빈혈 환자에서 단일풍선 소장내시경으로 발견한 공장의 모세혈관상 혈관종 1예
A Case of Capillary Hemangioma in the Jejunum Detected by Single Balloon Enteroscopy in a Patient with Anemia
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초록
소장 혈관종은 매우 드문 질환이며 관련 증상으로 위장관 출혈이 대표적이다. 공장이 가장 호발하는 부위로 진단을 위해서는 캡슐내시경이나 소장내시경을 이용한 소장 관찰이 필요하다. 모세혈관상 혈관종은 작은 모세혈관의 내피 세포가 과다 증식하여 발생하는 비상피성 양성 종양으로, 이번 증례와 같이 소장의 모세혈관상 혈관종을 수술 전에 단일풍선 소장내시경으로 발견한 보고는 없다. 저자들은 심한 빈혈로 내원한 환자에서 캡슐내시경과 단일풍선 소장내시경을 시행하고 소장 분절 절제술로 치료한 모세혈관상 혈관종 1예를 경험하여서 문헌고찰과 함께 보고한다.
Abstract
Hemangiomas are uncommon benign vascular tumors that account for up to 10% of all small bowel tumors. The jejunum is the most common location, and gastrointestinal bleeding is a frequent clinical presentation. Histologically, hemangiomas are classified as cavernous, capillary, or mixed types. Capillary hemangiomas are dense collections of capillaries usually with a hyperplastic endothelium. There have been a few cases of small bowel capillary hemangioma revealed by capsule endoscopy and confirmed after surgical resection. But preoperative detection of hemangiomas in the small intestine has not been reported, as far as we know, associated with the use of balloon-assisted enteroscopy. This report describes a 44-year-old male with a small bowel mass considered to be a cause of severe iron deficiency anemia. In this case, we performed capsule endoscopy and single balloon enteroscopy to examine the lesion. The patient then underwent a segmental resection of the jejunum, which confirmed the presence of a capillary hemangioma with surface ulceration.
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