내시경 풍선확장술로 호전된 거대세포바이러스 대장염 관련 직장협착 1예 |
박권오ㆍ김경호ㆍ박종원ㆍ이상호ㆍ조현정ㆍ천승연ㆍ박혜원ㆍ김학량 |
한림대학교 의과대학 내과학교실 |
A Case of a Cytomegalovirus Colitis Related Rectal Stricture Treated by Endoscopic Balloon Dilation |
Kwonoh Park, M.D., Kyung Ho Kim, M.D., Jong Won Park, M.D., Sangho Lee, M.D., Hyunjung Jo, M.D., Seungyun Chun, M.D., Hyewon Park, M.D. and Hak Yang Kim, M.D. |
Department of Internal Medicine, Hallym University College of Medicine, Seoul, Korea |
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Abstract |
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Cytomegalovirus (CMV) colitis is a common opportunistic infection in immunocompromised patients. Affected individuals present with abdominal pain, diarrhea, or hematochezia. Complications of CMV colitis can include massive bleeding, toxic megacolon, bowel perforation and, rarely, colon stricture. A 69-year-old woman who had no specific past history was admitted to the orthopedic department for pelvic bone fracture with right iliac artery rupture caused by a traffic accident. She was successfully managed with emergency transarterial coil embolization. After 2 weeks, she developed hematochezia and recurrent abdominal pain. Colonoscopy showed a huge, deep ulcer in the rectosigmoid colon. Biopsy and immunohistochemical staining revealed giant cells with intracellular inclusion bodies that were positive for CMV antigen. She received antiviral treatment after which her symptoms improved. On follow-up colonoscopy 3 months later, we found a tight luminal narrowing in the rectum. We did a repeat endoscopic balloon dilation in this patient and she experienced improvement. (Korean J Gastrointest Endosc 2010;41:240-244) |
Key Words:
Cytomegalovirus, Colitis, Stricture, Balloon dilation |
주요어:
거대세포바이러스, 대장염, 직장 협착, 풍선확장술 |
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