내시경을 이용한 지혈클립으로 치료한 충수절단부 출혈
Appendiceal Stump Bleeding That was Treated by Endoscopic Hemoclipping
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초록
충수절제술을 받은 후 절단부(stump)에 궤양이 생겨 발생한 출혈은 대량의 하부위장관 출혈을 일으킬 수 있다. 충수절단부에서 대량 출혈이 발생하는 경우는 매우 드문 합병증이지만 즉각적인 치료가 되지 않을 경우에는 생명의 위협을 초래할 수 있다. 일반적인 치료로는 응급 개복술 또는 복강경을 통해 출혈부위의 혈관을 찾아 결찰하는 방법이나 맹장부위 절제술이 있으며 최근에는 혈관색전술도 이용된다. 저자들은 충수절제술을 받은 지 6일 후 발생한 대량의 충수절단부 출혈을 외과 수술이나 혈관색전술 없이 내시경을 이용한 지혈클립으로 성공적으로 치료할 수 있었기에 문헌 고찰과 함께 보고하는 바이다.
Abstract
Appendiceal stump bleeding is a rare, but occasionally life-threatening complication. Significant lower gastrointestinal hemorrhage from an ulcerated appendiceal stump may occur after uncomplicated appendectomy. The common management includes ligation of the bleeding vessel or cecal resection by either emergency laparotomy or laparoscopy. Angiographic embolization of the bleeding vessel is an alternative therapeutic option. We report here on a case of gastrointestinal hemorrhage from an appendiceal stump, and this occurred six days after appendectomy. The bleeding was controlled endoscopically by placing hemoclips on the distinct vessel. The patient recovered thereafter without further intervention. Endoscopic hemoclipping is an effective and safe procedure, and it can replace emergency laparotomy, laparoscopy or angiographic embolization for treating appendiceal stump bleeding. (Korean J Gastrointest Endosc 2007;34:108-110)
참고문헌 (14)
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