장중첩증으로 나타난 맹장암 및 동시성 S상결장암 1예
A Case of Cecal Colon Cancer Causing Intussusception and Synchronous Sigmoid Colon Cancer
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초록
장중첩증은 성인에서는 드문 질환이며, 대장의 경우 대부분 악성 종양에 의해 이차적으로 발생한다. 그리고 만성적인 경과를 취하여 수술 전보다는 수술 중 진단되는 경우가 대부분이다. 하지만 복부 초음파 및 전산화 단층촬영이 보편화된 후 수술 전 진단율이 높아지고 있으나 수술 전 대장 내시경 검사의 유용성에 대한 정확한 보고가 없다. 대장 및 직장에서의 다발성 원발성 종양은 타 장기에 비해서 비교적 발생 빈도가 높아 대장 내시경 검사를 통해 조직학적인 진단 및 동시성 종양 유무나 기타 병변의 유무를 확인하는 것이 중요하다. 저자들은 장중첩증을 동반한 복부 종괴 환자에 대하여 수술 전 대장 내시경 검사를 통하여 진단하였던 동시성 맹장암 및 S상결장암을 경험하였기에 보고하는 바이다.
Abstract
The incidence of intussusception in adults is quite low. A preoperative diagnosis was quite difficult due to the atypical clinical features, but the success rate of preoperative diagnosis of intussusception has improved with the advances in abdominal US and CT. However, the value of colonoscopy in making a preoperative diagnosis is unclear. The incidence of multiple primary cancer of the colon and rectum can vary widely. We report a case of intussusception in a patient who had synchronous cecal and sigmoid colonic cancer. A 71-year-old man was visited our hospital for diarrhea and general weakness. The abdominal US and CT revealed a mass lesion in the cecal area. Preoperative colonoscopy confirmed the lesion to be cecal cancer with a synchronous sigmoid colon cancer. In conclusion, the rarity of these synchronous cancers may result in a misdiagnosis. Therefore, a preoperative colonoscopy or postoperative colonoscopy might be useful. (Korean J Gastrointest Endosc 2006;32:152-155)
참고문헌 (20)
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