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Journal of the Korean Geriatrics Society 2007;11(1):38-42.
Published online March 31, 2007.
Two Cases of Rectal Dieulafoy's Lesion with Massive Hematochezia in Elderly Patients
Young Wook Yoo, Sung Hee Jung, Ki Woon Kang, Si Bum Kim, Yong Soo Cho, Yun Jung Lee, Anna Kim, Hyeon Woong Yang, Sang Woo Cha
Department of Internal Medicine, Eulji University School of Medicine, Eulji University Hospital, Daejeon, Korea. jsh@eulji.ac.kr
노인 환자에서 대량의 혈변을 보였던 직장 Dieulafoy 병변 2예
Abstract
Dieulafoy's lesion is rare cause of massive gastrointestinal bleeding. Dieulafoy's lesion is understood to represent a tiny submucosal defect with fibrinoid necrosis at its base, overlying a large, tortous, thick-walled artery in the muscularis mucosa. Although the original descriptions and early reports were of lesions in the proximal stomach, similar lesions have subsequently been reported in the esophagus, duodenum, jejunum, colon and rectum. Rectal Dieulafoy's lesion is rare but it is one of the causes of massive hematochezia. We report two cases of rectal Dieulafoy's lesion that was successfully treated with endoscopic hemostasis by clipping in the elderly patients.
Key Words: Dieulafoy's lesion, Rectum, Hemoclip
초 록
Dieulafoy 병변은 주변의 궤양없이 비정상적으로 큰 점막하 동맥이 점막 결손을 통해 장관 내로 돌출한 것으로 치명적인 대량 위장관 출혈을 일으키는 질환이다. Die- ulafoy 병변은 주로 위의 근위부에서 발생하며, 식도, 십이지장, 소장, 대장, 직장 등 모든 부위의 위장관에서 발생할 수 있다. 직장에서의 Dieulafoy 병변은 대량의 직장 출혈을 유발하는 드문 질환이다. 저자들은 노인에서 갑자기 발생한 대량의 혈변으로 내원하여 직장의 Dieulafoy 병변으로 진단 후 지혈클립으로 성공적으로 지혈한 2예를 경험하여 이를 문헌 고찰과 함께 보고하는 바이다.


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