식도 조직검사 후 발생하고 내시경 고무 결찰술로 악화된 식도 벽내혈종 1예
Intramural Hematoma of the Esophagus after Endoscopic Pinch Biopsy and Endoscopic Band Ligation
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초록
식도 벽내혈종은 급성 식도 손상에서 드물게 발생하며 주로 중년 여성에서 많이 나타난다. 식도 벽내혈종은 하부식도의 점막하층에서 출혈이 발생하여 덮고 있는 점막층은 유지된 채 광범위의 점막하층을 박리시킴으로써 유발되는 것으로 생각되어지며, 발생원인으로는 자발성과 이차적 손상으로 나눌 수 있다. 흉골 후방 통증이 흔하며 허리 통증, 혈액 구토, 연하통 등이 동반될 수 있다. 식도 벽내혈종은 대부분 금식, 수액 요법 등 보존적 치료로 호전되며 2∼3주 안에 완전히 회복된다. 저자들은 aspirin을 장기간 복용한 환자에서 상부위장관내시경 조직검사 후 발생한 식도 벽내혈종의 조절 목적으로 시행한 내시경 고무 결찰술 후 벽내혈종의 악화를 경험한 1예를 경험하였기에 보고하는 바이다.
Abstract
Esophageal intramural hematoma (EIH) is an uncommon clinical entity among the acute esophageal injuries, and EIH predominantly occurs in middle-aged women. The pathogenesis of EIH has not been clarified, yet this. Seems to occur within the submucosal layer of the esophagus after dissection of the mucosa. EIH may occur spontaneously or secondary to trauma. Patients usually complain of a sudden onset of severe retrosternal chest pain, hematemesis, back pain or dysphagia. Most EIHs show improvement through conservative management, including fasting and intravenous hydration, and this usually completely recovers within a period of 2∼3 weeks. We report here on a case that EIH occurred after endoscopic pinch biopsy and endoscopic band ligation and this EIH was exacerbated in a patient who was taking long-term aspirin medication.
참고문헌 (15)
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