내시경적 클립술로 치료한 대장천공 1예
A Case of Successful Clipping of a Colonic Perforation during Diagnostic Colonoscopy
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초록
대장내시경검사는 대장 질환을 진단하는데 정확하고 안전하게 시행할 수 있는 검사지만, 드물게 출혈, 천공 등의 우발증이 발생한다. 이중 진단 대장내시경 검사시 천공은 가장 흔한 우발증으로 천공이 발생하면 대부분의 경우 수술을 시행하였다. 치료 방법에 대해서 논란이 있지만 최근에 내시경 기술의 발달로 대장천공이 발생한 환자에서 보존적 치료로 치유된 보고가 있었다. 저자들은 진단적 대장내시경검사 중 발생한 S자결장천공을 내시경적 클립술로 치료하였기에 문헌고찰과 더불어 보고한다.
Abstract
The use of colonoscopy is important to prevent colon cancer. Despite the safety of the colonoscopy procedure, the most common complication of a colonoscopy is perforation, which occurs with a rate of approximately 0.3% during diagnostic colonoscopy and occurs with a rate of approximately 1.1% with the use of therapeutic colonoscopy. Surgery is the treatment of choice for most cases of colonic perforation. With the development of endoscopic devices and techniques, conservative treatment of colonic perforation has been reported by the use of endoscopic clipping. We report here a patient with iatrogenic perforation of the sigmoid colon that was caused by diagnostic colonoscopy. The perforation presented as pneumoretroperitoneum, which was successfully treated with endoscopic clipping.
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