장중첩증을 유발한 맹장의 염증성 섬유양 용종 1예
A Case of Inflammatory Fibroid Polyp of the Cecum Causing Intussusception
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염증성 섬유양 용종은 위장관에 발생하는 용종성 병변으로 섬유조직, 혈관 및 호산구에 의한 염증성 증식이 특징이다. 점막하층에 국한된 비교적 드문 양성 병변으로, 주로 위 전정부와 회장에 호발하며, 식도 및 소장과 대장 어디에서도 발생한다. 위에 발생하면 간헐적 복통, 구토, 전정부 폐쇄 증상 등이 있고 출혈이 발생하기도 한다. 소장 및 대장에 발생하면 주로 장관폐쇄 증상이 있으나 병변의 위치에 따라 다르며 이로 인한 장중첩증은 흔하지 않다. 42세 남자 환자가 우하복부 통증을 주소로 내원하여, 복부 전산화 단층촬영 및 대장 내시경으로 맹장의 종양성 병변에 의한 장중첩증을 확인하고, 개복술에 의한 쐐기 절제술을 통해 염증성 섬유양 용종을 조직학적으로 확진하였다. 저자들은 맹장에 발생한 염증성 섬유양 용종에 의한 장중첩증 1예를 경험하였기에 이를 보고한다.
Abstract
Inflammatory fibroid polyp is a polypoid lesion of the gastrointestinal tract, composed of fibrous tissue, blood vessels, and inflammatory infiltration often dominated by eosinophilic leukocytes. It is infrequent, localized, and non-neoplastic condition. It is most often formed in the gastric antrum and ileum, and rarely in the esophagus, small bowel or colon. The polyp in the stomach is mainly located in the submucosa of the antrum, and may cause intermittent epigastric pain, vomiting, antral obstructive symptoms or rarely bleeding. When present in small bowel, it is usually localized in the ileum and presents with obstructive symptoms but clincal manifestations are different according to the location. Intussusception resulting from the mass is not common. We report a case of inflammatory fibroid polyp of the cecum causing intussusception. A 42-year-old male patient was referred to the hospital for the evaluation of right lower quadrant abdominal pain and palpable mass. A contrast-enhanced CT scan of the whole abdomen and colonoscopic examination revealed intussusception with a cecal mass. Inflammatory fibroid polyp causing intussusception was histologically confirmed by surgical wedge resection.
참고문헌 (20)
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