Korean Journal of Gastrointestinal Endoscopy 2005;30(4): 217-221.
후천성면역결핍증후군 환자에서 발생한 거대세포바이러스 장염에 의한 회장 천공 1예
김연수·허원석·채경훈·강윤세·정재훈·박기오·성재규·김연숙·정현용·송규상*
충남대학교 의과대학 내과학교실, *병리학교실
Ileal Perforation due to Cytomegalovirus Enteritis in a Patient with Acquired Immune Deficiency Syndrome
Yeon Soo Kim, M.D., Won Seok Heo, M.D., Kyung Hoon Chae, M.D., Youn Se Gang, M.D., Jae Hoon Jung, M.D., Ki O Park, M.D., Jae Kyu Seong, M.D., Yeon Sook Kim, M.D., Hyun Yong Jeong, M.D. and Geu Sang Song, M.D.*
Departments of Internal Medicine and *Pathology, Chungnam National University College of Medicine, Daejeon, Korea
Abstract
Cytomegalovirus (CMV) infection is one of important opportunistic infections and cause significant morbidity and mortality in immunocompromised patients. The colon, stomach, and esophagus are the organs frequently involved with CMV infection. CMV enteritis makes up less than 10% of the CMV gastroenteritis cases, usually presents with diarrhea, bleeding and perforation. Several reports have described patients with acquired immune deficiency syndrome (AIDS) in whom CMV enterocolitis were complicated by ileal perforation, but have been rarely reported in Korea. We report a case of multiple ileal perforation associated with CMV enteritis in 67 years old man who was diagnosed as AIDS later. He complained of hematochezia and abdominal pain. During emergency operation, multiple perforated lesions were seen at the distal ileum above ileocecal valve. Colonoscopic examination revealed multiple shallow aphthoid ulcers at descending colon. CMV enteritis and colitis were diagnosed by microscopic findings of both surgical and endoscopic specimens. He was recovered by antiviral therapy with ganciclovir. (Korean J Gastrointest Endosc 2005;30:217221)
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