위의 Dieulafoy 병변 출혈 때문에 발생한 허혈성 대장염 1예
A Case of Ischemic Colitis Results from the Bleeding on Gastric Dieulafoy Lesions
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초록
허혈성 대장염은 가장 흔한 허혈성 위장관 손상이다. 일과성 허혈성 대장염은 장간막동맥의 관류저하에 의해 발생하며, 그 선행인자가 다양하여 정확한 인과관계를 밝히기 어렵다. 상부위장관 출혈도 하부 위장관의 관류 상태에 영향을 줄 수 있다. 또 서로 임상 양상이 유사하기 때문에 진단 및 치료에 주의할 점이 많다. 아직 상부위장관 출혈 때문에 발생한 허혈성 대장염이 보고된 적은 없다. 저자들은 의식 소실 및 흑색변을 주소로 내원한 63세 남자 환자에서 위의 Dieulafoy 병변 출혈을 치료한 후에 발생한 허혈성 대장염을 경험한 바 있어, 문헌고찰과 함께 보고하는 바이다.
Abstract
Ischemic colitis is the most common ischemic injury of the gastrointestinal tract. It can result from ischemia caused by compromised blood flow to the mesenteric arteries. Colonic ischemia may be precipitated by several conditions, although a cause is not clearly identified in most cases. A 63-year-old man was admitted because of loss of consciousness with melena. After endoscopic bleeding control of Dieulafoy lesions of the stomach, hematochezia occurred during the in-hospital care period. A sigmoidoscopy and computed tomography scan were conducted to evaluate the hematochezia, and ischemic colitis was diagnosed. Here, we report a case of ischemic colitis associated with massive upper gastrointestinal bleeding.
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