사지 마비의 척삭종 환자에서 동반된 장관 기종 1예
A Case of Pneumatosis Intestinalis in a Chordoma Patient with Tetraplegia
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장관 기종은 소화관 장벽의 점막하층 또는 장막하층에 다발성 낭포를 보이는 드문 질환으로 원인이 명확하게 밝혀지지 않았으나 소화기, 호흡기, 교원성 질환과 연관된 이차성 장관 기종이 85%를 차지한다. 장관 기종만의 특징적인 증상은 없으나 진단은 단순 복부 촬영 및 복부 CT로 진단한다. 장관 기종은 대부분 예후가 양호하나, 약 3%에서는 장폐쇄, 장중첩증, 장천공 등의 합병증이 발생한다. 저자 등은 사지마비의 척삭종 환자가 복부팽만으로 내원하여 시행한 단순 복부 촬영에서 소장의 장관 기종을 진단하고 금식, 항생제 치료만으로 호전된 증례를 경험하여 문헌 고찰과 함께 보고한다.
Abstract
Pneumatosis cystoides intestinalis (PCI) is an uncommon clinical condition of undetermined etiology that is characterized by multiple subserosal or submucosal gas-filled cysts. PCI may be associated with gastrointestinal, pulmonary or connective vascular diseases. The clinical manifestations are non-specific. PCI is diagnosed by plain X-ray or CT of the abdomen. The clinical course and prognosis are usually good. Complications such as intestinal obstruction, intussusceptions and bowel perforation can occur in rare cases. Here we report a case of PCI in a chordoma patient with tetraplegia who complained of abdominal distension. The patient was diagnosed by plain X-ray which showed bubbles in the small bowel. The abdominal distension and the bubbles were markedly improved by conservative treatment.
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