당뇨병 환자에서 발생한 대장 가성폐색증 1예 = A Case of Colonic Pseudo-Obstruction in a Patient with Diabetes Mellitus

국문 초록 (Abstract)

가성 장폐색은 기계적인 폐색부위가 없이 복부팽만과 구토 등 장폐색의 증상과 징후가 나타나는 질환을 말하며, 선행원인을 찾을 수 없는 원발성 가성 장폐색과 다른 질환에 이차적으로 발생하는 속발성 가성 장폐색으로 나눌 수 있다. 당뇨병은 잘 알려진 속발성 가성 장폐색의 원인이지만 실제로 당뇨병에 의한 가상 장폐색의 발생 빈도는 매우 드문 것으로 보이며, 가성 장폐색의 적절한 치료에 대해서는 아직 논란이 있다. 저자들은 2형 당뇨병 환자에게 대장에 국한된 급성 가성 장폐색을 진단하고 보존적 치료를 시행하여 호전된 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

다국어 초록 (Multilingual Abstract)

Colonic pseudo-obstruction is a disorder characterized by gross dilatation of the colon in the absence of any anatomic lesions, which obstructs the flow of the intestinal contents. Diabetes is a well known cause of secondary pseudo-obstruction but its prevalence in rare and not well understood.
A 59-year-old woman patient was admitted due to abdominal distension and nausea of a day's duration. She was diagnosed with diabetes 15 years ago, but the condition had been poorly controoled.
On the abdominal radiographs, there were marked small and large bowel dilatation with the, exception of the descending colon. Our initial diagnosis was mechanical obstruction, but the possible causes were not found. Also, we could not find another cause of the secondary pseudo-obstruction, with the exception of diabetes mellitus. Thus, she was diagnosed with a diabetes induced intestinal pseudo-obstruction. The colonic dilatation was resolved by conservative management and she became comfortable in 10 hospital days, and was subsequently discharged.