A Case of Duodenal Wall Abscess Caused by a Foreign Body

이물질에 의한 십이지장벽 농양 1예

  • Ji, Byoung-Hoon (Department of Internal Medicine, Bong Seng Memorial Hospital) ;
  • Yoon, Ji-Hoon (Department of Internal Medicine, Bong Seng Memorial Hospital) ;
  • Lee, Jin-Ho (Department of Internal Medicine, Bong Seng Memorial Hospital) ;
  • Lee, Hee-Ryong (Department of Internal Medicine, Bong Seng Memorial Hospital) ;
  • Yu, Seong-Min (Department of Internal Medicine, Bong Seng Memorial Hospital) ;
  • Kim, Min-Dae (Department of Internal Medicine, Bong Seng Memorial Hospital) ;
  • Choi, Young-Il (Department of General Surgery, Bong Seng Memorial Hospital) ;
  • Lee, Il-Seon (Department of Pathology, Bong Seng Memorial Hospital)
  • Published : 2011.06.30

Abstract

Duodenal abscess is a form of phlegmonous enterocolitis and is a rarely reported disease throughout the entire world. Duodenal abscess mostly develops from complications of duodenal ulcer perforation, and may result in a clinically fatal course because it is difficult to differentiate from some diseases such as gastric ulcer, gastric cancer, hepatobiliary disorders etc.. The therapeutic gold standard is surgical intervention including abscess removal and drainage. We experienced a case of duodenal abscess that expressed non-specific symptoms, weight loss and epigastric pain, and diagnosed by gastrointestinal endoscopy, abdominal computed tomography. We successfully treated it through surgical intervention with intravenous antibiotics.

십이지장 농양은 장관에서 발생하는 농양의 한 형태로 드물게 발생하는 질환으로 알려져 있으며, 상복부 통증, 식욕부진과 같은 비특이적인 증상을 보이는 경우가 많고 위궤양, 위암, 담도계 질환과의 감별이 어려워 진단과 치료가 늦어져서 치명적인 임상경과로 진행할 수 있다. 본 증례는 알코올 남용, 흡연, 스테로이드 제제 및 비스테로이드성 항염증약물의 복용과 같은 위장관 점막 손상의 복합적인 위험 인자를 가진 59세 남자환자에게서 체중감소 및 심와부 통증 등의 비특이적인 증상으로 발현된 십이지장벽 농양의 예이다. 저자들은 병리소견과 병변부 세균배양검사 결과를 종합하여 이물질로 인해 발생한 십이지장농양으로 결론을 내렸고 수술적 치료와 경피적배농술 및 항생제 투여를 통해 임상경과의 호전을 경험하여 문헌고찰과 함께 보고한다.

Keywords

References

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