The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
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Intramural Duodenal Hematoma Caused by Acute Gallstone Pancreatitis

급성 담석 췌장염의 합병증으로 발생한 십이지장 벽내 혈종 1예

  • Kwon, Hyuk Hee (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Choi, Hyo In (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Jeon, Min Ji (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Song, Ho June (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Lee, Sang Soo (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Jung, Hwoon Yong (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Jin Ho (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine)
  • 권혁희 (울산대학교 의과대학 서울아산병원 내과학교실) ;
  • 최효인 (울산대학교 의과대학 서울아산병원 내과학교실) ;
  • 전민지 (울산대학교 의과대학 서울아산병원 내과학교실) ;
  • 송호준 (울산대학교 의과대학 서울아산병원 내과학교실) ;
  • 이상수 (울산대학교 의과대학 서울아산병원 내과학교실) ;
  • 정훈용 (울산대학교 의과대학 서울아산병원 내과학교실) ;
  • 김진호 (울산대학교 의과대학 서울아산병원 내과학교실)
  • Received : 2012.06.26
  • Accepted : 2012.08.16
  • Published : 2013.04.01
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Abstract

Intramural duodenal hematoma (IDH) is a rare complication of pancreatitis. We report a unique case of IDH caused by acute gallstone pancreatitis in a 37-year-old man. The patient presented with hematemesis and sudden exacerbation of upper abdominal pancreatic pain. An abdominal computed tomography scan showed an intramural hyperdense hematoma and symmetric thickening of the duodenal wall along with peripancreatic inflammation and gallbladder stones. A duodenoscopy also revealed a bloody edematous duodenal wall with a narrow lumen due to IDH. The patient recovered fully from the acute pancreatitis and IDH without pancreaticoduodenectomy using conservative management and a subsequent cholecystectomy.

췌장 기원의 십이지장 벽내 혈종은 드문 질환으로서 저자들은 담석에 의한 급성 췌장염 환자에서 십이지장 벽내 혈종이 발생한 1예를 경험하였다. 급성 췌장염에서 복통과 장관 폐쇄의 악화, 위장관 출혈이 병발한 경우에는 합병증으로서 십이지장 벽내 혈종을 의심할 수 있다. 본 증례에서는 췌장과 십이지장 절제 없이 내과적인 방법으로 췌장염과 십이지장 벽내 혈종을 치료하였다.

Keywords

References

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