상부 위장관 내시경 후 발생한 식도천공에 의한 심부 경부감염증
A Deep Neck Infection Due to Esophageal Perforation That Was Caused by Upper Gastrointestinal Endoscopy
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
상부 위장관의 진단적 내시경은 다양한 증상의 환자들의 진단 방법으로 매우 자주 사용하며, 안전한 술기이나 종종 합병증이 발생한다. 식도 천공은 상부 위장관 내시경에서 매우 드물게 발생하지만 비교적 치사율이 높은 합병증이다. 대게 수술적 치료를 하게 되지만 천공이 크지 않고 폐혈증 같은 전신적인 합병증이 없는 경우에는 내과적 치료로 완치될 수 있다. 심부 경부감염증은 삽관이 잘 되지 않아 어려움을 겪었던 환자에서 생길 수 있으며 후인두에 상처가 생겼거나, 임상적으로 뚜렷하지 않은 식도천공과 연관하여 발생할 수 있다. 저자들은 진단적 상부 위장관에 의해 식도 천공이 발생하고 이후 심부 경부감염증이 생겨 배농술로 완치된 1예를 경험하여 보고한다.
Abstract
Diagnostic upper gastrointestinal endoscopy is a very commonly performed procedure. Physicians use it as a safe diagnostic tool to evaluate patients with a wide range of problems and complaints, but it can cause several complications in few cases. Esophageal perforation is a rare complication of upper gastrointestinal endoscopy, but it is associated with a relatively high mortality rate. Surgical management is required in most such cases. However, medical treatment can be considered for selected patients who are without a large perforation or systemic effects such as sepsis. Deep neck abscess can develop in patients who have had difficult intubations, and this may be related to retropharyngeal trauma or unapparent perforations. We experienced a case of deep neck infection due to an esophageal perforation that developed as a complication of diagnostic upper gastrointestinal endoscopy, and we successfully treated this patient with incision and drainage.
참고문헌 (18)
- Girardi A, "Retroperitoneal, mediastinal and subcutaneous emphysema as a complication of routine upper gastrointestinal endoscopy", Endoscopy, 22, pp.83~84 (1990)
- Eisen GM, "Complications of upper GI endoscopy", Gastrointest Endosc, 55, pp.784~793 (2002)
- Lee SH, "Impressive complication associated with diagnostic and therapeutic upper GI endoscopy (translated from Korea)", Korean J Gastrointest Endosc, 30, pp.53S~55S (2005)
- Park SH, "The management of difficulties and complications of therapeutic endoscopy and motility test in private clinics (translated from Korean)", Korean J Gastrointest Endosc, 27, pp.182S~185S (2003)
- 정성원, "상부위장관내시경 검사의 합병증으로 발생한 일측성 성대마비 2예", 대한소화기내시경학회지, 33(1), pp.32~36 (2006), 대한소화기내시경학회
- Penston JG, "Mallory-Weiss tears occurring during endoscopy: a report of seven cases", Endoscopy, 24, pp.262~265 (1992)
- Rai A, "Tension pneumothorax complicating diagnostic upper endoscopy: a case report", Am J Gastroenterol, 94, pp.845~847 (1999)
- 박성준, "응급실을 통해 내원한 심부 경부 감염환자의 임상적 고찰", 대한응급의학회지, 14(4), pp.341~345 (2003), 대한응급의학회
- Bartlett JG, "Anaerobic infections of the head and neck", Otolaryngol Clin North Am, 9, pp.655~678 (1976)
- Myers EM, "The head and neck sequelae of cervical intravenous drug abuse", Laryngoscope, 98, pp.213~218 (1988)
- Eisen GM, "Complications of upper GI endoscopy", Gastrointest Endosc, 55, pp.784~793 (2002)
- Botoman VA, "Bacteremia with gastrointestinal endoscopic procedures", Gastrointest Endosc, 32, pp.342~346 (1986)
- Pettersson G, "Differentiated treatment of intrathoracic oesophageal perforations", Scand J Thorac Cardiovasc Surg, 15, pp.321~324 (1981)
- Schulze S, "Iatrogenic perforation of the esophagus. Causes and management", Acta Chir Scand, 148, pp.679~682 (1982)
- Bladergroen MR, "Diagnosis and recommended management of esophageal perforation and rupture", Ann Thorac Surg, 42, pp.235~239 (1986)
- White RK, "Diagnosis and management of esophageal perforations", Am Surg, 58, pp.112~119 (1992)
- Sawyer R, "Short- and long-term outcome of esophageal perforation", Gastrointest Endosc, 41, pp.130~134 (1995)
- Sethi DS, "Deep neck abscesses-changing trends", J Laryngol Otol, 108, pp.138~143 (1994)