교통사고로 인한 다발성 손상 후 발생한 거대세포바이러스 장관염에 의한 소장의 허혈성 괴사

• Published in: Annals of surgical treatment and research Vol. 66; no. 5; pp. 430 - 434
• Main Authors: 박길춘(Kil Chun Park), 장혁재(Hyuk Jai Jang), 조용필(Yong Pil Cho), 김용호(Yong Ho Kim), 정승문(Seung Mun Jung), 박양순(Yang Soon Park), 한명식(Myeng Sik Han)
• Format: Journal Article
• Language: Korean
• Published: 대한외과학회 01.05.2004
• Subjects: 일반외과학; ileal ischemia; Segmental; 허혈성 회장괴사; 거대세포바이러스 장관염; CMV enteritis; Traffic accident; 교통사고; Cytomegalovirus (CMV)
• ISSN: 2288-6575; 2288-6796

Cytomegalovirus infections (CMV) of the gastrointestinal tract (GI) are common, and most often seen in patients with acquired immunodeficiency syndrome (AIDS), inflammatory bowel disease, or those receiving immunosuppressive therapy. CMV enteritis is uncommon in an immunocompetent individual. A CMV infection of the small bowel accounts for 4.3% of all CMV infections of the GI tract. The GI manifestations of CMV include: diarrhea, bleeding, obstruction and perforation, all of which are usually secondary to discrete erosions or ulceration. High mortality rates have been reported for CMV enteritis. Here, a rare case of CMV enteritis, resulting in segmental ileal ischemia, is reported in a 47-year old man following a traffic accident. On the 17th hospital day, he developed melena, watery diarrhea, fever and abdominal pain. An abdominal computed tomography (CT) on the 23rd hospital day showed an enlarged appendix with mild periappendiceal infiltration and segmental wall thickening in the terminal ileum. An ileocecal resection was performed. Pathological evaluation of the operative specimen revealed CMV inclusion bodies, with ulcerations. The patient was treated with ganciclovir therapy for 3 weeks after which his symptoms improved. If a CMV infection is highly suspected in multiply injured trauma victims, the earlier recognition of potential small bowel involvement can hopefully decrease the incidence of bleeding, ischemic demage to the bowel and perforation, which are usually fatal events. KCI Citation Count: 0