소아의 Dieulafoy병 치험 1례
A Case of Dieulafoy’s Disease in a Child
이의성, 한석주, 정기섭, 오창희, 김제우,
소속 상세정보
이의성 ( Lee Eui-Sung )
연세의대 소화과학교실
한석주 ( Han Seok-Joo )
연세대학교 의과대학 외과학교실
정기섭 ( Chung Ki-Sup )
연세대학교 의과대학 소아과학교실
오창희 ( Oh Chang-Hee )
연세의대 소화과학교실
김제우 ( Kim Je-woo )
연세의대 소화과학교실
KMID : 0816119990020010080
Abstract
저자들은 대량의 상부위장관 출혈을 주소로 내
원하여 시행받은 상부위장관 내시경 검사 결과
Dieulafoy병으로 진단된 5년 8개월된 남아 1례를
치험하였기에 문헌 고찰과 함께 보고하는 바이다.
Dieulafoy’s disease, a vascular anomaly mainly in the upper stomach, is a rare but
potentially life-threatening cause of upper gastrointestinal bleeding. Pathogenesis is still
controversial, but the most accepted theory is that a persistent caliber vessel in the
submucosa is exposed by a small mucosal erosion leading to massive bleeding. The
bleeding site is usually within 6 ㎝ of the esophagogastric junction in the cardia or
fundus of the stomach. The treatment of choice is therapeutic endoscopy or surgery.
The age of patients reported is mainly between 50 and 70 years, and patients of
pediatric age are extremely rare.
We are reporting a 5-year-old male patient who had Dieulafoy’s disease which was
diagnosed by emergency upper gastrointestinal endoscopy. Endoscopic finding was a
nodular lesion with an adherent clot on the lessor curvature of the stomach 2 ㎝ below
the esophagogastric junction. Epinephrine and BeriplastR was injected in
the lesion. On the second day after endoscopic sclerotherapy, the patient had recurred
massive hematemesis and accompanying shock. So we performed gastrotomy and
ligation. After the operation, he showed an improved general condition and was
discharged at the 12th hospital day.
키워드
Dieulafoy’s disease; Upper gastrointestinal bleeding; Endoscopy; Child;
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