위수술 후 수술 문합부에 발생한 장중첩증 2예
Two Cases of Intussusception Occurring through the Stoma after Gastric Surgery
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초록
위절제수술 후에 수술문합부위에서 발생하는 장중첩증은 위절제수술의 드문 합병증으로 국내에는 6예가 보고되어 있으며, 진단이 지연될 경우 사망률이 높아지므로 신속한 진단이 필요하다. 저자들은 내원 30년 전 궤양에 의한 협착으로 위공장문합술을 시행받았던 58세 여자 환자가 복통과 토혈을 주소로 내원하여 내시경검사와 전산화단층촬영검사에서 공장위장중첩증으로 진단을 받고 수술로 정복한 1예와, 내원 7년 전 위암으로 위전절제술을 시행받았던 60세 남자 환자가 복통과 토혈을 주소로 내원하여 내시경검사와 전산화단층촬영검사에서 만성 장중첩증으로 진단을 받고 자연 정복된 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.
Abstract
Intussusception is a rare but potentially serious complication of gastric surgery, and 6 cases have been reported in Korea. Diagnosis can be made by endoscopy, upper gastrointestinal series or computed tomography, but it needs a high index of suspicion for diagnosis. Early diagnosis and prompt surgical intervention is mandatory to avoid mortality. We report two cases of intussusception occurring through the stoma after gastric surgery. A 58-year-old woman presented with epigastric pain and vomiting followed by hematemesis, 30 years after gastrojejunostomy for pyloric obstruction caused by duodenal ulcer. Endoscopy showed jejunogastric intussusception and CT scan was compatible with the diagnosis. She was managed by segmental resection and anastomosis of the jejunum. Another 60-year-old man presented with epigastric pain and hematemesis, 7 years after total gastrectomy with a Roux-en-Y anastomosis for advanced gastric cancer. He was diagnosed as having chronic type jejunal intussusception by endoscopy and CT scan, and intussusception was resolved spontaneously.
참고문헌 (20)
- "Intussusception,a complication of gastric sugery", 57, pp.480~488 (1965)
- "Jejunogastric intussusception presented with hematemesis:a case presentation and review of the literature", 1, pp.1~ (2001)
- "Jejunogastric intussusception.A new diagnostic test", 122, pp.1190~1192 (1987)
- "Computed tomography of acute jejunogastric intussusception", 13, pp.531~533 (1989)
- "A rare cause of hematemesis review of the literature and report of two cases", retrograde jeju(gastric intussusception), pp.1009~1017
- "Acute and chronic jejunogastric intussusception", 253, pp.635~640 (1955)
- "역행성 공장위 중첩증(3예 보고 및 문헌고찰)", 17, pp.332~339 (1981)
- "위장관 문합술 후 Braun 문합부를 통한 역행성 상부 공장중첩증 1예", 27, pp.359~362 (1995)
- "Billroth II operation 후 Braun 문합부에서 발생한 역행성 장중첩증", 52, pp.446~450 (1997)
- "내시경으로 진단된 역행성 공장위 중첩증 1예", 19, pp.287~291 (1999)
- "위아전절제술 후 발생한 역행성 공장-위중첩증 1예", 37, pp.466~469 (2001)
- "an indication for emergent endoscopy", 57, pp.593~595 (2003)
- "Jejunojejunal intussusception after Roux- en-Y gastrojejunostomy a rare cause of postoperative bowel obstruction in an adult", pp.451~452
- "Jejuno-gastric intussusception following gastro-enterostomy and vagotomy", 141, pp.541~546 (1955)
- "Jejunogastric intus-susception", 115, pp.1449~1452 (1980)
- "Jejunogastric intussusception", 27, pp.475~480 (1940)
- "Hematemesis caused by jejunogastric intussusception", 18, pp.162~164 (1986)
- "Jejunogastric intussusception:review of 4 cases-diagnosis and management", 163, pp.93~96 (1966)
- "Endoscopic management of retrograde jejunogastric intussusception", 34, pp.56~57 (1988)
- "Non- surgical treatment of jejunogastric intussusception", 2, pp.88~91 (1988)