내시경적 배액술로 치료한 생선뼈에 의한 위벽내 농양 1예
Gastric Wall Abscess Caused by a Fish Bone and Treated with Endoscopic Management
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초록
위벽내 농양은 화농 위염의 국소적인 형태로 극히 드물게 발생한다. 화농 위염은 그 침범 정도에 따라서 미만형과 국소형으로 나뉜다. 미만형은 위를 전체적으로 침범하게 되며 점막하층으로부터 전층에 염증소견을 나타낸다. 국소적인 형태를 위벽내 농양이라 정의하며 전체의 5∼15%를 차지하고 있다. 위벽내 농양은 미생물의 직접적인 침윤 혹은 원발 부위로부터의 혈행성 전파에 의해 발생하는 것으로 알려져 있으며 이물질 특히 생선 가시의 섭취나 내시경 용종 절제술, 위궤양 등과 관련한 점막손상이 원인이 될 수 있다. 저자 등은 드문 질환인 위벽내 농양을 상부위장관내시경 검사와 복부 전산화 단층촬영을 통해 진단하고 내시경 절개와 배농을 통해 성공적인 치료를 경험하였기에 보고한다.
Abstract
Intramural gastric abscess is a rare condition representing a localized form of suppurative gastritis. According to the extent of the disorder, suppurative gastritis is classified into diffuse and localized types. The diffuse or phlegmonous type is more common and involves the entire stomach with inflammation spreading to all layers from the submucosa. The localized form referred to as “intramural gastric abscess” accounts for 5% to 15% of cases. The pathogenic mechanism includes direct invasion by microorganisms and hematogenous spread from a distant source. Cases are usually diagnosed with a combination of imaging modalities such as ultrasound, computed tomography, endoscopic ultrasound, and esophagogastroduodenoscopy. Herein we report a case of intramural gastric abscess that developed following ingestion of a fish bone. It was successfully treated with endoscopic incision and drainage of pus.
참고문헌 (18)
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