Korean J Gastrointest Endosc > Volume 38(5); 2009 > Article
Korean Journal of Gastrointestinal Endoscopy 2009;38(5): 275-378.
진단이 어려웠던 입구가 좁은 십이지장 유두주위 게실 출혈 1예
김진남ㆍ이홍식ㆍ안재홍ㆍ김승영ㆍ김동일ㆍ이상우ㆍ최재현
고려대학교 의과대학 내과학교실, 소화기연구소
A Case of Narrow Opened Priampullary Diverticular Bleeding with Diagnostic Difficulty
Jin Nam Kim, M.D., Hong Sik Lee, M.D., Jae Hong Ahn, M.D., Seung Young Kim, M.D., Dong Il Kim, M.D., Sang Woo Lee, M.D. and Jae Hyun Choi, M.D.
Department of Internal Medicine, Digestive Disease and Nutrition, Korea University College of Medicine, Seoul, Korea
Abstract
A duodenal diverticulum is most common in the medial aspect of the second portion of the duodenum and rarely causes symptoms. An obstruction, bleeding, perforation, jaundice and pancreatitis are uncommon complications of a duodenal diverticulum. Bleeding from the periampullary diverticulum should be considered in the diagnosis of a patient who presents with upper gastrointestinal bleeding of unknown origin. The second portion of the duodenum is sometimes difficult to observe entirely from the tangent line with the use of a forward-viewing endoscope. The diagnosis and treatment of periampullary diverticular bleeding may be achieved more easily by use of a side-viewing endoscope. We report here a case of narrow opened periampullary diverticular bleeding diagnosed by the use of a side-viewing endoscope with difficulty. (Korean J Gastrointest Endosc 2009; 38:275-278)
Key Words: Periampullary diverticulum, Diverticular bleeding, Side-viewing endoscope
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