거짓동맥류를 동반한 구불결장 Dieulafoy 병변 출혈 1예 |
김태완ㆍ김홍주ㆍ민재훈ㆍ변선정ㆍ이지애ㆍ장승훈ㆍ최성연 |
성균관대학교 의과대학 강북삼성병원 내과학교실 |
A Case of Dieulafoy's Lesion with Pseudoaneurysm in the Sigmoid Colon |
Tae Wan Kim, M.D., Hong Joo Kim, M.D., Jae Hoon Min, M.D., Sun Jeong Byun, M.D., Ji Ae Lee, M.D., Seung Hun Jang, M.D. and Sung Youn Choi, M.D. |
Department of Internal Medicine, Kangbuk Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea |
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Abstract |
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Dieulafoy's lesions are characterized by a single large tortuous arteriole in the submucosa, and this arteriole does not undergo normal branching. These lesions are an uncommon cause of massive, sometimes fatal gastrointestinal bleeding; this had been reported to be the cause of 0.3∼1.5% of the cases of major gastrointestinal bleeding. The lesions mainly occur in the proximal stomach, but they may occur in all parts of the gastrointestinal tract, including the small bowel, colon and rectum. Endoscopy is a common method for the diagnosis and treatment of Dieulafoy's lesions. However, in the case of a high risk lesion, angiography, laparoscopy or laparotomy can be performed instead. We experienced a rare case of bleeding from a Dieulafoy's lesion with pseudoaneurysm in the sigmoid colon. Angiography with embolization was performed, but the patient expired due to rebleeding. We report on this case along with a review of the relevant literature. (Korean J Gastrointest Endosc 2010;41:303-307) |
Key Words:
Dieulafoy's lesion, Pseudoaneurysm, Angiographic embolization |
주요어:
Dieulafoy 병변, 거짓동맥류, 혈관색전술 |
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