Clinical Endoscopy

  • 제40권5호
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  • Pages.316-320
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  • 2010
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  • 2234-2400(pISSN)
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  • 2234-2443(eISSN)
대한소화기내시경학회 (The Korean Society of Gastrointestinal Endoscopy)
권호 표지

내시경 클리핑을 이용하여 비수술적으로 치료한 이물에 의한 식도천공 2예

Two Cases of Foreign Body-induced Esophageal Perforation That Were Treated by Endoscopic Clipping and Non-surgical Management

  • 박정복 (인제대학교 의과대학 일산백병원 내과학교실) ;
  • 배원기 (인제대학교 의과대학 일산백병원 내과학교실) ;
  • 이형돈 (인제대학교 의과대학 일산백병원 내과학교실) ;
  • 김정훈 (인제대학교 의과대학 일산백병원 내과학교실) ;
  • 김남훈 (인제대학교 의과대학 일산백병원 내과학교실) ;
  • 김경아 (인제대학교 의과대학 일산백병원 내과학교실) ;
  • 이준성 (인제대학교 의과대학 일산백병원 내과학교실) ;
  • 문영수 (인제대학교 의과대학 일산백병원 내과학교실)
  • Park, Jung-Bok (Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Bae, Won-Ki (Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Lee, Hyoung-Don (Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Kim, Jung-Hoon (Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Kim, Nam-Hoon (Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Kim, Kyung-Ah (Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Lee, June-Sung (Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Moon, Young-Soo (Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine)
  • 투고 : 2009.12.28
  • 심사 : 2010.02.07
  • 발행 : 2010.05.30
⟨ 이전 논문 다음 논문 ⟩

초록

치료 내시경 시술이나 이물질의 연하 그 외 특발성이나 외상 등에 의해 발생하는 식도천공은 치료가 지연되는 경우 사망률이 급격히 상승하므로 조기진단 및 적극적인 치료가 필요하다. 식도 이물에 의한 식도천공은 드물게 발생하며 합병증으로는 종격동기종, 종격동염, 농흉, 식도기관루, 복막염, 후복막농양 등이 있다. 신속한 외과적 처치가 주된 치료이나 일부에 있어서는 비수술적인 방법으로 클립을 이용한 내시경 봉합술 후 비경구적 영양요법, 전신적 항생제 투여 등의 보존적 치료로 완전히 회복된 사례가 보고되고 있다. 저자들은 이물에 의한 식도천공 2예를 경험하여, 이 중 1예의 경우에는 내시경 봉합술이 완전하지 않았으나 비수술적인 방법으로 치료하여, 완전한 내시경 봉합술이 이루어진 다른 1예와 마찬가지로 동일한 치료효과를 보여 보고한다.

Perforation of the esophagus is a deadly injury that requires careful management if the patient is to survive. Prompt recognition and proper treatment of esophageal perforation may avert death or minimize complications. Esophageal perforation might be followed by mediastinitis, broncho-esophageal fistula, pneumomediastinum, peritonitis and empyema. Although primary surgical repair is the mainstay of treatment, non-surgical management can be attempted in selected patients. Endoscopic closure of an esophageal perforation with metallic clips and conservative therapy has recently been reported. We describe here two patients with esophageal perforation and pneumomediastinum that were caused by fish bones. One was completely closed by endoscopic clipping and the other was not. Non-surgical management that was made up of parenteral nutrition and antibiotic therapy produced the same successful outcomes in these two cases.

키워드

참고문헌

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