Korean J Gastrointest Endosc > Volume 32(1); 2006 > Article
Korean Journal of Gastrointestinal Endoscopy 2006;32(1): 48-52.
내시경적 지혈술로 치료된 결절성 다발 동맥염에 의한 공장 출혈 1예
권혁춘·최정우·최승준·우성일·선주성*·원제환*·서창희·이기명·함기백·김진홍
아주대학교 의과대학 소화기내과학교실, *진단방사선과학교실, 알레르기-류마티스내과학교실
A Case of Endoscopically Treated Jejunal Bleeding from Polyarteritis Nodosa
Hyeok Choon Kwon, M.D., Jeong Woo Choi, M.D., Seung Jun Choi, M.D., Seung Il Woo, M.D., Joo Sung Sun, M.D.*, Je Hwan Won, M.D.*, Chang Hee Suh, M.D., Kee Myung Lee, M.D., Ki Baik Hahm, M.D. and Jin Hong Kim, M.D.
Departments of Gastroenterology, *Radiology and Allergy-Rheumatology, Ajou University School of Medicine, Suwon, Korea
Abstract
Polyarteritis nodosa is a necrotizing vasculitis of the small and medium-sized arteries of multiple organ systems. The common symptoms of gastrointestinal involvement are abdominal pain, nausea, and vomiting. However, the symptoms at presentation are sometimes non-specific and vague. The well-known complications of gastrointestinal involvement are mucosal ulceration, bowel infarction, perforation, cholecystitis and hepatitis. We describe a case of a 6-year-old male with jejunal bleeding who was diagnosed with polyarteritis nodosa by angiography. After controlling the systemic symptoms with immunosuppressants and steroids, jejunal bleeding occurred. The jejunal bleeding was treated endoscopically with a hemoclip and increasing the immunosuppressant dose. Generally, massive gastrointestinal bleeding in a patient with polyarteritis nodosa is treated surgically. In this case, the jejunal bleeding was controlled with an endoscope because the bleeding site was located within reach of the endoscope, and systemic symptoms subsided with medication. There is no report of gastrointestinal bleeding from the polyarteritis nodosa in a child in Korea. Therefore, we report this case with a review of the relevant literature. (Korean J Gastrointest Endosc 2006;32:48⁣52)
Key Words: Polyarteritis nodosa, Gastrointestinal hemorrhage, Jejunum
주요어: 결절성 다발 동맥염, 위장관 출혈, 공장
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