Korean J Gastrointest Endosc > Volume 35(4); 2007 > Article
Korean Journal of Gastrointestinal Endoscopy 2007;35(4): 267-271.
췌담관 폐쇄를 유발한 췌장 결핵과 대장암을 동반한 대장결핵 1예
황래석ㆍ남승우ㆍ이성은ㆍ권낙현ㆍ강효성ㆍ김성훈ㆍ남기석ㆍ홍경득ㆍ함세운ㆍ전영웅*ㆍ박세혁*ㆍ진성찬ㆍ안혜선
국립의료원 내과, *외과, 영상의학과, 병리과
A Case of Pancreaticobiliary Duct Obstruction due to Pancreatic Tuberculosis Combined with a Colon Adenocarcinoma and Tuberculous Colitis
Lae Seok Hwang, M.D., Seong Woo Nam, M.D., Seong Eun Lee, M.D., Nak Hyun Kwon, M.D., Hyo Sung Kang, M.D., Sung Hoon Kim, M.D., Kee Suk Nam, M.D., Kyung Deuk Hong, M.D., Se Woon Ham, M.D., Young Woong Jeon, M.D.*, Se Hyuk Park, M.D.*, Sung Chan Jin, M.D.,Hae Sun Ahn, M.D.
Departments of Internal Medicine, *Surgery, Radiology and Pathology, National Medical Center, Seoul, Korea
Abstract
Systemic manifestation of tuberculosis is common, but tuberculous biliary obstruction of the pancreas and a colon adenocarcinoma with combined colonic tuberculosis is an uncommon disorder. We encountered a case of the above condition in 63-year-old male that was admitted to our hospital because of fever, diffuse abdominal pain and rigidity. Abdominal computed tomography showed biliary and pancreatic duct dilatation with left colonic wall thickening and surrounding peritoneal infiltration. Emergency segmental resection of the descending colon with intraoperative T-tube choledochostomy was performed due to the colon mass and biliary obstruction. A colonofiberoscopy was performed for low abdominal pain and hematochezia at 12 days after surgery. It showed multiple colonic ulcerations with a partial stricture. A colonic biopsy showed granulomatous inflammation with acid-fast bacilli. The cause of the biliary obstruction was also revealed as pancreatic tuberculosis by an intraoperative pancreatic and mesenteric biopsy. The patient improved after antituberculous treatment and the patient has been in good health until the last outpatient follow-up visit. (Korean J Gastrointest Endosc 2007;35:267-271)
Key Words: Pancreatic tuberculosis, Biliary obstruction, Colon cancer, Colonic tuberculosis
주요어: 췌담관 폐쇄, 췌장 결핵, 대장암, 대장결핵
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