EndoTODAY | EndoATLAS | OPD

Parasite | Eso | Sto | Cancer | ESD

Boxim | DEX | Sono | Schedule

Home | Recent | Blog | Links

EndoTODAY ³»½Ã°æ ±³½Ç


[EsoTODAY 018 - Reflux esophagitis due to GI obstruction. Obstructuve reflux esophagitis]

Previous | Next

¸ðµç ¿ª·ù¼º ½Äµµ¿°ÀÌ GERD¿¡ ÀÇÇÑ °ÍÀº ¾Æ´Õ´Ï´Ù.

Gastric outlet obstruction¿¡¼­ À½½Ä¹°°ú À§»êÀÌ Á¤Ã¼µÇ°í ½Äµµ·Î ¿ª·ùµË´Ï´Ù. ±× °á°ú ¿ª·ù¼º ½Äµµ¿°ÀÌ ¹ß»ýÇÒ ¼ö ÀÖ½À´Ï´Ù. ³»½Ã°æ ¼Ò°ßÀº Åë»óÀÇ ¿ª·ù¼º ½Äµµ¿°°ú »ó´çÈ÷ ´Ù¸¨´Ï´Ù. ¸¹Àº °æ¿ì confluent erosionÀ̸鼭 ¸Å¿ì ÁöÀúºÐÇÏ°í ÇϺνĵµ¿¡¼­ ½ÉÇÕ´Ï´Ù.

¶Ç ´Ù¸¥ Áõ·ÊµéÀÔ´Ï´Ù.

´Ù¸¥ ¿¹¿¡¼­µµ ¿ª½Ã ¹«Ã´ ÁöÀúºÐÇØ º¸ÀÔ´Ï´Ù. ½ÊÀÌÁöÀå±Ë¾ç ÇùÂøÀÔ´Ï´Ù.

ÀüÁ¤ºÎ º¸¸¸ type IV¿¡ ÀÇÇÑ obstruction Áõ·ÊÀÔ´Ï´Ù. °Ë»çÇϽŠ¼±»ý´Ô²²¼­ LA classification group B¶ó°í ºÙÀ̴̼µ¥¿ä... »ç½Ç Àû´çÇÑ °ÍÀº ¾Æ´Õ´Ï´Ù. LA ºÐ·ù´Â obstruction ¶§¹®¿¡ »ý±ä ¿ª·ù¼º ½Äµµ¿°ÀÎ ¾Æ´Ï ¾Æ´Ñ Åë»óÀÇ ¿ª·ù¼º ½Äµµ¿°(GERD)¿¡ »ç¿ëÇÏ´Â ºÐ·ùÀ̱⠶§¹®ÀÔ´Ï´Ù. ±×³É gastric outlet obstructionÀÌ ÀÖ°í ÀÌ·Î ÀÎÇÑ 2Â÷ º¯È­·Î ½Äµµ¿°ÀÌ ÀÖ´Ù·Î ¾²¸é ¾î¶³±î¿ä? ¹«¸®ÇÏ¿© LA ºÐ·ù¸¦ ºÙÀÌÁö ¸»°í...

Á¤½Ä À̸§ÀÌ ¾ø¾î¼­ Á¦°¡ À̸§À» ¸¸µé¾ú½À´Ï´Ù. Obstructive reflux esophagitis.

Adhesive ileus¿¡ ÀÇÇÑ 2Â÷ ¿ª·ù¼º ½Äµµ¿°ÀÔ´Ï´Ù.

º¸¸¸ 4Çü ÁøÇ༺ À§¾Ï ȯÀÚ¿¡¼­ PPI¸¦ Åõ¾àÇÏ¿´À½¿¡µµ ºÒ±¸ÇÏ°í ÁøÇàÇÑ obstructive reflux esophagitis. ¸¶Áö¸· ³»½Ã°æ¿¡¼­ bite on bite techniqueÀ¸·Î ÁøÇàÇÑ Á¶Á÷°Ë»ç·Î À§¾ÏÀ» È®ÀÎÇÏ°í ¼ö¼úÇÏ¿´À½.


[FAQs]

[2019-3-1. ¾Öµ¶ÀÚ Áú¹®]

Ovarian cancer with p-seedingȯÀÚ·Î ÃÖ±Ù multiorgan failure ¼Ò°ßµµ Àִµ¥ L-tube ÀÇ brownish drainÀÌ ÀÖ¾î r/o GI bleedingÀ¸·Î ÀÇ·ÚµÇ¾î ³»½Ã°æÀ» ÇÏ¿´½À´Ï´Ù. ½Äµµ¿°ÀÌ ¾ÆÁÖ ½ÉÇÏ¿© Á¤»óÁ¡¸·ÀÌ °üÂûµÇÁö ¾Ê°í, »çÁø¸¸ º¸¸é ¸¶Ä¡ ÇϺο¡¼­ Å©·Ðº´°ú °°ÀÌ º¸¿´½À´Ï´Ù. °ø±â¸¦ Á¶±Ý¸¸ ³Ö¾îµµ diffuse oozing bleeding ÀÌ °üÂûµÇ¾î Á¶Á÷°Ë»ç¸¦ ¸øÇÏ¿´½À´Ï´Ù.

