[20111115. Peptic ulcer (38): Stricture (1) - Clinical pictures]
¼Òȼº±Ë¾ç ÇùÂøÀº 1- 2%¿¡¼ ¹ß»ýÇÑ´Ù. ±Ë¾çÀÇ À§Ä¡¿¡ µû¶ó ±× ºóµµ°¡ ´Þ¶óÁø´Ù. ³¯¹®¿¡ °¡±î¿î °÷¿¡ À§Ä¡ÇÑ À§±Ë¾çÀ̳ª ½ÊÀÌÁöÀå ±Ë¾ç¿¡¼ ÈçÈ÷ ¹ß»ýÇÑ´Ù.
ÇùÂøÀº Å©°Ô µÎ Á¾·ù°¡ ÀÖ´Ù. (1) Fixed mechanical obstructionÀº scar Çü¼º¿¡ ÀÇÇÑ ºñ°¡¿ªÀû ÇùÂøÀÌ´Ù. (2) relative obstructionÀº ±Þ¼º±â ±Ë¾ç°ú °ü·ÃµÈ ¿°Áõ°ú ºÎÁ¾¿¡ ÀÇÇÑ ÀϽÃÀû °¡¿ªÀû ÇùÂøÀÌ´Ù. ½ÉÇÑ ÇùÂøÁõ¼¼°¡ ÀÖ´õ¶óµµ ¸çÄ¥ ±Ý½ÄÇÏ¸é¼ ±Ë¾çÀ» Àß Ä¡·áÇϸé ÇùÂøÀÌ ¾î´À Á¤µµ È£ÀüµÇ¾î À½½ÄÀ» ¸ÔÀ» ¼ö ÀÖ°Ô µÈ´Ù.
¾Æ·¡´Â ½ÊÀÌÁöÀå±Ë¾ç ÇùÂøÀÌ´Ù. ÀÏ°ß complete obstruction °°À¸³ª ³»½Ã°æÀ» Á¶½É½º·´°Ô ¹Ð¾îº¸¸é ½ÊÀÌÁöÀå Á¦ 2ºÎ·Î Åë°úÇÒ ¼ö ÀÖ´Ù. ¼ö¼úÇÏÁö ¾Ê°í °æ°ú°üÂûÇÑ °æ¿ìÀÌ´Ù.
¼Òȼº ±Ë¾çÀÌ ¹Ýº¹µÇ¸é¼ gastric outlet obstructionÀÌ µÇ¸é antral type º¸¸¸ 4Çü ÁøÇ༺ À§¾Ï°ú ±¸ºÐÀÌ ¾î·Á¿ï ¼ö ÀÖ½À´Ï´Ù.
30´ë ³²ÀÚ. 3°³¿ù ÀüºÎÅÍ ¹ß»ýÇÑ º¹Åë°ú ±¸Åä·Î ³»¿øÇÏ¼Ì°í ¿©·¯¹ø Á¶Á÷°Ë»ç¿¡¼ ¾ÏÀÌ ³ª¿ÀÁö ¾Ê¾ÒÀ½. ¼ö¼úÀ» ÇÏ¿´À½. Antrectomy with truncal vagotomy¸¦ ÇÏ¿´°í ÀýÁ¦ÇÑ Ç¥º»¿¡¼µµ peptic ulcer with inflammed granulation tissue·Î¸¸ ³ª¿Ô°í ¾Ï ¼Ò°ßÀº ¾ø¾úÀ½.
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