담도염으로 오인된 십이지장 게실염 1예 = A Case of Duodenal Diverticulitis Mimicking Cholangitis

다국어 초록 (Multilingual Abstract)

The duodenum ranks second to the colon as the most common site of diverticulosis in the gastrointestinal tract with a prevalence of more than 20%. It is usually asymptomatic, and rarely requires treatments for complications, including diverticulitis, hemorrhage, and luminal obstructions. Unlike diverticulosis, duodenal diverticulitis is extremely rare. Given that the radiological appearance and clinical presentation of duodenal diverticulitis often mimic those of pancreaticobiliary neoplasms or inflammations, it is a challenge for clinicians to diagnose it correctly, which often leads to misdiagnosis and inappropriate management. Here we report a case of a 69 year-old female patient with duodenal diverticulitis, whose clinical symptoms and radiological images were similar to those of acute cholangitis. We also briefly review the literature.

국문 초록 (Abstract)

십이지장은 대장에 이어 두 번째로 게실이 많이 발생하는 부위로 20% 이상의 빈도를 가진다. 십이지장 게실은 대부분 무증상이나 드물게 감염이나 출혈, 총담관 폐쇄, 시술과 관련된 천공 등의 합병증을 일으키는데 십이지장 게실염은 발생률이 낮아서 보고가 드물다. 십이지장 게실염은 임상 증상이나 방사선학적 소견이 췌담도 염증성 질환과 종양 등과 유사한 소견을 보여 오인되기 쉬우며, 감별진단에서도 일반적으로 고려되지 않는 경향이 있기 때문에 진단이 쉽지 않다. 저자들은 하루간의 우상복부통증, 발열, 오한 증세로 내원한 69세 여자에서 담도염을 의심하여 내시경역행성담췌관조영술 중 바터팽대부 주위의 십이지장 게실염을 확인 후 내시경유두괄약근절개술을 통한 게실 입구의 확장과 게실 배액 및 세척을 하여 호전을 보인 증례를 경험하여 보고한다.

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