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[EsoTODAY 015 - Hiatal henia type 4 and Cameron ulcer]

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Cameron ulcer¿Í hiatal hernia. PDF 3.7M - Case Reviews in Gastroenterology

Hiatal hernia´Â º¸Åë type 1 (sliding), type 2 (paraesophageal), type 3 (mixed)·Î ³ª´¯´Ï´Ù. ±×·±µ¥ ¾î¶² Ã¥À» º¸¸é hiatal hernia typeÀ» 1, 2, 3, 4·Î ³ª´©±âµµ ÇÕ´Ï´Ù. À§°¡ ¸ù¶¥ Ⱦ°æ¸· À§·Î ¿Ã¶ó°£ °æ¿ì¸¦ type 4·Î º¸¸é µË´Ï´Ù. º¸Åë type 3°¡ ¸Å¿ì ½ÉÇØÁö¸é type 4ó·³ µË´Ï´Ù.

Recurrent bleedingÀ¸·Î ³»¿øÇϽŠ¿©¼ºÀÔ´Ï´Ù. Hiatal hernia°¡ ½ÉÇÏ°í Cameron ulcer·Î ÀÎÇÑ ÃâÇ÷ÀÌ ¹ß»ýÇÑ °æ¿ì¿´½À´Ï´Ù. ¼ö¼úÀû Ä¡·á¸¦ ±ÇÇßÀ¸³ª ȯÀÚ°¡ ¾à¹°Ä¡·á¸¦ ¿øÇÏ¿© »ó´ç ±â°£ PPI¸¦ »ç¿ëÇÏ¿´½À´Ï´Ù. ±×·³¿¡µµ ºÒ±¸ÇÏ°í ÃâÇ÷ÀÌ ¹Ýº¹µÇ¾ú½À´Ï´Ù. óÀ½¿¡´Â ½ÉÇÑ sliding hernia »óÅ¿´À¸³ª ½Ã°£ÀÌ Áö³ª°í ±¸Åä, º¹Åë, ÃâÇ÷·Î ȯÀÚ°¡ ¼ö¼úÀ» °á½ÉÇÏ°Ô µÉ ¹«·Æ¿¡´Â À§ ÀüºÎ°¡ Ⱦ°Ý¸· À§·Î ¿Ã¶ó¿Â type 4 hiatal hernia°¡ µÈ »óÅ¿´½À´Ï´Ù.

½ÉÇÑ sliding hiatal hernia with Cameron ulcer bleeding »óÅÂ

¼ö¼úÇϱâ Á÷Àü. À§ Àüü°¡ Ⱦ°æ¸· »ó¹æÀ¸·Î À̵¿µÈ type 4 hiatal hernia »óÅÂ

Laparoscopic hernia reduction and partial fundoplicationÀ̶ó´Â ¼ö¼úÀ» ÇÏ¿´°í ±ò²ûÈ÷ ÁÁ¾ÆÁ³½À´Ï´Ù.


[2016-12-5. ¾Öµ¶ÀÚ Áú¹®]

ÃÖ±Ù hiatal hernia°¡ ½ÉÇÑ È¯ÀÚ¸¦ º¸¾Ò½À´Ï´Ù. 80¼¼ ³²ÀÚ È¯ÀÚºÐÀÌ ¿Ü·¡¿¡ ¿À¼Ì½À´Ï´Ù. À§³»½Ã°æ Çϸ鼭 '³»½Ã°æ ÁÖÇàÀÌ ÀÌ»óÇѵ¥? Hiatal hernia°¡ ½ÉÇÏ´Ù. Hiatal hernia sac¿¡ À½½Ä±îÁö °í¿©ÀÖ±¸³ª'ÇÏ´Â »ý°¢Àº Çß¾úÁö¸¸, type 4ÀÎ °ÍÀº ±ú´ÝÁö ¸øÇÏ¿´½À´Ï´Ù.

¾àÀ» µå·Áµµ Å« È£ÀüÀÌ ¾ø¾î¼­ ÀÌÀü »çÁøµéÀ» ÀÚ¼¼È÷ »ìÆ캸´Ï À§ Àüü°¡ Èä°û¾ÈÀ¸·Î µé¾î°¡ ÀÖ´õ±º¿ä. Chest CT´Â óÀ½¿¡´Â ¹º°¡ ÀÌ»óÇѵ¥ Çϸ鼭µµ µµ´ëü ¹¹°¡ ÀÌ»óÇÑÁö ¸ð¸£´Ù°¡, óÀ½¿¡´Â Á¦ ´«À» ÀǽÉÇß¾ú½À´Ï´Ù. ±×¸®°í óÀ½ »çÁøÀ» Àß »ìÆ캸´Ï °¡½¿»çÁø¿¡ºÎÅÍ ½ÉÀå µÚ¿¡ air-fluid levelÀÌ ÀÖ¾ú½À´Ï´Ù.

air fluid level

a great proportion of stomach in the thorax

ȯÀÚ´Â º¹ºÎ CT ¸¦ ½ÃÇàÇÏ·Á´Ù°¡ Cr ÀÌ ³ô¾Æ¼­ º¹ºÎ ÃÊÀ½Æĸ¦ ÇÏ¿´°í, ´ëµ¿¸Æ·ù°¡ ¹ß°ßµÇ¾î 3Â÷ º´¿øÀ¸·Î Àü¿øµÇ¾ú½À´Ï´Ù. µµ¹«Áö ¼ÒÈ­°¡ ¾ÈµÇ°í À½½ÄÀÌ Á¤Ã¼µÇ´Â ´À³¦À̶ó Çϼ̴µ¥, hiatal hernia type 4ÀÓÀ» ±ú´Ý´Â ¼ø°£ ¾ó¸¶³ª ºÒÆíÇßÀ»Áö ´À³¥ ¼ö ÀÖ¾ú½À´Ï´Ù.

Ȥ½Ã type 4 hiatal hernia¸¦ ¼ö¼úÀûÀ¸·Î Ä¡·áÇغ¸½Å °æÇèÀÌ ÀÖÀ¸½ÅÁö¿ä?

[2016-12-5. ÀÌÁØÇà ´äº¯]

ÁÁÀº Áõ·Ê ¼Ò°³ÇØ Áּż­ °¨»çÇÕ´Ï´Ù. ½ÉÇÑ sliding type hiatal hernia¿¡¼­µµ ½ÉÀå µÚ¿¡ air fluid levelÀÌ º¸ÀÏ ¼ö ÀÖ½À´Ï´Ù. Type 4´Â À§ Àüü°¡ Ⱦ°æ¸· »ó¹æÀ¸·Î ¿Ã¶ó°£ °æ¿ìÀä, ´ëºÎºÐ ÈäºÎ¿Ü°ú·Î ÀǷڵDZ⠶§¹®¿¡ Á¦°¡ Áø´ÜÇÏ¿© ¼ö¼úÇÑ °æ¿ì´Â 1 ¿¹ ¹Û¿¡ ¾ø¾ú½À´Ï´Ù (Âü°í: EsoTODAY 15¹ø Áõ·Ê). ¼ö¼úÀº »ý°¢º¸´Ù ¾î·ÆÁö ¾Ê´Ù°í ÇÕ´Ï´Ù.

* Âü°í: EndoTODAY Hiatal hernia


[References]

1) EsoTODAY - Esophageal diseases

2) SmallTODAY - Small bowel diseases

3) ColonTODAY - Colorectal diseases

4) Dr. Sinn's LiverTODAY - Liver diseases

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