혈액담즙증으로 나타난 결절성 다발성 동맥염 1예
A Case of Polyarteritis Nodosa That Presented as Hemobilia
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초록
혈액담즙증은 담도계의 출혈에 의하여 복통, 황달, 위장관 출혈로 나타나는 질환이다. 혈액담즙증의 원인으로는 외상, 간담도계 관련 시술 또는 수술로 인한 손상, 간농양의 파열이나 간동맥류의 파열 등이 있다. 혈액담즙증의 합병증으로 담낭염이 생길 수 있다. 결절성 다발성 동맥염은 작은 크기나 중간 크기 동맥의 괴사성 혈관염을 일으키는 질환으로 전신적, 다발성 장기를 침범하는 질환이다. 결절성 다발성 동맥염이 장간동맥을 침범하여 위장관 출혈, 장경색, 장천공 등으로 나타나는 경우는 매우 드물다. 저자들은 결절성 다발성 동맥염이 간동맥 및 장간막동맥을 침범하여 국소적으로 간동맥류 파열로 인한 혈액담즙증 1예를 경험하여 이를 보고한다.
Abstract
Hemobilia is defined as hemorrhage into the biliary tract, and the patients with hemobilia present with abdominal pain, jaundice and gastrointestinal bleeding. The causes of hemobilia are traumatic or operative injury to the liver or bile ducts, intraductal rupture of the hepatic abscess or aneurysm of the hepatic artery. Cholecystitis can also develop in patients with hemobilia. Polyarteritis nodosa (PAN) is a multisystem, necrotizing vasculitis of the small and medium-sized muscular arteries and patients with this illness may present with fever, sweats, weight loss, severe arthralgia and myalgia. Mesentery artery involvement that can result in gastrointestinal hemorrhage, bowel infarction and perforation is rare, yet very serious in patients with PAN. We report here on a rare case of PAN that presented as hemobilia due to rupture of a hepatic arterial aneurysm.
참고문헌 (17)
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