아르곤 플라즈마와 코카콜라 주사를 병용하여 내시경으로 분쇄 제거한 거대 위석 1예
A Huge Gastric Bezoar That Was Removed by Endoscopic Combination Therapy with an Argon Plasma and Coca-Cola Injection
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초록
위석은 소화관 내에서 음식물이나 이물질이 축적되어 응결된 것을 말한다. 위석의 치료로 과거에는 주로 개복술이나 복강경 같은 수술적 치료를 하였으나, 현재는 겸자, 올가미, 전기 수압 쇄석기, 레이저, 아르곤 플라즈마를 사용한 내시경적 분쇄 제거를 하거나 소화 효소제, 위장운동 항진제, 콜라를 사용하는 약물적 치료를 한다. 하지만 내시경적 분쇄 제거나 약물적 치료를 단독으로 사용할 경우 시간이 오래 걸리고, 분쇄되어 남은 위석에 의한 합병증도 발생할 수 있다. 저자들은 10×8×8 cm 크기의 거대 위석을 아르곤 플라즈마와 코카콜라 주사를 병용하여 내시경으로 분쇄 제거하였다. 한 가지 치료법을 사용한 경우와 비교하여 시술 시간이 짧아졌고 시술 횟수가 줄어들었으며, 분쇄되어 남은 위석에 의한 합병증도 감소하여 문헌고찰과 함께 보고한다.
Abstract
Bezoars are collections or concretions of indigestible foreign material in the gastrointestinal tract. In the past, the most common method for the treatment of bezoar was surgical management. The current treatment methods for bezoars include chemical dissolution and endoscopic lithotripsy using biopsy forceps and, snare, electrohydraulic lithotripsy and laser. Cases of endoscopic fragmentation of gastric bezoars using an argon plasma and dissolution of gastric bezoars with Cola have recently been described, but it took a long time in those cases to remove a bezoar by a single method. Moreover, fragmented, residual bezoar-related complications sometimes occurred. We report here on a case of a 35-year-old man with a 10×8×8 cm sized huge gastric bezoar that was successfully removed by combination therapy using an argon plasma and Coca-Cola injection. Compared with the previous single method, combination therapy using an argon plasma and Coca-Cola injection shortened the procedure time and reduced the complications related to a fragmented, remaining bezoar.
참고문헌 (17)
- Kuo JY, "Endoscopic fragmentation of gastric phytobezoar by electrohydraulic lithotripsy", Gastrointest Endosc, 39, pp.706~708 (1993)
- Yoon JI, "Endoscopic laser therapy for removal of gastric bezoars -a report of two cases-", Korean J Intern Med, 38, pp.578~583 (1990)
- 하병욱, "위내 거대 위석의 아르곤 플라즈마를 이용한 내시경 분쇄제거 치료 1예", Clinical Endoscopy, 34(2), pp.88~93 (2007), 대한소화기내시경학회
- Ladas SD, "Gastric phytobezoars may be treated by nasogastric Coca-Cola lavage", Eur J Gastroenterol Hepatol, 14, pp.801~803 (2002)
- Kato H, "The first report of successful nasogastric Coca-Cola lavage treatment for bitter persimmon phytobezoars in Japan", Am J Gastroenterol, 98, pp.1662~1663 (2003)
- Schwartz GF, "Ingested foreign bodies of the gastrointestinal tract", Am Surg, 42, pp.236~238 (1976)
- Feldman M, "Sleisenger & Fordtran's gastrointestinal and liver disease" (2002), W.B. Saunders
- 이성근, "분석(Bezoar) 25예에 대한 임상적 고찰", 대한외과학회지, 68(5), pp.407~413 (2005), 대한외과학회
- Byrne WJ, "Foreign bodies, bezoars, and caustic ingestion", Gastrointest Endosc Clin N Am, 4, pp.99~119 (1994)
- Lee J, "Bezoars and foreign bodies of the stomach", Gastrointest Endosc Clin N Am, 6, pp.605~619 (1996)
- 김동우, "내시경적 Urokinase 주입으로 치료한 위석 1예", 대한내과학회지, 76(1), pp.65~69 (2009), 대한내과학회
- Delpre G, "Metoclopramide in the treatment of gastric bezoars", Am J Gastroenterol, 79, pp.739~740 (1984)
- Lee BJ, "How good is cola for dissolution of gastric phytobezoars?", World J Gastroenterol, 15, pp.2265~2269 (2009)
- Canard JM, "Clinical application of argon plasma coagulation in gastrointestinal endoscopy: has the time come to replace the laser", Endoscopy, 33, pp.353~357 (2001)
- McCloy RF, "Duodenal pH in health and duodenal ulcer disease: effect of a meal, Coca-Cola, smoking, and cimetidine", Gut, 25, pp.386~392 (1984)
- Sechopoulos P, "Gastric bezoar treated endoscopically with a carbonated beverage: case report", Gastrointest Endosc, 60, pp.662~664 (2004)
- Chung YW, "Huge gastric diospyrobezoars successfully treated by oral intake and endoscopic injection of Coca-Cola", Dig Liver Dis, 38, pp.515~517 (2006)