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[SmallTODAY 007 - Short bowel syndrome after obesity surgery]

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2016³â 6¿ù 10ÀÏ »ï¼ºÀÇ·á¿ø Áý´ãȸ¿¡¼­ ¹ßÇ¥µÈ »ï¼º¼­¿ïº´¿ø Áõ·Ê¸¦ ¼Ò°³ÇÕ´Ï´Ù.


°íµµºñ¸¸ ¼ö¼ú ÈÄ ¹ß»ýÇÑ short bowel syndrome

ºñ¸¸ ¼ö¼ú ÈÄ ¹ß»ýÇÑ ºÎÁ¾À¸·Î ³»¿øÇÑ 30´ë ¿Ü±¹ÀÎ. °íµµºñ¸¸À¸·Î µÎ¹øÀÇ gastric bypass surgery ÈÄ ³»¿ø 3°³¿ùÀüºÎÅÍ ¹ß»ýÇÑ both lower leg edema, bruise ·Î 2Â÷º´¿ø ÀÔ¿ø Áß r/o protein losing enteropathy ·Î Àü¿ø. ÀÌ È¯ÀÚ´Â protein losing enteropathy´Â ¾Æ´Ï¾ú°í common channel ±æÀÌ°¡ ª¾ÆÁ® ¹ß»ýÇÑ short bowel syndromeÀ̾ú½À´Ï´Ù.

¥á1-Antitrypsin clearance °Ë»ç °á°ú´Â ¾Æ·¡¿Í °°ÀÌ Á¤»óÀ̾ú½À´Ï´Ù.

¥á1-Antitrypsin, serum : 95.3 mg/dL (ref. 90-200)

¥á1-Antitrypsin, feces : 8.5 mg/dL (ref. 0-54)

¥á1-Antitrypsin plasma clearance : 0.18 mL/day (ref. 27 mL/dayÀÌÇÏ)

°ø½Ä: Alpha 1-AT plasma clearance = ((stool volume) x (stool alpha 1-AT)) / (serum alpha-1 AT), Alpha-1-antitrypsin (A1A) is resistant to degradation by digestive enzymes and is, therefore, used as an endogenous marker for the presence of blood proteins in the intestinal tract. A1A clearance is reliable for measuring protein loss distal to the pylorus.

Albumin replacement, ¿µ¾ç °ø±Þ (TPN, high protein diet, protein powder, IV iron, vitamin K, vitamin B12 replacement) µî Ä¡·á ÈÄ Ã¼Áßµµ °¨¼ÒÇÏ°í ¿Â°® Áõ»óµµ È£ÀüµÇ¾î µÇÀÇ·ÚÇÏ¿´½À´Ï´Ù.


[References]

1) EsoTODAY - Esophageal diseases

2) SmallTODAY - Small bowel diseases

3) ColonTODAY - Colorectal diseases

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