만성 신부전 환자에서 위와 직장의 Dieulafoy양 병변에 의한 위장관 출혈 1예 |
임철현·조영석·김현진·문성진·이승우·노치호·신동일·박종현 김창환·김성수·김영옥·윤선애·채현석·이창돈·최규용·정인식 |
가톨릭대학교 의과대학 내과학교실 |
A Case of Gastrointestinal Bleeding Caused by Dieulafoy-like Lesions of theStomach and Rectum in a Patient with Chronic Renal Failure |
Chul Hyun Lim, M.D., Young Seok Cho, M.D., Hyun Jin Kim, M.D., Sung Jin Moon, M.D., Seung Woo Lee, M.D., Chee Ho Noh, M.D., Dong Il Shin M.D., Jong Hyun Park, M.D., Chang Whan Kim, M.D., Sung Soo Kim, M.D., Young Ok Kim, M.D., Sun Ae Yoon, M.D., Hiun Suk |
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea |
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Abstract |
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Dieulafoy's lesion is a very rare cause of gastrointestinal bleeding that occurs after rupture of an exposed submucosal artery. The majority of lesions are found in the stomach, but rarely it has also been identified in the duodenum, small bowel, colon and rectum. We describe a 78-year-old female with chronic renal failure who presented with melena and was subsequently found to have a Dieufaloy-like lesion in the stomach. The bleeding was successfully managed by endoscopic hemoclipping. During the follow-up, massive gastrointestinal bleeding was developed by a Dieulafoy-like lesion in the rectum. This lesion was managed by endoscopic band ligation, but there was recurrent bleeding from the ulcer site. The ulcer site was locally excised and primary closure was carried out. (Korean J Gastrointest Endosc 2004;28:146150) |
Key Words:
Dieulafoy-like lesion, Gastrointestinal bleeding, Chronic renal failure |
주요어:
Dieulafoy양 병변, 위장관 출혈, 만성 신부전 |
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