간이식을 하지 않은 환자에서 발생한 담관 원주 증후군 1예
A Case of Biliary Cast Syndrome in a Non-liver Transplatation Patients
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초록
담관 원주 증후군은 주로 간이식후 발생하는 후기 담도계 합병증으로 간이식을 하지 않은 환자에게서는 드물게 발생한다. 담즙 정체가 발생하고 여기에 점액, 칼슘 빌리루빈염, 콜레스테롤 결정체가 축적되어 담관 원주를 형성하게 되며 특징적인 모양을 갖는다. 간이식을 하지 않은 환자에서 발생한 담관 원주 증후군은 항인지질항체 증후군에서 발생한 증례, B 세포성 비호치킨 림프종 환자에서 발생한 증례, 동종 조혈모 세포 이식 후 발생한 증례 및 담낭 제거술 후 발생한 증례 등이 있으며 그 기전에 대해서는 아직 명확히 밝혀져 있지 않다. 본 증례는 특이병력 없이 10년간 있어온 만성적인 복부 통증으로 입원한 77세 남자에서 담관 원주 증후군을 진단하고, 담관 원주를 내시경적으로 제거하여 문헌고찰과 함께 보고한다.
Abstract
The development of total biliary casts is very unusual, and especially in patients who have not undergone liver transplantation. There are only a few reports of total biliary casts in non-liver transplantation patients who have antiphospholipid antibody syndrome, B-cell non-Hodgkin's lymphoma, cholecystectomy or allogenic hematopoietic stem cell transplantation. Here we present the case of a previously well 77-year-old man who developed a total biliary casts without any risk factors and there was no obvious liver insult. The casts were managed endoscopically.
참고문헌 (14)
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