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½ÊÀÌÁöÀå °úÇü¼º ¿ëÁ¾ÀÇ Dieulafoy¾ç º´º¯¿¡ ´ëÇÑ ³»½Ã°æÀû HemoclipÄ¡·á 1¿¹

A Case of Endoscopic Hemoclip Management of Dieulafoy-like Lesion on the Hyperplastic Polyp in the Duodenum

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¼ÛÁ¤ÈÆ ( Song Jung-Hoon ) - ¼­¿ïÀû½ÊÀÚº´¿ø ³»°ú
ÀÌÀººó ( Lee Eun-Bin ) - ¼­¿ïÀû½ÊÀÚº´¿ø ³»°ú
°­º´±¹ ( Kang Byung-Kook ) - ¼­¿ïÀû½ÊÀÚº´¿ø ³»°ú
Áø´ëÈ£ ( Jin Dae-Ho ) - ¼­¿ïÀû½ÊÀÚº´¿ø ³»°ú
¾ÈÅÂÈ« ( Ahn Tae-Hong ) - ¼­¿ïÀû½ÊÀÚº´¿ø ³»°ú
ÇÑÀ±ÁÖ ( Han Yun-Ju ) - ¼­¿ïÀû½ÊÀÚº´¿ø ³»°ú
ÀÌÇü¼® ( Lee Hyung-Suk ) - ¼­¿ïÀû½ÊÀÚº´¿ø ³»°ú

Abstract

Dieulafoy º´º¯Àº À§Àå°ü ÃâÇ÷ÀÇ µå¹® ¿øÀÎÀ̸ç, À§Àå°ü ÃâÇ÷ÀÇ 0.3¡­6.7%·Î º¸°íµÇ°í ÀÖ´Ù. ´ëºÎºÐÀÇ °æ¿ì À§ ½Äµµ Á¢ÇպΠ6 cm À̳»ÀÇ À§ÀÇ ±ÙÀ§ºÎ¿¡¼­ ¹ß»ýÇϰí, ½Äµµ, ½ÊÀÌÁöÀå, ¼ÒÀå, ´ëÀå ¹× Á÷Àå ³»¿¡¼­µµ µå¹°°Ô ¹ß°ßµÇ´Â °ÍÀ¸·Î º¸°íµÇ°í ÀÖÀ¸¸ç, ½ÊÀÌÁöÀå¿¡¼­´Â ½ÊÀÌÁöÀå ±¸ºÎ°¡ ´ëºÎºÐÀ» Â÷ÁöÇÑ´Ù. ÃÖ±Ù¿¡´Â ³»½Ã°æ Ä¡·á¼úÀÇ ¹ß´Þ·Î hemoclipÀ» ÀÌ¿ëÇϰųª °í¹« ¹êµå °áÂû¼úÀ» ÀÌ¿ëÇÏ¿© ÁÁÀº Ä¡·á È¿°ú¸¦ °ÅµÎ°í Àִµ¥Æ¯È÷, hemoclipÀÇ °æ¿ì ½ÊÀÌÁöÀå°ú °°ÀÌ »ó´ëÀûÀ¸·Î Àå°üº®ÀÌ ¾ã°í ³»°­ÀÌ Á¼Àº °æ¿ì¿¡ ´ëÇØ ¾ÈÀüÇϰí È¿°úÀûÀÎ Ä¡·á·Î º¸°íµÇ°í ÀÖ´Ù. ÀúÀÚµéÀº Èæ»öº¯°ú ÅäÇ÷À» ÁÖ¼Ò·Î ³»¿øÇÑ 47¼¼ ³²ÀÚ È¯ÀÚ¿¡¼­ ½ÊÀÌÁöÀå Á¦2ºÎ ±ÙÀ§ºÎÀÇ °úÇü¼º ¿ëÁ¾ À§¿¡ ¹ß»ýÇÑ Dieulafoy¾ç º´º¯À» ¹ß°ßÇϰí À̸¦ hemoclip ¿ä¹ýÀ» ÅëÇØ ¼º°øÀûÀ¸·Î ÁöÇ÷ÇÏ¿´À¸¸ç, ÀÌ¿Í À¯»çÇÑ Dieulafoy¾ç º´º¯ÀÇ º¸°í°¡ µå¹°±â¿¡ ¹®Çå °íÂû°ú ÇÔ²² À̸¦ º¸°íÇÏ´Â ¹ÙÀÌ´Ù.

Dieulafoy¡¯s lesion (DL) is an uncommon but important cause of massive upper gastrointestinal bleeding that has been reported to be involved in 0.3¡­6.7% of cases of major gastrointestinal bleeding. The lesion usually occurs in the lesser curvature of the stomach within 6 cm of the gastroesophageal junction. Similar lesions have also been observed in the esophagus, duodenum, small intestine, colon, and rectum. Most DLs encountered in the duodenum occur in the bulb. Recently, with the advances in endoscopic techniques, the successful management of DL has been achieved through the application of a hemoclip or elastic band ligation. In particular, the application of a hemoclip is considered to be a safe and effective treatment for DL located on a relatively narrow and thin walled canal such as the duodenum. We report the successful application of endoscopic hemoclipping for the treatment of a rare Dieulafoy-like lesion on a hyperplastic polyp in the 2nd portion of the duodenum.

Ű¿öµå

Dieulafoy¾ç º´º¯; ³»½Ã°æÀû hemoclipping; À§Àå°ü ÃâÇ÷; ½ÊÀÌÁöÀå
Dieulafoy-like lesion; Endoscopic hemoclipp-ing; Gastrointestinal bleeding; Duodnedum
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