위 점막하종양 출혈로 오인된 비장동맥 가성동맥류 출혈 1예
A Case of Splenic Pseudoaneurysmal Rupture Misrecognized as Bleeding from Gastric Submucosal Tumor
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초록
비장동맥의 가성동맥류는 급성 및 만성 췌장염의 드문 합병증으로서 대부분 무증상이지만 파열되면 복강, 후복강 또는 위장관으로 대량출혈을 일으킴으로써 치명적일 수 있다. 가성동맥류가 위벽을 침범한 경우 상부위장관 내시경검사에서 위 점막하종양으로 보일 수 있다. 저자들은 토혈을 주소로 내원한 환자에서, 위 점막하종양 출혈로 오인하였으나, 비장동맥의 가성동맥류가 위장으로 출혈한 것임을 확인하여 색전술로 치료한 1예를 문헌고찰과 함께 보고한다.
Abstract
Splenic arterial pseudoaneurysm is an uncommon life-threatening complication of acute and chronic pancreatitis. Pseudoaneurysm can lead to massive bleeding into the abdominal cavity and the retroperitoneum. Less commonly, it may rupture directly into the stomach, small bowel or pancreatic duct and may present as an acute gastrointestinal hemorrhage. It can be diagnosed by various imaging modalities including computerized tomography, ultrasound and angiography. Percutaneous transvascular embolization of the pseudoaneurysm is one of the alternative treatment methods. Here we present a case of splenic arterial pseudoaneurysmal rupture misrecognized as bleeding from a gastric submucosal tumor in patient with hematemesis. We also review the literature.
참고문헌 (14)
- Kahn LA, "Variable color doppler appearance of pseudoaneurysm in pancreatitis", AJR Am J Roentgenol, 162, pp.187~188 (1994)
- Kubo K, "Ruptured aneurysm and gastric perforation associated with acute pancreatitis: a rare cause of hematemesis", Gastrointest Endosc, 53, pp.658~660 (2001)
- Yajko RD, "Current management of upper gastrointestinal bleeding", Ann Surg, 181, pp.474~480 (1975)
- Forsmark CE, "Endoscopy-negative upper gastrointestinal bleeding in a patient with chronic pancreatitis", Gastroenterology, 102, pp.320~329 (1992)
- Christensen NM, "Unusual malifestations of pancreatic pseudocysts and their surgical management", Am J Surg, 130, pp.199~205 (1975)
- 김지현, "췌장염에서 발생한 가성동맥류의 임상 양상 : 단일기관 경험 및 국내문헌 고찰", 대한소화기학회지, 50(2), pp.108~115 (2007), 대한소화기학회
- Gadacz TR, "Visceral vessel erosion associated with pancreatitis. Case reports and a review of the literature.", Arch Surg, 113, pp.1438~1440 (1978)
- Falkoff GE, "Hepatic artery pseudoaneurysm: diagnosis with real time and pulsed Doppler US", Radiology, 158, pp.55~56 (1986)
- Vujic I., "Vascular complications of pancreatitis", Radiol Clin North Am, 27, pp.81~91 (1989)
- Stabile BE, "Reduced mortality from bleeding pseudocysts and pseudoaneurysms caused by pancreatitis", Arch Surg, 118, pp.45~51 (1983)
- Roach H, "Endoscopic ultrasound-guided thrombin injection for the treatment of pancreatic pseudoaneurysm", Endoscopy, 37, pp.876~878 (2005)
- Maleux G, "Multiple small pseudoaneurysms complicating pancreatitis: angiographic diagnosis and transcatheter embolization", Eur Radiol, 10, pp.1127~1129 (2000)
- Lina JR, "Aneurysm rupture secondary to transcatheter embolization", AJR Am J Roentgenol, 132, pp.553~556 (1979)
- 정윤화, "악성 점막하종양으로 오인된 위저부 양성궤양 1예", Clinical Endoscopy, 36(3), pp.150~153 (2008), 대한소화기내시경학회