속립성 결핵환자에서 간문 임파선염에 의해 발생한 식도 정맥류 출혈 치험 = A Case of Esophageal Variceal Bleeding due to Lymphadenopathy of Porta Hepatis Associated with Miliary Tuberculosis

다국어 초록 (Multilingual Abstract)

Esophageal variceal hleeding is usually caused by portal hypertension associated with liver cirrhosis. However, it might be caused by lymphadenopathy of porta hepatis in noncirrhotic patient. A 19-year-old student was admitted to this hospital because of profuse hematemesis. He had been treated with anti-tuberculosis agents of miliary tuberculosis during past nine months period. On admission, gastroduodenal fiberscopy revealed esophageal variceal bleeding, Abdominal sono- graphy disclosed nothing remarkable except thickened gallbladder wall, but computed tomography showed low attenuated lymphadenopathy in porta hepatis. Further doppler sonography demonstrated lymphadenopathy of porta hepatis with fibrosis and obliteration of rnain portal vein with collateral circulations. Laparoscopic findings suggested tuberculous peritonitis without any evidence of cirrhosis of the liver. We report a very rare case of variceal bleeding caused by lymphadenopathy of porta hepatis during anti-tubereulous treatment. (Korean J Gastroenterol 1997; 29:122-128)