직장 유암종에 대한 내시경적 절제술 시행 후 12일째 발생한 대량 지연 출혈 1예 = A Case of Delayed Massive Hemorrhage after Endoscopic Resecting a Rectal Carcinoid Tumor

다국어 초록 (Multilingual Abstract)

Endoscopic resection is currently accepted as a standard therapy for colon polyp because of its safety and efficiency. The indications for endoscopic resection have been expanded to treat mucosal colon cancer and submucosal tumor. The major complications of endoscopic resection are hemorrhage, perforation and post- polypectomy coagulation syndrome. Hemorrhage is the most common complication, and this can occur immediately following colonoscopic polypectomy or it can be delayed after completion of the procedure. Delayed hemorrhage usually occurs within 7 days and this can stop by itself or the hemorrhage can be controlled endoscopically in the majority of patients, with only the unusual and serious cases requiring transfusion, angiography and surgery. We experienced a case of delayed massive hemorrhage with hypotension that required transfusion 12 days after performing endoscopic resection for rectal carcinoid tumor. We report here on this case to provide a good example and to place emphasis on delayed massive hemorrhage after endoscopic resection.

국문 초록 (Abstract)

내시경적 용종 절제술은 대장 용종의 표준 치료로 인정받고 있으며, 내시경 술기 및 기기의 발달로 내시경적 점막절제술 및 내시경적 점막하 박리술을 이용하여 점막에 국한된 조기 대장암 및 일부 점막하 종양의 치료로 발전하고 있다. 이와 같은 내시경적 절제술은 비교적 안전하며 삶의 질을 높일 수 있어 수술적 치료를 대체하고 있으나 출혈, 천공 및 용종 절제술 후 응고 증후군 등의 합병증이 발생할 수 있다. 내시경적 용종 절제술과 관련된 가장 흔한 합병증은 출혈로서 약 0.3∼6.1%에서 발생하며 시술 중에 발생하는 즉시 출혈과 시술 이후에 발생하는 지연 출혈로 나눌 수 있다. 지연 출혈의 경우 대부분 일주일 내에 소출혈의 양상을 보이게 된다. 저자들은 1.2 cm 크기의 직장 유암종을 내시경적 절제술로 제거한 후 조기 출혈 없이 퇴원하였으나, 시술 12일째 불안정한 활력 징후를 보이며 수혈 치료가 필요했던 대량 지연 출혈 1예를 경험하여 문헌 고찰과 함께 보고한다.

참고문헌 (Reference)

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