Clinical Endoscopy

  • 제42권6호
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  • Pages.419-423
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  • 2011
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  • 2234-2400(pISSN)
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  • 2234-2443(eISSN)
대한소화기내시경학회 (The Korean Society of Gastrointestinal Endoscopy)
권호 표지

간이식을 시행하지 않은 환자에서 발생한 담관 원주 증후군 1예

A Case of Biliary Cast Syndrome in a Non-liver Transplant Patient

  • 전성곤 (순천향대학교 의과대학 내과학교실, 소화기 연구소) ;
  • 전성란 (순천향대학교 의과대학 내과학교실, 소화기 연구소) ;
  • 문종호 (순천향대학교 의과대학 내과학교실, 소화기 연구소) ;
  • 조영덕 (순천향대학교 의과대학 내과학교실, 소화기 연구소)
  • Jun, Sung-Gon (Department of Internal Medicine, Institute for Digestive Research, Digestive Disease Center, Soonchunhyang University College of Medicine) ;
  • Jeon, Seong-Ran (Department of Internal Medicine, Institute for Digestive Research, Digestive Disease Center, Soonchunhyang University College of Medicine) ;
  • Moon, Jong-Ho (Department of Internal Medicine, Institute for Digestive Research, Digestive Disease Center, Soonchunhyang University College of Medicine) ;
  • Cho, Young-Deok (Department of Internal Medicine, Institute for Digestive Research, Digestive Disease Center, Soonchunhyang University College of Medicine)
  • 발행 : 2011.06.30
⟨ 이전 논문 다음 논문 ⟩

초록

담관 원주 증후군은 담도 찌꺼기가 담도의 형태를 따라 원주를 형성하는 질환으로 간이식을 시행받은 환자에서 드물게 발생하는 담도계 합병증이다. 담도폐쇄와 담도염이 흔히 동반되어 있고 이로 인한 허혈성 간담도 손상과 담즙 저류를 보이나 발병 기전은 아직 명확치 않다. 간이식을 시행하지 않은 경우에서는 매우 드물게 보고되고 있다. 담도계 수술 후 또는 수술 후 다량의 수혈을 받은 경우, 선행하는 동반 질환을 가진 환자에서 장기간 금식이나 완전 비경구 영양요법을 시행한 경우 또는 중증 감염으로 이환된 경우에서 발생한 보고가 있다. 저자들은 수술 과거력이 없으며 동반된 선행 질환이 뚜렷하지 않는 65세 남자에서 ERCP와 경피경간 담도경검사로 담관 원주 증후군으로 진단하였고, 반복적인 내시경 치료를 통해 담관 원주를 제거한 증례를 경험하여 문헌 고찰과 함께 보고한다.

Biliary casts are uncommon but are typically seen in post-liver transplant patients, whereas very few cases have been reported in non-liver transplant patients. A 65-year-old man, who had not undergone a liver transplantation or other hepatobiliary surgery, presented with jaundice and fever. Radiological imaging studies showed diffuse thickening and enhancement of the intrahepatic duct with mild ductal dilatation and multiple linear filling defects. A percutaneous transhepatic cholangioscopy revealed severe bile duct inflammation and multiple biliary casts, which were removed with multiple percutaneous choledocoscopic procedures. The pathogenesis of the biliary casts in this patient was uncertain. However, we presumed that biliary tract infection with subsequent extensive cholangitis was an important predisposing factor in the cast formation. We report a case of biliary cast syndrome with no preexisting morbidity that was managed favorably with endoscopic removal.

키워드

참고문헌

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