Korean J Gastrointest Endosc > Volume 34(1); 2007 > Article
Korean Journal of Gastrointestinal Endoscopy 2007;34(1): 56-59.
쯔쯔가무시병에 병발된 회장말단의 궤양을 동반한 하부위장관 출혈 1예
백수정·심기남·강민정·송현주·유금혜·염혜정 · 김태헌·정성애·유 권·문일환·정규원
이화여자대학교 의과대학 내과학교실, 의과학연구소
A Case of Lower Gastrointestinal Bleeding with Ileal Ulceration in Scrub Typhus
Su Jung Baik, M.D., Ki-Nam Shim, M.D., Min Jung Kang, M.D., Hyun Joo Song, M.D., Kum Hei Ryu, M.D., Hye Jung Yeom, M.D., Tae Hun Kim, M.D., Sung-Ae Jung, M.D., Kwon Yoo, M.D., Il Hwan Moon, M.D. and Kyu Won Chung, M.D.
Department of Internal Medicine, Ewha Medical Research Institute, Ewha Womans University College of Medicine, Seoul, Korea
Abstract
Scrub typhus, an acute febrile illness caused by Orientia tsutsugamushi-induced vasculitis, is common in Korea, Asia and Pacific Islands. Endoscopic mucosal lesions or mucosal damages have rarely been reported in Scrub typhus. However, four cases of upper gastrointestinal bleeding, controlled by hemoclipping, in Tsutsugamushi-infected patients have been reported in Korea; although, no case of lower gastrointestinal bleeding in Scrub typhus has been reported. We experienced massive hematochezia in a 77-year-old female patient with Scrub typhus. Special studies, including upper gastroduodenoscopy, colonoscopy, abdominal CT scan, and SMA angiography were performed, but the focus of the bleeding could not be found. An RBC scan showed suspicious small bowel bleeding, but a capsule endoscopy could not reveal the focus of the bleeding focus; however, a colonoscopy showed active bleeding at the terminal ileum, with multiple ileal ulcerations. After conservative therapy, the patient's condition was stable and the hematochezia disappeared.
Key Words: Scrub typhus, Hematochezia, Ileal ulceration
주요어: 쯔쯔가무시병, 혈변, 회장궤양
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