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제1형 신경섬유종증 환자의 파열된 위십이지장동맥 동맥류에서 발생한 위중한 십이지장 궤양 출혈
임규성 ( Kyu Sung Im ),김선용 ( Sun Yong Kim ),임준욱 ( Jun Uk Lim ),전장원 ( Jung Won Jeon ),신현필 ( Hyun Phil Shin ),차재명 ( Jae Myung Cha ),주광로 ( Kwang Ro Joo ),이정일 ( Joung Ll Lee ),박재준(교신저자) ( Jae Jun Park ) 대한소화기학회 2015 대한소화기학회지 Vol.66 No.3
Vasculopathy is rarely reported in neurofibromatosis type 1, but when it occurs it primarily involves the aorta and its main branches. Among vasculopathies, aneurysmal dilatation is the most common form. Although several case reports concerning aneurysms or pseudoaneurysms of visceral arteries in neurofibromatosis type 1 patients have been reported, there are no reports describing gastroduodenal artery aneurysms associated with neurofibromatosis type 1. We experienced a case of life-threatening duodenal ulcer bleeding from a ruptured gastroduodenal artery aneurysm associated with neurofibromatosis type 1. We treated our patient by transarterial embolization after initial endoscopic hemostasis. To our knowledge, this is the first reported case of its type. High levels of suspicion and prompt diagnosis are required to select appropriate treatment options for patients with neurofibromatosis type 1 experiencing upper gastrointestinal bleeding. Embolization of the involved arteries should be considered an essential treatment over endoscopic hemostasis alone to achieve complete hemostasis and to prevent rebleeding. (Korean J Gastroenterol 2015;66:164-167)