종격동 기종과 공기후복막증이 발현된 신경성 식욕부진 1예
A case of anorexia nervosa complicated by pneumomediastinum and retropneumoperitoneum
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Since anorexia nervosa is a multi-systemic disorder, as well as a psychiatric disorder, it needs a multidisciplinary approach. It causes many medical problems, including irregular menstruation, hematologic problems, decreased bone density, electrolyte imbalance, and dysrhythmias. Sometimes, this disorder also causes rare, unexpected complications, including abnormal air collections, such as pneumomediastinum, retropneumoperitoneum, or subcutaneous emphysema. The cause of these phenomena is unknown, although fragile parenchymal tissue that is disrupted easily when the local pressure is increased by coughing, vomiting, or defecation is a suggested cause. We experienced a case of anorexia nervosa complicated with abnormal air collections. After we excluded other possible causes, such as perforation of the gastrointestinal tract, and ordered the patient to undergo a short fast and inhale oxygen, the abnormal air collections resolved. We report this case because of its rarity and benign course.
Abstract
신경성 식욕부진은 정신과적인 문제뿐만 아니라 여러 계통의 합병증을 유발한다. 월경이상, 혈액학적 이상, 간 기능 이상 등은 흔하게 알려져 있는 합병증이고, 원인은 정확히 알려지지는 않았으나, 신체 내 비정상적인 공기 축적을 보일 수 있는데, 종격동 기종, 피하 공기증, 공기후복막증 등이 나타날 수 있다. 이러한 합병증은 드물게 발생하는 것이라 소화기계의 천공 같은 다른 이차적인 문제는 없는지 확인해 보아야 할 것이다. 저자들은 이차적인 문제없이 신경성 식욕부진과 병발된 종격동 기종, 공기후복막증, 피하공기증을 보인 환자 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.
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