대한영상의학회지 (Journal of the Korean Society of Radiology)

  • 제65권3호
  • /
  • Pages.267-270
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  • 2011
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  • 1738-2637(pISSN)
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  • 2288-2928(eISSN)
대한영상의학회 (The Korean Society of Radiology)
권호 표지

급성 복부팽만 증상을 보인 소아에서 생긴 총담관의 자연 천공: 증례 보고

Spontaneous Perforation of Common Bile Duct in a Child with a Clinical Manifestation of Acute Abdominal Distension: A Case Report

  • 정희록 (한림대학교 의과대학 춘천성심병원 영상의학과학교실) ;
  • 남궁숙 (한림대학교 의과대학 춘천성심병원 영상의학과학교실) ;
  • 김흥철 (한림대학교 의과대학 춘천성심병원 영상의학과학교실) ;
  • 홍명선 (한림대학교 의과대학 춘천성심병원 영상의학과학교실)
  • Jeong, Hee-Rok (Department of Radiology, Chuncheon Sacred Heart Hospital, College of Medicine, Hallym University) ;
  • NamKung, Sook (Department of Radiology, Chuncheon Sacred Heart Hospital, College of Medicine, Hallym University) ;
  • Kim, Heung-Cheol (Department of Radiology, Chuncheon Sacred Heart Hospital, College of Medicine, Hallym University) ;
  • Hong, Myung-Sun (Department of Radiology, Chuncheon Sacred Heart Hospital, College of Medicine, Hallym University)
  • 발행 : 2011.09.01
⟨ 이전 논문 다음 논문 ⟩

초록

소아의 총담관 자연 천공(spontaneous perforation of common bile duct)은 드물지만 조기 진단과 함께 조기 수술로써 치료하지 않으면 사망에 이를 수 있는 치명적인 질환으로, 주로 점진적인 복부팽만, 변동성 경증 황달 그리고 회백색 대변 등의 담도성 증상이나 징후를 보이는 것으로 알려져 있다. 담도성 증상이나 징후 없이 급성 복부팽만을 보인 3세 여아에서 수술로써 확진되고 영상의학적 검사로 췌담관 합류 이상(anomalous pancreaticobiliary ductal union)과 총담관 협착 소견을 보인 총담관의 자연 천공 증례를 보고한다.

Spontaneous perforation of common bile duct (CBD) is extremely rare in children, but potentially a fatal disorder that requires an emergency laparotomy. Most of the patients present with insidious symptoms including slowly progressive abdominal distension with accumulation of the ascites, fluctuating mild jaundice, and clay-colored stools. We report a case of surgically confirmed spontaneous perforation of the CBD in a 3-year-old girl who presented with acute abdominal distension with no biliary symptoms or signs, and who showed imaging findings consistent with anomalous pancreaticobiliary ductal union with a focal stenosis in the CBD.

키워드

참고문헌

  1. Karrer FM, Hall RJ, Stewart BA, Lilly JR. Congenital biliary tract disease. Surg Clin North Am 1990;70:1403-1418 https://doi.org/10.1016/S0039-6109(16)45291-6
  2. Haller JO, Condon VR, Berdon WE, Oh KS, Price AP, Bowen A, et al. Spontaneous perforation of the common bile duct in children. Radiology 1989;172:621-624 https://doi.org/10.1148/radiology.172.3.2672089
  3. Chardot C, Iskandarani F, De Dreuzy O, Duquesne B, Pariente D, Bernard O, et al. Spontaneous perforation of the biliary tract in infancy: a series of 11 cases. Eur J Pediatr Surg 1996;6:341-346 https://doi.org/10.1055/s-2008-1071011
  4. Vijay BB, Kumar R, Gupta DK, Ragavan M, Mohapatra T, Dhanpathi H, et al. Spontaneous biliary perforation in an infant: an unusual chronic presentation. Clin Nucl Med 2008;33:273-275 https://doi.org/10.1097/RLU.0b013e3181662adb
  5. Carubelli CM, Abramo TJ. Abdominal distention and shock in an infant. Am J Emerg Med 1999;17:342-344 https://doi.org/10.1016/S0735-6757(99)90081-5
  6. Lee MJ, Kim MJ, Yoon CS. MR cholangiopancreatography findings in children with spontaneous bile duct perforation. Pediatr Radiol 2010;40:687-692 https://doi.org/10.1007/s00247-009-1447-7