Korean Journal of Gastrointestinal Endoscopy 2004;28(4): 208-212.
난원공 개존증과 동반된 심부 정맥 혈전증에 의한 허혈성 직장 궤양 1예
이상훈·김효종·박미나·김남훈·정용희·임근우·강흥선·한요셉·김병호·장영운·이정일·장
경희대학교 의과대학 내과학교실
A Case of Ischemic Colitis with Deep Vein Thrombosis and Patent Foramen Ovale
Sang Hoon Lee, M.D., Hyo Jong Kim, M.D., Mi Na Park, M.D., Nam Hoon Kim, M.D., Yong
Department of Internal Medicine, Kyunghee University College of Medicine, Seoul, Korea
Abstract
Colonic ischemia is the most prevalent form of gastrointestinal ischemia and causes 3∼
9% of all acute lower intestinal bleeding. Most common cause is known to be cardiac embolus. A
67-year-old female patient presented with rectal bleeding. The patient had cerebral infarction 15
days ago. A colonoscopy showed a large ulcer with hemorrhage in the rectum. Computed tomography
showed deep vein thrombosis from the left popliteal vein to infrarenal inferior vena cava.
Transthoracic echocardiography was carried out, but no abnormal feature was found. Then, tran
sesophageal echocardiography, with agitated saline contrast to find out a right to left shunt, was
performed, patent foramen ovale was found. This patient was treated with anticoagulation and
inferior vena cava filtering. We suggest this ischemic colitis may be due to arterial embolization from
deep vein thrombosis through PFO. (Korean J Gastrointest Endosc 2004;28:208212