만성 신부전 환자에서 발생한 정맥경화성 대장염 = A Case of Phlebosclerotic Colitis in a Patient of Chronic Renal Failure

국문 초록 (Abstract)

정맥경화성 대장염은 허혈성 대장염의 드문 형태로 장간막 정맥의 석회화와 동반된 대장 정맥의 울혈로 인해 발생한다. 주 증상은 복통, 설사 및 혈변이고 특징적으로 대장내시경에서 청자색 점막 소견, 방사선 검사에서 장간막 정맥의 다발성 석회화, 조직병리소견에서 정맥의 섬유화 및 비후가 있다. 만성 신부전으로 혈액투석을 받고 있는 65세 남자가 혈변을 주소로 내원하였다. 대장내시경 검사에서 특징적인 청자색 점막을 보였고 방사선 검사에서 복부에 다발성 석회화가 관찰되었으며 조직검사에서 점막의 괴사와 염증 소견이 관찰 되었다. 복부 전산화단층촬영에서 동맥 폐색의 소견은 보이지 않아 정맥경화성 대장염으로 진단하였다. 저자들은 만성 신부전으로 혈액투석 치료 중인 환자에서 국내에서 보고되지 않은 정맥경화성 대장염 증상을 보인 1예를 경험하여 문헌고찰과 함께 보고한다.

다국어 초록 (Multilingual Abstract)

Phlebosclerotic colitis is a rare disease sub-entity of ischemic colitis that is caused by venous obstruction due to colonic and mesenteric venous calcifications. Abdominal pain, diarrhea and hematochezia are frequent symptoms of phlebosclerotic colitis. The disease is characterized by typical dark purple mucosa on endoscopy, various venous calcifications on radiological findings, and microscopic findings showing fibrous degeneration, mucosal bleeding and venous wall thickening. A 64-year-old male who was undergoing maintenance hemodialysis was admitted to our hospital due to hematochezia. There was typical dark purple colored mucosa seen on colonoscopy, multiple abdominal calcifications were seen on radiology and diffuse necrosis and inflammatory changes were seen on the histophathology, but there was no mesenteric arterial occlusion seen on abdominal CT. On the basis of these findings, we diagnosed the patient as having phlebosclerotic colitis. To the best of our knowledge, this is the first reported case of phlebosclerotic colitis in Korea.

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