철 결핍성 빈혈을 주소로 내원한 Cameron 궤양 1예

Abstract

Cameron 궤양은 식도열공탈장이 있는 경우 탈장 내부의 위점막에 나타나는 미란이나 궤양을 말하며, 우연히 발견되거나 위장관 출혈 등의 증상으로 위내시경검사를 시행할 경우 발견하게 된다. 유병률은 그리 높지 않으나, 최근 아스피린 복용의 증가 등과 관련하여 위장관 출혈의 예가 증가하고 있고, 종종 위급한 임상 상황을 야기하므로 관심이 필요하며 아직 국내에서는 자세하게 보고된 바가 없다. 저자들은 철 결핍성 빈혈과 간헐적인 흑색변이 있는 환자에게 내시경검사를 시행하여 식도열공탈장 내부의 궤양 1예를 경험하였으며 문헌고찰과 함께 보고한다.

Patients suffering with sliding hiatal hernia may develop Cameron erosions or ulcers. Mechanical trauma, ischemia, and peptic injury have been proposed as the etiology of these lesions. These lesions can be associated with iron deficiency anemia and GI bleeding. An 83-year-old woman was admitted with iron deficiency anemia and intermittent melena. Her past history consisted of pneumonia and pulmonary tuberculosis. She had no current medication history. The laboratory findings were Hb 6.8 g/dL, MCV 75 fL and MCH 23.6 pg. Upon esophagogastroduodenoscopy (EGD), a huge diaphragmatic hernia was noted and multiple ulcers were located at the neck of the hernia. Esophagogram showed a huge diaphragmatic hernia. The bleeding ceased and the anemia was resolved after proton pump inhibitor treatment. (Korean J Gastrointest Endosc 2006;32:33-36) Patients suffering with sliding hiatal hernia may develop Cameron erosions or ulcers. Mechanical trauma, ischemia, and peptic injury have been proposed as the etiology of these lesions. These lesions can be associated with iron deficiency anemia and GI bleeding. An 83-year-old woman was admitted with iron deficiency anemia and intermittent melena. Her past history consisted of pneumonia and pulmonary tuberculosis. She had no current medication history. The laboratory findings were Hb 6.8 g/dL, MCV 75 fL and MCH 23.6 pg. Upon esophagogastroduodenoscopy (EGD), a huge diaphragmatic hernia was noted and multiple ulcers were located at the neck of the hernia. Esophagogram showed a huge diaphragmatic hernia. The bleeding ceased and the anemia was resolved after proton pump inhibitor treatment.