내시경으로 진단한 상장간막동맥증후군과 이에 동반된 위석의 아르곤 플라즈마 응고 소작술을 이용한 분쇄 제거 치료 1예 |
강민경ㆍ권창일ㆍ이지은ㆍ김용훈ㆍ고광현ㆍ홍성표ㆍ박필원ㆍ김희진* |
포천중문의과대학교 내과학교실, *영상의학교실 |
A Case of a Gastric Bezoar Combined with Superior Mesenteric Artery Syndrome |
Min Kyoung Kang, M.D., Chang-Il Kwon, M.D., Ji Eun Lee, M.D., Yong Hun Kim, M.D., Kwang Hyun Ko, M.D., Sung Pyo Hong, M.D., Pil Won Park, M.D. and Hee Jin Kim, M.D.* |
Departments of Internal Medicine and *Radiology, College of Medicine, Pochon CHA University, Seongnam, Korea |
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Abstract |
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Superior mesenteric artery syndrome is caused by compression of the third part of the duodenum between the superior mesenteric artery (SMA) and the aorta. Recently, we experienced a case of a gastric bezoar combined with SMA syndrome. A 58-year-old man presented with upper abdominal pain, bloating and weight loss of 5 kg. An endoscopic examination identified a huge gastric bezoar. The bezoar was broken and fragmented into small pieces using an argon plasma coagulator and endoscopic snare catheter. Hypotonic duodenography showed a longitudinal linear band that was presumed to be a vascular impression of the third portion of the duodenum and contrast-enhanced spiral CT showed a reduced distance of 8.4 mm but a normal angle of 38.5o between the arota and the SMA. A second endoscopic examination demonstrated prominent pulsations that compressed the duodenal wall at the third portion. Luminal expansion with full inflation of air was not attempted under endoscopy. (Korean J Gastrointest Endosc 2008;37:271-275) |
Key Words:
SMA syndrome, Bezoar, Argon plasma coagulation |
주요어:
상장간막동맥증후군, 위석, 아르곤 플라즈마 응고 소작술 |
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