소장 출혈을 유발한 Peutz-Jeghers 용종의 캡슐내시경 진단 및 이중풍선 소장내시경에 의한 용종절제술 1예
A Case of Peutz-Jeghers Polyp that was Diagnosed using Capsule Endoscoy and the Polyp was Removed by Means of Double Balloon Enteroscopy
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Peutz-Jeghers 증후군은 주로 상염색체 우성유전을 하며 위장관에 다발성 과오종을 형성하고 피부점막에 색소 침착이 특징적인 질환으로 용종은 소화관 어디에서나 생길 수 있으나 소장에서 가장 흔하다. 증상으로 용종에 의한 장폐색과 장중첩증으로 인한 복부 동통이 흔하고 위장관 출혈을 유발할 수 있다. Peutz-Jeghers 증후군에서 발생하는 소장 용종의 진단에서 최근 캡슐내시경 검사가 종래의 바륨 소장조영술보다 민감도가 높다는 보고와 소장 용종을 이중풍선 소장내시경으로 제거한 보고가 있다. 저자들은 반복적인 흑색변을 주소로 내원한 환자에서 캡슐내시경 검사를 통해 발견된 회장 원위부 용종을 대장내시경을 이용하여 절제 후 Peutz-Jeghers 증후군으로 진단하고 남아 있는 소장 용종을 이중풍선 소장내시경으로 합병증 없이 제거하였기에 보고하는 바이다.
Abstract
Peutz-Jeghers syndrome is an autosomal dominant hereditary disease that's characterized by hamartomatous polyps of the gastrointestinal tract and mucocutaneous melanin pigmentation. Hamartomatous polyps can arise anywhere in the gastrointestinal tract, but they are most common in the small intestine. The major symptoms of Peutz-Jeghers syndrome are abdominal pain, intussusception and anemia due to gastrointestinal bleeding, which are all caused by harmatomatous polyp. Capsule endoscopy has been reported to have a higher diagnostic yield than small bowel barium radiography for patients with Peutz-Jeghers syndrome and who have small bowel polyp. Small bowel polyp in patients with Peutz-Jeghers syndrome can be resected by double balloon enteroscopy without laparotomy. We report here on a patient with melena that was caused by small bowel polyps, and this was found by using capsule endoscopy. Polyp in the distal ileum was resected by using colonoscopy and the patient was diagnosed as suffering with Peutz-Jeghers syndrome. The other proximal ileum polyp was resected by using double balloon enteroscopy without complication. (Korean J Gastrointest Endosc 2007;35:424-428)
참고문헌 (16)
- "Dormandy TL. Gastrointestinal polyposis with mucocutaneous pigmentation", pp.1186~1190
- "Gastrointestinal polyps in children: advances in molecular genetics, diagnosis and management", 138, pp.621~628 (2001)
- "A case of Peutz-Jeghers syndrome with intussusception", 20, pp.73~76 (2000)
- "A case of Peutz-Jeghers syndrome with multiple intussusception and rectal adenocarcinoma", 22, pp.220~224 (2001)
- "A case of a solitary Peutz-Jeghers type hamartomatous polyp in the duodenum with upper gastrointestinal bleeding as the initial diagnosis", 19, pp.796~800 (1999)
- "Endoscopic resection of Peutz-Jeghers polyps throughout the small intestine at double-balloon enteroscopy without laparotomy", 61, pp.140~147 (2005)
- "Waugh JM. Intestinal polyposis associated with mucocutaneous pigmentation. Surg Gynecol Obstet 1962", pp.1~11
- "Hereditary colorectal cancer: risk assessment and management", 58, pp.89~97 (2000)
- "Peutz-Jeghers syndrome", 95, pp.596~604 (2000)
- "Peutz-Jeghers syndrome", 34, pp.1007~1011 (1997)
- "The molecular basis and clinical aspects of Peutz-Jeghers syndrome", 55, pp.735~750 (1999)
- "Utility of capsule endoscopy in Peutz- Jeghers syndrome", 14, pp.159~167 (2004)
- "Peutz-Jeghers syndrome: its natural course and management", utsu(miya j), pp.71~82
- "Jimenez J. Peutz-Jeghers syndrome in children report of two cases and review of the literature. J Pediatr Surg 1983", pp.1~6
- "Phillips RK. Towards decreasing the relaparotomy rate in the Peutz-Jeghers syndrome the role of peroperative small bowel endoscopy. Br J Surg 1990", pp.301~302
- "A case of Peutz-Jeghers syndrome treated with segmental resection of ileum and intraoperative enteroscopic polypectomy", 20, pp.207~212 (2000)