Cyanoacrylate (Histoacryl？) 경화치료 후 발생한 식도폐색 1예
A Case of Esophageal Obstruction after Cyanoacrylate Injection Sclerotherapy
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초록
Cyanoacrylate (HistoacrylⓇ)는 위정맥류 출혈의 치료에 널리 사용되고 있으나, 식도정맥류 치료에는 빈번한 합병증을 유발하고 식도정맥류 결찰요법(endoscopic variceal ligation, EVL)과 같은 다른 효과적인 치료법이 있으므로 상대적으로 드물게 이용되고 있다. 식도정맥류는 종종 잦은 결찰로 인해 반흔이 형성되어 더 이상 EVL 치료가 불가능한 증례를 경험할 수 있다. 저자는 이런 결찰술이 불가능한 환자에서 cyanoacrylate를 이용한 경화요법을 시행하여 성공적으로 지혈하였으나, 이후 연하곤란이 발생하여 시행한 상부위장관 내시경검사에서 경화요법 후 발생한 식도폐색을 경험하고, 6주 간의 추적 후 중합체가 자연적으로 탈락되면서 폐색증상도 함께 소실되었던 증례 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.
Abstract
Cyanoacrylate is well recognized for its effect in the treatment of the gastric variceal bleeding rather than the esopahgeal variceal bleeding. We used endoscopic injection sclerotherapy (EIS) with cyanoacrylate for the control of esophageal variceal bleeding in which endoscopic variceal ligation (EVL) was difficult due to severe post-EVL scar changes of the esophageal mucosa. The hemostasis by EIS with cyanoacrylate was successfully achieved despite the massive bleeding. However, esophageal obstruction occurred after the EIS treatment. Later, the obstruction resolved spontaneously as the polymer was expelled into the esophageal lumen. We report this case with a brief review of the literatures.
참고문헌 (13)
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