ÀÌ·¸°Ô ½ÉÇÑ esophagitis ¸¦ óÀ½ º¸¾Æ¼­ Áø´ÜÀ» ¾î¶»°Ô ºÙ¿©¾ßÇÒÁö °í¹ÎµÇ¾î, Severe esophagitis with diffuse oozing bleeding À̶ó°í ºÙ¿©º¸¾Ò½À´Ï´Ù. ÃâÇ÷ º´¼Ò°¡ ¸íȮġ ¾Ê¾Æ ÁöÇ÷¼úÀº ½Ãµµµµ ¸øÇß°í ÁÖÄ¡ÀÇ¿¡°Ô Å« µµ¿òÀº ¾ÈµÇ°ÚÁö¸¸ PPI Á¤µµ ½áº¸¶ó°í ÇÏ¿´½À´Ï´Ù. ÀÌ·¯ÇÑ °æ¿ì Ȥ½Ã ´õ Àû´çÇÑ Áø´Ü ¹× manage °¡ ÀÖÀ»Áö ¹®Àǵ帳´Ï´Ù.

[2019-3-1. ÀÌÁØÇà ´äº¯]

½Äµµ¿¡¼­´Â »ý°¢º¸´Ù ´Ù¾çÇÑ »óȲÀ» ¸¸³ª°Ô µË´Ï´Ù. Ÿ Àå±â ÁúȯÀ¸·Î GI motility°¡ ÇöÀúÈ÷ ¶³¾îÁ³°Å³ª À§½ÊÀÌÁöÀå ¾ÏÀ¸·Î gastric outlet obstructionÀÌ ÀÖÀ¸¸é ½ÉÇÑ (obstructive) reflux esophagitis°¡ ¹ß»ýÇÒ ¼ö ÀÖ½À´Ï´Ù. ÀÌ È¯ÀÚ¿¡¼­µµ óÀ½ ½Äµµ¿¡ µé¾î°¬À» ¶§ ´Ù·®ÀÇ bile-tinged fluid°¡ °í¿©ÀÖ¾ú½À´Ï´Ù. Bile°ú À§»ê°ú pepsin µîÀÌ ¼¯¿©¼­ ¿ª·ùÇÏ¿© ½Äµµ¸¦ ½ÉÇÏ°Ô ¼Õ»ó½ÃŲ °æ¿ìÀ̸ç, systemic blood supplyµµ ÁÁÁö ¾ÊÀ» °ÍÀÌ´Ï »óȲÀÌ ¾ÇÈ­µÇ¾úÀ» °ÍÀÔ´Ï´Ù. ±× °á°ú ½Äµµ Á¡¸·ÀÌ diffuseÇÏ°Ô ¼Õ»óµÇ¾ú°í, °ø±â¸¦ Á¶±Ý¸¸ ³Ö¾îµµ ½Äµµ Á¡¸·ÀÌ Âõ¾îÁö¸é¼­ ÃâÇ÷µÇ´Â friability°¡ »ý±ä °ÍÀÔ´Ï´Ù.

¡°Severe esophagitis with diffuse oozing bleeding¡±Àº ¸Å¿ì ÀûÀýÇÑ impressionÀ̶ó°í »ý°¢ÇÕ´Ï´Ù. ´ç¿¬È÷ Á¶Á÷°Ë»ç°¡ ÇÊ¿äÇÑ °æ¿ì´Â ¾Æ´Õ´Ï´Ù. CMV¿Í °°Àº viral esophagitis ¾ç»óÀÌ ¾Æ´Ï±â ¶§¹®ÀÔ´Ï´Ù. Å©·Ðº´°ú´Â ¿µ ´Ù¸¨´Ï´Ù.^^ Ä¡·á³»½Ã°æ ´ë»óµµ ¾Æ´Õ´Ï´Ù. Àü±â¼ÒÀÛ¼ú µîÀ» ½ÃµµÇß´Ù¸é ¿ÀÈ÷·Á »óȲÀÌ ³ªºüÁ³À» °ÍÀÔ´Ï´Ù (õ°ø µî). ½ÉÇÑ Àü½ÅÁúȯ°ú À§½ÊÀÌÁöÀå¾× ¿ª·ù¿¡ ÀÇÇÑ ½Äµµ Á¡¸·ÀÇ diffuseÇÑ friability »óȲÀ̹ǷΠ³»½Ã°æ ÀÇ»ç·Î¼­´Â ¡°PPI¸¦ ¾²¸é¼­ best supportive care ÇÏ´Â ¼ö ¹Û¿¡ ¾øÀ» °Í °°½À´Ï´Ù¡±¶ó°í ´äº¯µå¸®´Â °ÍÀÌ ÃÖ¼±ÀÔ´Ï´Ù. ±×³É ³»½Ã°æÀ» »¡¸® »©´Â °ÍÀÌ ÃÖ¼±ÀÔ´Ï´Ù. ¿äÄÁµ¥ ¾ÆÁÖ Àß Çϼ̴ٴ ¸»¾¸ÀÔ´Ï´Ù.


[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.