Korean J Gastrointest Endosc > Volume 37(4); 2008 > Article
Korean Journal of Gastrointestinal Endoscopy 2008;37(4): 276-279.
소장 폐쇄를 동반한 위석을 대장내시경의 구강 접근으로 제거한 1예
백수정ㆍ심기남ㆍ김성은ㆍ정혜경ㆍ정성애ㆍ유권ㆍ문일환ㆍ이주호*
이화여자대학교 의과대학 내과학교실, *외과학교실, 의과학연구소
Endoscopic Removal of Small Bowel Bezoars using Colonoscopy through the Oral Approach
Su Jung Baik, M.D., Ki-Nam Shim, M.D., Seong-Eun Kim, M.D., Hye-Kyung Jung, M.D., Sung-Ae Jung, M.D., Kwon Yoo, M.D., Il Hwan Moon, M.D. and Joo-Ho Lee, M.D.*
Departments of Internal Medicine and *Surgery, Ewha Medical Research Institute, Ewha Womans University School of Medicine, Seoul, Korea
Abstract
Bezoars are accumulations of foreign materials and foods in the gastrointestinal tract and can be the cause of small bowel obstruction. A bezoar usually begins as a gastric phytobezoar that migrates to the small bowel in patients who have undergone gastric surgery and have delayed gastric emptying. We report a case of diagnosed small bowel obstruction due to the presence of a persimmon phytobezoar (diospyrobezoar) in a patient with a history of gastric surgery. Abdomen-pelvis computed tomography demonstrated the presence of an air-containing localized lesion (5×3.5 cm), a suspicious bezoar in the jejunum. The gastroduodendoscopy failed to reach to the lesion but diospyrobezoars were found in the proximal jejunum at 120 cm from the upper incisors using a colonoscope inserted using the oral approach. Most of the bezoars were fragmented by a tripod and were removed with a snare. The patient was discharged after symptomatic improvement without surgery. We report this case with a review of the relevant literature. (Korean J Gastrointest Endosc 2008; 37:276-279)
Key Words: Bezoar, Intestinal obstruction
주요어: 위석, 소장 폐쇄
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