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노출 혈관을 가진 위궤양 출혈에서 히스토아크릴(N-Butyl-2-Cyanoacrylate)을 이용하여 내시경적 지혈을 실시한 3예
성용완,신영민,노지훈,조영화,구동영,유재훈,윤준모 대한소화기내시경학회 2009 Clinical Endoscopy Vol.38 No.4
Upper gastrointestinal bleeding is a primary and emergency complication of peptic ulcer. Injection of Histoacryl (N-butyl-2-cyanoacrylate) is an effective endoscopic hemostasis procedure to treat peptic ulcer bleeding. However, Histoacryl injection is not a widely used method because of its various and sometimes severe complications. Therefore, the use of Histocaryl should be considered as a second line treatment modality to achieve therapeutic endoscopic hemostasis when the conventional treatment modalities fail or the patient has a high risk of needing operative therapy. Three patients, who had gastric ulcer bleeding from an exposed blood vessel, were each treated by an injection of Histoacryl diluted with Lipiodol at a dilution ratio of 1:1. All 3 procedures were successfully accomplished without any complications. 상부 위장관 출혈은 소화성 궤양의 중요하며 위급한 합병증이다. 소화성 궤양 출혈시 히스토아크릴(N-butyl-2-cyanoacrylate) 주입법은 효과적인 내시경적 지혈술이다. 하지만 높은 지혈 성공률에도 불구하고 히스토아크릴 주입 후 발생하는 다양하고 때로는 심각한 부작용들로 인해 소화성 궤양 출혈에서 히스토아크릴이 널리 쓰이지 못하고 있으며, 기존의 일차적인 내시경적 지혈술이 실패했거나 수술적 치료가 힘든 경우 이차적인 치료 방법으로 고려되고 있다. 해외 문헌에서 소화성 궤양 출혈에서 히스토아크릴을 이용하여 내시경적 지혈술을 실시한 몇몇 보고들이 있지만, 국내에서의 문헌 보고는 아직 없다. 이에 저자들은 노출된 혈관을 가진 위궤양 출혈을 보인 3명의 환자를 대상으로 리피오돌과 1:1로 희석한 히스토아크릴을 이용하여 성공적인 내시경 지혈술을 실시하였고, 특별한 부작용 없이 환자를 치료하였기에 문헌고찰과 함께 보고한다.
내시경적 밴드 결찰술로 치료한 출혈을 동반한 위 혈관이형성증 1예
김갑식,허종현,성용완,조영화,구동영,유재훈,노지훈,문원 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.2
Gastric angiodysplasia is vascular ectasia in mucosa and submucosa of the gastric wall. It is an uncommon cause of upper gastrointesinal hemorrhage that may occur in the stomach or duodenum. There are many kinds of endoscopic treatments, such as argon plasma coagulation, electrocoagulation, heat probe, and submucosal injection of hypertonic saline mixed with epinephrine for gastric angiodysplasia. However, these treatment methods are associated with high rate of rebleeding. In order to avoid the recurrence, endoscopic band ligation has recently been used as an alternative method for endoscopic treatment of gastric angiodysplasia. We encountered a case of gastric angiodysplasia that presented with overt bleeding and anemia, and was successfully treated with endoscopic band ligation.
내시경적 절제로 진단된 폴립 형태의 심재성 낭종성 위염 2예
허종현,조영화,성용완,유재훈,구동영,김갑식,노지훈,문원 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.2
Gastritis cystica profunda (GCP) is a disease characterized by hyperplastic and significant extension of cystic dilatation of the gastric mucous glands, which results in a cystic lesion in gastric submucosa. It often occurs on the part of gastroenterostomy, but can be found in the stomach without any previous surgery. GCP has variable gross finding including solitary polyps, diffuse ones, submucosal tumors, and rare giant gastric mucosal fold. It is difficult to tell GCP from a cancerous lesion by gross finding that the disease demands a necessary tissue biopsy, though GCP is commonly showed as a benign in the progress. We report a case of GCP in polypoid types diagnosed by endoscopic polypectomy.