자발적 위천공을 동반한 신경성 식욕부진 환자의 재급식 증후군 치험 1예
A Refeeding Syndrome in the Treatment of Anorexia Nervosa Complicated by Spontaneous Gastric Rupture
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참고문헌
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초록
신경성 식욕부진은 수많은 합병증을 초래하고 높은 치사율을 보이는 만성 질환이다. 저자들은 과다한 체중 감소로 보행이 불가능하여 입원한 13세 남아에서 자발적 위천공 수술 후 말초 정맥 영양과 경구 영양으로 재급식 증후군을 성공적으로 치료한 예를 경험하였기에 이에 보고하는 바이다.
Abstract
We report a rare case of gastric perforation in a 13-year-old boy with anorexia nervosa. He was admitted to our hospital with the chief complaint of body weight loss. He had lower abdominal pain after 2 days. An abdominal CT revealed diffuse peritonitis. At laparotomy, the stomach was dilated and perforated. Postoperatively, the patient suffered from malnutrition. We monitored electrolytes, minerals, and fluids closely before and during the initiation of feedings to prevent morbidity and mortality associated with refeeding syndrome. We present an extremely rare complication that relates to this phenomenon, describing an acute gastric dilatation that led to gastric necrosis and perforation through an unusual mechanism in an extremely anorectic teenager during hospitalization for refeeding.
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