중 발생된 천공을 동반한 점막하 식도박리 1예", Clinical Endoscopy, 35(5), pp.328~331 (2007), 대한소화기내시경학회
- Shimada T, "Spontaneous submucosal dissection of the esophagus", Intern Med, 32, pp.795~797 (1993)
- Yen HH, "Esophageal intramural hematoma: an unusual complication of endoscopic biopsy", Gastrointestinal Endosc, 62, pp.161~163 (2005)
- Williams B, "Case report: oesophageal laceration following remote trauma", Br J Radiol, 30, pp.666~668 (1957)
- Cullen SN, "Dissecting intramural haematoma of the oesophagus", Eur J Gastroenterol Hepatol, 12, pp.1151~1162 (2000)
- Phan GQ, "Intramural esophageal dissection", Ann Thorac Surg, 63, pp.1785~1786 (1997)
- Guzman C, "Intraduodenal hematoma complicating intestinal biopsy: case reports and review of the literature", Am J Gastroenterol, 93, pp.2547~2550 (1998)
- Zinelis SA, "Intramural duodenal hematoma following upper gastrointestinal endoscopic biopsy", Dig Dis Sci, 34, pp.289~291 (1989)
- Hanson JM, "Intramural esophageal dissection", Thorax, 46, pp.524~527 (1991)
- Ackert JJ, "Spontaneous intramural hematoma of the esophagus", Am J Gastroenterol, 84, pp.1325~1328 (1989)
- Kerr WF, "Spontaneous intramural rupture and intramural haematoma of the oesophagus", Thorax, 35, pp.890~897 (1980)
- Kim BH, "Endoscopic treatment of spontaneous intramural dissection of the esophagus: a case report", Korean J Med, 73, pp.930~934 (2007)
- Murata N, "Submucosal dissection of the esophagus: a case report", Endoscopy, 23, pp.95~97 (1991)
- Choi SC, "Spontaneous submucosal dissection of the esophagus-A case report", Korean J Gastrointestinal, 18, pp.202~210 (1998)
- Barone JE, "Conservative treatment of spontaneous intramural perforation (or intramural hematoma) of the esophagus", Am J Gastroenterol, 74, pp.165~167 (1980)