Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
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Portal and Mesenteric Venous Thrombosis Complicating Endoscopic Injection Sclerotherapy

내시경 경화요법 후 합병된 문맥 및 장간막정맥 혈전증 1예

  • Ko, Seouk-Chan (Department of Internal Medicine, Seoul Medical Center) ;
  • Kim, Bong-Roung (Department of Internal Medicine, Seoul Medical Center) ;
  • Jang, Yoo-Hyun (Department of Internal Medicine, Seoul Medical Center) ;
  • Kim, Jang-Eon (Department of Internal Medicine, Seoul Medical Center) ;
  • Kim, Yoon-Jeong (Department of Internal Medicine, Seoul Medical Center) ;
  • Lee, Seung-June (Department of Internal Medicine, Seoul Medical Center) ;
  • Lee, Seong-Tae (Department of Internal Medicine, Seoul Medical Center) ;
  • Lee, Hyang-Im (Department of Pathology, Seoul Medical Center)
  • Received : 2010.04.01
  • Accepted : 2010.10.12
  • Published : 2010.11.30
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Abstract

Endoscopic injection sclerotherapy is an effective and relatively safe modality for controlling bleeding esophageal varices. Injection of sclerosant causes acute mural thrombosis with a necroinflammatory response and subsequent sclerosis in the venous system of the distal esophagus. A few cases of mesenteric venous thrombosis with small bowel infarction after sclerotherapy have been reported, and most of which were fatal. The association between mesenteric venous thrombosis and sclerotherapy has been strongly suggested, but this still remains unproved. We report here on a case of mesenteric venous thrombosis with small bowel infarction that developed after endoscopic injection sclerotherapy.

내시경 경화요법은 주입된 경화제에 의해 문맥 및 장간막정맥에 급성 혈전증을 유발 할 수 있으므로 특히 이식혈관의 개통성이 중요시 되고 있는 간이식을 염두에 두고 있는 말기 간질환 환자의 식도정맥류 출혈에서는 가급적 식도정맥류 결찰술과 같은 내시경 지혈술을 사용해야 한다. 저자들은 식도정맥류 출혈로 내원한 알코올성 간경화 환자에서 식도정맥류 출혈에 대한 내시경 경화요법 시행 후 발생한 급성 문맥 및 장간막정맥 혈전증에 의한 소장경색을 경험하여 문헌 고찰과 함께 보고한다.

Keywords

References

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