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[SMC Monday GI conference 2016-11-14]

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1. Colon perforation during colonoscopy (ÀÓ»ó°­»ç ±èÁö¿ø)

* Âü°í: EndoTODAY ¾Öµ¶ÀÚ Áõ·Ê ÆíÁö - ´ëÀå õ°ø - ²À Àо¼¼¿ä!!


ÀÌÁØÇà comment: ±× µ¿¾È Á¦°¡ ¿·¿¡¼­ º¸¾Ò´ø ´ëÀå õ°ø »çÁø ¸î °³ ¼Ò°³ÇÕ´Ï´Ù. Àú¾ß ´ëÀå³»½Ã°æÀ» °ÅÀÇ ÇÏÁö ¾ÊÁö¸¸...

º¸´Ù ÀÚ¼¼ÇÑ ¼³¸íÀ» º¸½Ã·Á¸é ¾Æ·¡¸¦ Âü°íÇϼ¼¿ä. º¸¸¸ 4Çü ÁøÇ༺ À§¾Ï°ú õ°øÀº ³»½Ã°æÀÇ»çÀÇ ¼÷¸íÀÔ´Ï´Ù. Á¶½ÉÇÏ°í Àß ´ëóÇÏ´Â ¼ö¹Û¿¡... Àý´ë·Î ÇÇÇÒ ¼ö ¾øÀ¸´Ï...

* Âü°í: EndoTODAY õ°ø


2. Small bowel bleeding

½ÅÀμ· ¼±»ý´Ô²²¼­ 2015³â ACG °¡À̵å¶óÀÎÀ» ¹ÙÅÁÀ¸·Î ¹ßÇ¥ÇØ Áּ̽À´Ï´Ù.

Á¦°¡ °¡Àå °­Á¶ÇÏ°í ½ÍÀº ³»¿ëÀÔ´Ï´Ù. À§³»½Ã°æ°ú ´ëÀå³»½Ã°æÀ» ¹Ýº¹ÇÏ´Â °ÍÀÌ µµ¿òµÉ ¶§°¡ ¸¹½À´Ï´Ù. À§³»½Ã°æÀ̳ª ´ëÀå³»½Ã°æ¿¡¼­ ÃâÇ÷º´¼Ò¸¦ ³õÄ¡°í ¾û¶×ÇÏ°Ô ¼ÒÀåÃâÇ÷ ȯÀÚ·Î Áø´ÜÀ» ºÙÀÌ´Â °æ¿ì°¡ Àֱ⠶§¹®ÀÔ´Ï´Ù.

2015³â ACG °¡À̵å¶óÀο¡ µû¸¥ °á·ÐÀε¥ Àú´Â Á¶±Ý ´Ù¸£°Ô »ý°¢ÇÕ´Ï´Ù. ĸ½¶³»½Ã°æ Àü¿¡ CT¸¦ Âï¾îº¸´Â °ÍÀÌ ¿©·¯¸ð·Î À¯¸®ÇÕ´Ï´Ù. EndoTODAY obscure GI bleedingÀ» Âü°íÇϽñ⠹ٶø´Ï´Ù.


2016³â 11¿ù 2ÀÏ APDW2016 PG course¿¡¼­ ÀϺ»ÀÇ Naoki Ohmiya ¼±»ý´Ô²²¼­µµ CTÀÇ Á߿伺À» °­Á¶Çϼ̽À´Ï´Ù. ´ç½Ã Á¦°¡ ÇöÀå Áß°èÇÏ¿´´ø ³»¿ëÀ» ¼Ò°³ÇÕ´Ï´Ù.

Ohmiya N. Dig Endoscopy 2015

Occult¿Í overt GI bleedingÀÇ ¿øÀÎÀÌ Å©°Ô ´Ù¸£Áö ¾ÊÀ¸¹Ç·Î Ohmiya ¼±»ý´ÔÀº µÑÀ» ±¸ºÐÇÏÁö ¾Ê´Â algorithmÀ» Á¦¾ÈÇÏ¿´½À´Ï´Ù. Obscure GI bleeding (overt and occult)¿¡¼­ °¡Àå ¸ÕÀú chest-pelvic plain X-ray & contrast-enhanced CT¸¦ ù¹ø° °Ë»ç·Î Á¦¾ÈÇÏ¿´½À´Ï´Ù.

Ohmiya N. Dig Endoscopy 2015

Àú´Â ´ÙÀ½°ú °°Àº Áú¹®À» Çß½À´Ï´Ù. "In my opinon, the role of abdominal CT has been underestimated in the evaluation of obscure GI bleeding. So, I am very happy to see your algorithm. My question is what kind of CT do you recommend; just routine contrast-enhanced CT or CT angiography." ¿¬ÀÚ´Â °°Àº »ý°¢À» °¡Áö°í ÀÖ´Ù°í ´äÇϸ鼭, Àڽŵµ capsule endoscopy³ª enteroscopy Àü¿¡ CT¸¦ ½ÃÇàÇÏ°í ÀÖ´Ù°í ´äÇÏ¿´½À´Ï´Ù.

Active bleedingÀÇ °æ¿ì¿¡´Â small bowel enteroscopy¸¦ ¹Ù·Î ½ÃÇàÇÏ´Â °ÍÀÌ ´õ ÁÁÁö ¾ÊÀºÁö floor¿¡¼­ Áú¹®ÀÌ ÀÖ¾ú½À´Ï´Ù. ¿¬ÀÚ´Â CT´Â ´Ù¼Ò °í°¡ÀÌÁö¸¸ ½±°Ô ½ÃÇàÇÒ ¼ö ÀÖ´Ù°í ´äÇϸ鼭 "CT is the first diagnostic tool in Japan." À̶ó°í ÁÖÀåÇß½À´Ï´Ù. »óºÎ ³»½Ã°æ°ú ÇϺΠ³»½Ã°æ¿¡ ÀÌ»óÀÌ ¾øÀ» ¶§ capsule endoscopy³ª small bowel enteroscopy·Î ³Ñ¾î°¡±â Àü CTºÎÅÍ ÂïÀÚ´Â ¿¬ÀÚÀÇ ÁÖÀå¿¡ ÀüÀûÀ¸·Î µ¿ÀÇÇÕ´Ï´Ù.



© ÀÏ¿ø³»½Ã°æ±³½Ç ¹Ù¸¥³»½Ã°æ¿¬±¸¼Ò ÀÌÁØÇà. EndoTODAY Endoscopy Learning Center. Lee Jun Haeng.