혈액 담즙증을 동반한 황색육아종성 담낭염 및 담낭암 2예

Two Cases of Xanthogranulomatous Cholecystitis and Gallbladder Cancer with Hemobilia

  • Kwon, Jong-Kyu (Department of Internal Medicine, Daegu Fatima Hospital) ;
  • Kim, Dae-Jin (Department of Internal Medicine, Daegu Fatima Hospital) ;
  • Ryu, Hyun-Uk (Department of Internal Medicine, Daegu Fatima Hospital) ;
  • Seol, Soo-Hwan (Department of Internal Medicine, Daegu Fatima Hospital) ;
  • Hwang, Byung-Sik (Department of Internal Medicine, Daegu Fatima Hospital) ;
  • Park, Jong-Hun (Department of Surgery, Daegu Fatima Hospital) ;
  • Son, Kyung-Rak (Department of Pathology, Daegu Fatima Hospital)
  • 발행 : 2011.06.30

초록

혈액 담즙증은 드문 상부 위장관 출혈의 한 형태로 주로 외상에 의해 발생하나 다양한 간 및 췌담도 질환에 의해 발생할 수 있다. 담낭질환과 관련하여 발생하는 경우는 혈관질환, 종양, 용종, 이형성 위점막, 무담석 염증 등이 있으나 담석에 의해 발생하는 것이 가장 흔하며 대부분 담낭절제술로 치료한다. 양성 및 악성 질환 모두에서 발현 될 수 있으므로 혈액 담즙증이 진단된 경우에는 악성 질환을 배제 하려는 노력이 필요하며 담낭질환의 경우 반드시 담낭암의 가능성을 생각하여야 한다. 저자들은 상복부 통증과 혈액 담즙증이 있어 수술적 치료로 확인된 드문 황색 육아종성 담낭염과 담낭암 두 증례를 경험하여 문헌 고찰과 함께 보고한다.

Hemobilia is a rare upper gastrointestinal (GI) bleeding phenomenon usually caused by trauma but may occur due to various liver and pancreatobiliary diseases. Causes related to gallbladder disease include vascular disorders, malignancy, polyps, heterotopic GI mucosa, acalculous inflammation, and most commonly gallstones. Most cases are treated with a cholecystectomy. If hemobilia is detected, efforts must be made to exclude malignancy because hemobilia develops from both benign and malignant disease. Particularly in gallbladder disease with hemobilia, the possibility of gallbladder carcinoma should be considered. We report two cases of hemoblia by endoscopic retrograde cholangiopancreatography and duodenoscopy, with a review of the literature. The first case was xanthoglanulomatous cholesystitis and the second case was gallbladder cancer disclosed by cholecystectomy.

키워드

참고문헌

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