Clinical Endoscopy

  • 제41권3호
  • /
  • Pages.172-175
  • /
  • 2010
  • /
  • 2234-2400(pISSN)
  • /
  • 2234-2443(eISSN)
대한소화기내시경학회 (The Korean Society of Gastrointestinal Endoscopy)
권호 표지

내시경 용종절제술 후 발생한 대장 장중첩증 1예

A Case of Colonic Intussusception Occurring after Colonoscopic Polypectomy

  • 김사일 (한양대학교 의과대학 내과학교실) ;
  • 전용철 (한양대학교 의과대학 내과학교실) ;
  • 이길우 (한양대학교 의과대학 내과학교실) ;
  • 김영택 (한양대학교 의과대학 내과학교실) ;
  • 김태엽 (한양대학교 의과대학 내과학교실) ;
  • 은창수 (한양대학교 의과대학 내과학교실) ;
  • 한동수 (한양대학교 의과대학 내과학교실) ;
  • 손주현 (한양대학교 의과대학 내과학교실)
  • Kim, Sa-Il (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Jeon, Yong-Cheol (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Lee, Gil-Woo (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Kim, Young-Taek (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Kim, Tae-Yeob (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Eun, Chang-Soo (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Han, Dong-Soo (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Sohn, Joo-Hyun (Department of Internal Medicine, Hanyang University College of Medicine)
  • 투고 : 2010.05.24
  • 심사 : 2010.07.08
  • 발행 : 2010.09.30
⟨ 이전 논문 다음 논문 ⟩

초록

성인 장중첩증은 드문 질환이다. 성인 장중첩증의 대부분은 병리적인 선행 병변이 관찰되며 수술 치료가 대부분 필요하다. 대장의 내시경 용종절제술 후 장중첩증이 발생한 경우는 매우 드물다. 이번 증례는 77세 남자가 대장의 내시경 용종절제술을 시행 받은 후 발생한 복통으로 내원하여 장중첩증을 진단 받고 보전적인 치료만으로 자발적인 정복이 되지 않아 수술 치료를 한 증례이다. 수술 후 절제된 대장의 조직 소견을 통하여 용종 절제술을 시행한 부위가 장중첩증의 선행 병변이었음을 확인하였다.

Intestinal intussusception in adults is a rare disease. Most of the cases of adult intussusception are secondary to a definable lesion, and so surgical treatment generally needed. Intussusception that occurs after colonoscopic polypectomy is apparently a rare malady. A 77-year old man undergoing colonoscopic polypectomy was diagnosed as having colonic intussusception at the hepatic flexure. As there was no clinical improvement with conservative treatment, he underwent segmental resection of the ascending and transverse colon. Pathologic examination revealed that the colonoscopic polypectomy site was a leading point of the intussusception.

키워드

참고문헌

  1. Azar T, Berger DL. Adult intussusception. Ann Surg 1997;226:134-138. https://doi.org/10.1097/00000658-199708000-00003
  2. Takeuchi K, Tsuzuki Y, Ando T, et al. The diagnosis and treatment of adult intussusception. J Clin Gastroenterol 2003;36:18-21. https://doi.org/10.1097/00004836-200301000-00007
  3. Cappell MS, Friedel D. The role of sigmoidoscopy and colonoscopy in the diagnosis and management of lower gastrointestinal disorders: endoscopic findings, therapy, and complications. Med Clin North Am 2002;86:1253-1288. https://doi.org/10.1016/S0025-7125(02)00077-9
  4. Marinis A, Yiallourou A, Samanides L, et al. Intussusception of the bowel in adults: a review. World J Gastroenterol 2009;15:407-411. https://doi.org/10.3748/wjg.15.407
  5. Begos DG, Sandor A, Modlin IM. The diagnosis and management of adult intussusception. Am J Surg 1997;173:88-94. https://doi.org/10.1016/S0002-9610(96)00419-9
  6. Felix EL, Cohen MH, Bernstein AD, Schwartz JH. Adult intussusceptions: case report of recurrent intussusception and review of the literature. Am J Surg 1976;131:758-761. https://doi.org/10.1016/0002-9610(76)90196-3
  7. Yalamarthi S, Smith RC. Adult intussusception: case reports and review of literature. Postgrad Med J 2005;81:174-177. https://doi.org/10.1136/pgmj.2004.022749
  8. Nagorney DM, Sarr MG, McIlrath DC. Surgical management of intussusception in the adult. Ann Surg 1981;193:230-236. https://doi.org/10.1097/00000658-198102000-00019
  9. Eisen LK, Cunningham JD, Aufses AH Jr. Intussusception in adults: institutional review. J Am Coll Surg 1999;188:390-395. https://doi.org/10.1016/S1072-7515(98)00331-7
  10. Weilbaecher D, Bolin JA, Hearn D, Ogden W 2nd. Intussusception in adults. Review of 160 cases. Am J Surg 1971;121:531-535. https://doi.org/10.1016/0002-9610(71)90133-4
  11. Gayer G, Apter S, Hofmann C, et al. Intussusception in adults: CT diagnosis. Clin Radiol 1998;53:53-57. https://doi.org/10.1016/S0009-9260(98)80035-4
  12. Kitamura K, Kitagawa S, Mori M, Haraguchi Y. Endoscopic correction of intussusception and removal of a colonic lipoma. Gastrointest Endosc 1990;36:509-511. https://doi.org/10.1016/S0016-5107(90)71128-5
  13. Dominitz JA, Eisen GM, Baron TH, et al. Complications of colonoscopy. Gastrointest Endosc 2003;57:441-445. https://doi.org/10.1016/S0016-5107(03)80005-6
  14. Kim BK, Lee DH, Kim NY, Lee SH, Park YS. Colonic intussusception as a complication after colonoscopic polypectomy. Korean J Gastrointest Endosc 2009;39:111-114.