경피적 내시경 위조루관 교환 후 발생한 식도 천공
Esophageal Perforation after Change of a Percutaneous Endoscopic Gastrostomy Tube
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참고문헌
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초록
경피적 내시경 위조루술은 경구영양을 할 수 없는 환자에게 장기간 경장영양을 할 수 있는 안전한 방법으로 널리 사용되고 있다. 경피적 내시경 위조루술 후에 여러가지 합병증이 생길 수 있지만 이들 중 대부분은 생명에 영향을 미치지 않는다. 심한 합병증에는 복막염, 위장관 천공, 출혈, 괴사성 근막염 등이 있으나 드물게 발생한다. 경피적 내시경 위조루술 후 식도 천공은 매우 드물며 위험 인자로 Zenker씨 게실, 식도 협착, 종양 등이 있다. 본 증례에서는 식도 천공의 위험 인자가 뚜렷하지 않음에도 불구하고 경피적 내시경 위조루관 교체 후 식도 천공이 발생하였고 수술적 방법으로 이를 성공적으로 치료하였다.
Abstract
Percutaneous endoscopic gastrostomy (PEG) has become a widely used and safe method for long-term enteral feeding in patients who are unable to tolerate oral feeding. Although a number of complications can occur following PEG placement, most of these complications are not life threatening. Serious complications occur rarely after this procedure and they include peritonitis, visceral perforation, major gastrointestinal bleeding, and necrotizing fasciitis. An esophageal perforation following PEG placement is very rare and predisposing factors include Zenker’s or epiphrenic esophageal diverticuli, esophageal strictures, and mass lesions. We recently experienced a case of distal esophageal perforation following a PEG tube change. The predisposing esophageal perforation factor in this case was uncertain, and we successfully treated the patient with surgical intervention.
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