대장내시경으로 진단된 구불창자의 숙변성 천공 1예
A Case of Stercoral Perforation of Sigmoid Colon Diagnosed by Colonoscopy
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
숙변성 천공이란 대변이 딱딱하게 굳어 종괴를 형성하여 장벽에 허혈성 압력 괴사를 일으켜 궤양이 생기고 장천공이 발생하는 경우를 말한다. 주로 만성 질환이 있는 환자나 노인에서 발생하는 드문 질환으로 알려져 있었으나 고령화로 노인 인구 및 만성 노인 환자가 증가하면서 최근 그 빈도가 점차 증가하고 있다. 진단 시 분변으로 심하게 오염된 복막염이 동반된 상태로 발견되는 경우가 많아 예후가 나쁘다. 저자들은 만성 변비가 심한 66세 여자에서 혈변이 발생하여 대장내시경을 시행한 후 구불창자의 숙변성 천공으로 진단하고 잘룩창자절제술을 시행하여 회복한 1예를 보고한다.
Abstract
Stercoral perforation of the colon is a rare disease. Yet, in recent times, the number of reported cases has increased because of the growing elderly population. Stercoral perforation of the colon usually occurs in the elderly or bedridden patients with chronic constipation. Stercoral perforation may cause a massive hemorrhage or peritonitis. The prognosis of stercoral perforation is poor, as the reported postoperative mortality is 35∼40%. So, early diagnosis and proper treatment are very important for improving survival. However, making an early diagnosis may be difficult because of the nonspecific initial symptoms. We experienced a case of stercoral perforation that was diagnosed by colonoscopy. The defect was in the sigmoid colon, and it was covered with peritoneum. The patient completely recovered after resection and anastomosis of the perforated colon. We report here on this case with a review of the relevant literature.
참고문헌 (12)
- Serpell JW, "Stercoral perforation of the colon", Br J Surg, 77, pp.1325~1329 (1990)
- Noussias MP, "Spontaneous rupture of the bowel", Br J Surg, 50, pp.195~198 (1962)
- Serpell JW, "Stercoral perforation of the colon", Br J Surg, 77, pp.1325~1329 (1990)
- 남정광, "숙변성 대장 천공의 임상적 분석", 대한소화기학회지, 55(1), pp.46~51 (2010), 대한소화기학회
- 박찬섭, "에스상 결장의 숙변성 천공 1예", Journal of the Korean Society of Coloproctolgy, 22(4), pp.197~199 (2006), 대한대장항문학회
- 김성은, "근위부 대장에 발생한 숙변성 궤양(Stercoral ulcer) 1예", Clinical Endoscopy, 26(3), pp.163~166 (2003), 대한소화기내시경학회
- Maurer CA, "Use of accurate diagnostic criteria may increase incidence of stercoral perforation of the colon", Dis Colon Rectum, 43, pp.991~998 (2000)
- Tokunaga Y, "Spontaneous perforation of the rectum with possible stercoral etiology: report of a case and review of the literature", Surg Today, 28, pp.937~939 (1998)
- Shatila AH, "Stercoraceous ulcerations and perforations of the colon: report of cases and survey of the literature", Dis Colon Rectum, 20, pp.524~527 (1977)
- Rozenblit AM, "Case reports: stercoral perforation of the sigmoid coloncomputed tomography findings", Clin Radiol, 55, pp.727~729 (2000)
- Gekas P, "Stercoral perforation of the colon: case report and review of the literature", Gastroenterololgy, 80, pp.1054~1058 (1981)
- Guyton DP, "Stercoral perforation of the colon. Concepts of operative management", Am Surg, 51, pp.520~522 (1985)