Korean Journal of Gastrointestinal Endoscopy 2004;29(2): 85-89.
아나필락시스 쇼크 후에 생긴 비전형적 십이지장 궤양
변영혜·조윤주·김태헌·박영숙·주종은*·박상원·이종용·김용일
을지대학교 의과대학 내과학교실, *해부병리과
Atypical Duodenal Ulcer after Anaphylactic Shock
Young Hye Byun, M.D., Yun Ju Jo, M.D., Tae Hyun Kim, M.D., Young Sook Park, M.D.,Jong Eun Joo, M.D.*, Sang Won Park, M.D., Jong Yong Lee, M.D. and Yong Il Kim, M.D.
Departments of Internal Medicine and *Pathology, Eulji University School of Medicine, Seoul, Korea
Abstract
Anaphylaxis is an acute life-threatening event, presenting with various clinical symptoms. However, each pathophysiologic mechanism has not been completely understood. We report a case of atypical duodenal ulcers after cephradine induced anaphylactic shock. A 33-year- old woman was injected intravenously of cephradine and propofol for genoplasty, and anaphylactic reaction developed. After the recovery of shock, the patient who complained severe epigastric pain showed unusual endoscopic findings which were are multiple, irregular and shallow ulcerations at the bulb and the second portion of the duodenum. The symptom got improved after ulcer treatment. Histologically, the ulcerating inflammation was detected with eosinophilic infiltration and vascular thrombi. The skin provocation test for cephradine was positive. We suggest that the atypical duodenal ulcer was induced by transient ischemic mucosal injury and chemical damage due to the anaphylactic reaction. (Korean J Gastrointest Endosc 2004;29:8589)
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