클립으로 지혈된 십이지장 제3부의 거대 게실 내 Dieulafoy 병변 = Hemoclipped Dieulafoy's Lesion in Giant Diverticulum in the 3rd Portion of Duodenum

다국어 초록 (Multilingual Abstract)

A duodenal diverticulum is common in the second portion of the duodenum and can occur at any age. An obstruction, bleeding, perforation, diverticulitis are not an uncommon complicationa of duodenal diverticulum. As a rare complication, bleeding in the duodenal diverticulum may be massive, and duodenal diverticulum is resected primarily as a result of the difficulty in determining the site of bleeding. However, there has been a recent increase in endoscopic diagnosis and the treatment of diverticular bleeding. Band ligation increases the risk of duodenal diverticular perforation because of the thin diverticular wall. An endoscopic hemoclip is a preferable method for endoscopic sclerotherapy. We report a 48- year-old man with a giant duodenal diverticulum that was treated with a hemoclip. The duodenal diverticular perforation was treated effectively with supportive care. (Korean J Gastrointest Endosc 2007;35:441-444)

국문 초록 (Abstract)

십이지장 게실은 주로 제2부에 발생하고 폐색, 출혈, 천공, 게실염 등을 유발할 수 있다. 십이지장 게실 내의 출혈은 드문 합병증으로 가끔 대량 출혈을 초래할 수 있다. 십이지장 게실 출혈은 상부 위장관 내시경검사로 출혈 장소를 확인하기 어려워 수술적 절제술로 치료된 경우가 많았다. 그러나 최근에는 내시경 접근을 통해 게실 출혈의 진단과 치료가 증가하고 있다. 그러나 내시경 경화 요법이나 밴드 결찰술 등은 게실의 벽이 얇기 때문에 천공의 위험이 높아 지혈 클립이 가장 선호되는 내시경 치료로 인정받고 있다. 저자들은 남자 48세 환자에서 발생한 거대 십이지장 게실 내의 Dieulafoy 출혈을 지혈 클립을 사용한 치료 후 십이지장 천공이 발생하였고 이를 보존적 치료 후 효과적으로 치유한 증례를 보고하고자 한다.

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