Korean Journal of Gastrointestinal Endoscopy 2009;38(6): 360-363.
회장말단의 결핵 반흔에 의한 가성 게실의 급성출혈 1예
배서은ㆍ정성애ㆍ송현주ㆍ강민정ㆍ정지민ㆍ김성은ㆍ심기남ㆍ유 권
이화여자대학교 의학전문대학원 내과학교실
Acute Pseudodiverticular Bleeding from a Tuberculous Scar of the Terminal Ileum
Suh Eun Bae, M.D., Sung-Ae Jung, M.D., Hyun Joo Song, M.D., Min-Jung Kang, M.D., Ji Min Jung, M.D., Seong-Eun Kim, M.D., Ki-Nam Shim, M.D. and Kwon Yoo, M.D.
Department of Internal Medicine, Ewha Womans University School of Medicine, Ewha Medical Research Institute, Seoul, Korea
Abstract
Acquired ileal diverticuli are an uncommon condition and the diagnosis is often difficult when bleeding occurs from this source. Tuberculosis mainly involves the terminal ileum and has associated complications such as obstruction, perforation, stricture and bleeding, but rarely presents with pseudodiverticuli with a fistula. A 42-year-old man presented with massive hematochezia for three days. The patient had a history of pulmonary tuberculosis with complete recovery two times. Emergency sigmoidoscopy, esophagoduodenoscopy and computed tomography of the abdomen could not detect the bleeding focus. The next day, colonoscopy was performed, which demonstrated the opening of pseudodiverticuli at the terminal ileum. There was an exposed vessel in one of the pseudodiverticuli. The patient was treated successfully with epinephrine and ethanol sclerotherapy. A subsequent colonoscopy showed that the exposed vessel was completely healed seven days later. We report a case of acute pseudodiverticular bleeding from a tuberculous scar of the terminal ileum with a review of the relevant literature. (Korean J Gastrointest Endosc 2009;38:360-363)
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