대량출혈을 동반한 상행결장 허혈성 대장염 1예 |
김시민·박영숙·정인수·양진수·서유승·주연호·김태헌·조윤주·한준길*·주종은† |
을지의과대학교 노원을지병원 소화기내과학교실, *외과학교실, †해부병리과 |
A Case of Ischemic Colitis with Massive Bleeding |
Si Min Kim, M.D., Young Sook Park, M.D., In Su Jung, M.D., Jin Su Yang, M.D.,Yu Seoung Seo, M.D., Yeon Ho Joo, M.D., Tae Hun Kim, M.D., Yun Ju Cho, M.D.,Joon Kil Han, M.D.* and Jong Eun Joo, M.D.† |
Departments of Gastroenterology, *Surgery and †Pathology, Eulji University College of Medicine, Seoul, Korea |
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Abstract |
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Ischemic colitis generally develops in the elderly patients with concomitant cardiovascular condition, diabetes mellitus, and renal insufficiency. This disease predominently occurs in the left colon, particularly splenic flexure and sigmoid colon. The most frequent symptoms include abdominal pain, diarrhea, alteration in bowel functions and hematochezia. Blood loss is usually minimal in most patients. Herein, we report a case of ischemic colitis which developed on ascending colon with massive bleeding. A 48-year-old man was admitted because of massive lower gastrointestinal bleeding for 7 days. He has underwent hemodialysis for thirteen years. Colonoscopy showed a circular ulcer on the ascending colon with partial stenosis and mass-like oozing lesion distal to the stenotic area. We performed right hemi-colectomy. Grossly, colon showed shallow ulceration and congested ileocecal valve coated with hemorrhage. Microscopically, ulcer bed showed thickened and fibrotic submucosa which had nearly obliterated atherosclerotic vessels. (Korean J Gastrointest Endosc 2002;25:480483) |
Key Words:
Ischemic colitis, Ascending colon, Massive bleeding |
주요어:
허혈성 대장염, 상행결장, 대량출혈 |
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