내시경 점막하 박리술 후에 발생한 유문부 협착 2예
Two Cases of Pyloric Stenosis Caused by Endoscopic Submucosal Dissection
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초록
최근 위의 전암성 병변 및 조기 위암에 대한 치료로써 내시경 점막하 박리술(ESD)을 많이 시행하고 있다. ESD 후 협착은 드문 합병증이지만, 분문부나 유문부 근처에 위치한 큰 병변의 절제 후에 나타날 수 있다. 저자들은 고위험군에서 발생한 유문부 협착을 반복적인 풍선 확장술로 치료한 1예와 위험 인자가 없이 유문부 협착을 보였던 환자에서 경과 관찰 중 호전된 1예를 경험하였다. ESD 후 협착이 발생하기 쉬운 고위험 환자에서는 조기에 추적 내시경 검사를 시행하여 치료 계획을 세우는 것이 중요하다.
Abstract
Endoscopic Submucosal Dissection (ESD) has recently become a widely accepted treatment for premalignent lesions of the stomach and early gastric cancer. Post-ESD stenosis is a rare complication of ESD, but this can be caused by the removal of a large lesion when lesions are located near the cardia or pylorus. We experienced two cases of post-ESD stenosis. One developed in a high risk patient and this was treated by repeated balloon dilation. The other occurred in a patient who was without risk factors, but the stenosis improved spontaneously. It is important that we should perform early follow-up endoscopy in patients who are at a high risk for post-ESD stenosis, and administer effective treatment.
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