5 Mar 2020

결장 게실염 Diverticulitis in the colon

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결장 게실염 Diverticulitis in the colon

결장 게실염의 개요와 원인

  • 소아청소년들의 S상 결장에 게실이 생기는 경우는 흔치 않다.
  • 그러나 45세 이상 성인들에게는 비교적 흔히 생긴다.
  • 미극서 연간 130,00명이 결장에 생긴 게실병으로 병원에 입원치료 받는다고 한다.
  • 게실은 있지만 거기에 염증이 없으면 게실증(Diverculosis)이라 한다.
  • 게실에 염증이 있으면 게실염(Diverculitis)이라고 한다.
  • 원인은 확실히 모르나 섬유질이 적은 음식물을 섭취하거나, 육체적 활동을 적게 하거나, 비만, 흡연, 변비 등으로 인해 결장관 내 압이 증가되면 결장 게실이 생길 수 있다.
  • 성인의 결장 게실은 1~4단계로 분류한다.
  • 무 증상일 수도 있고 염증이이 있을 때는 그 단계에 따라, 합병증에 따라 증상이 다를 수 있다.
  • 구기, 구미 상실, 구토, 아랫배 복통 등이 있을 수 있다.

172.jpg

그림 266. S 결장에 생긴 게실.

Copyright ⓒ 2011 John Sangwon Lee, MD., FAAP

결장 게실염의 진단

  • 병력 진찰 소견, 결장 CT 스캔 검사, S 결장과 나머지 결장의 내시경 검사로 진단한다.

결장 게실염의 치료

  • 음식물 섭취 조절을 비롯한 유발 인자를 제거한다.
  • 염증이 있으면 경구용 또는 혈관용 Metronidazole, Augmentin, 또는 Quinolon 등 항생제로 치료하고 필요에 따라 수술 치료도 한다.

 

Diverticulitis in the colon 결장 게실염

Overview and causes of diverticulitis of the colon

• It is not uncommon for children and adolescents to develop diverticulum in the sigmoid colon. • However, it is relatively common among adults over the age of 45.

• It is reported that 130,00 people are hospitalized for diverticulosis in the colon per year.

• If diverticulum is present but there is no inflammation, it is called diverticulosis.

• If the diverticulum is inflamed, it is called diverticulitis.

• The cause is not clear, but eating low-fiber foods, less physical activity, or increased pressure in the colon duct due to obesity, smoking, or constipation can lead to colon diverticulum.

• The diverticulum of the colon in adults is classified into stages 1-4.

• Symptoms may be asymptomatic or inflamed. Symptoms may differ depending on the stage and complications.

• There may be goji, loss of taste, vomiting, and abdominal pain.

172.jpg

Figure 266. Diverticulum in the S colon. Copyright ⓒ 2011 John Sangwon Lee, MD., FAAP

Diagnosis of diverticulitis of the colon

• Diagnosis is performed by medical history findings, CT scan of the colon, and endoscopy of the sigmoid colon and the rest of the colon.

Treatment of colon diverticulitis

• Eliminate triggers, including regulation of food intake.

• If there is inflammation, treatment with antibiotics such as oral or vascular Metronidazole, Augmentin, or Quinolone, and surgical treatment as needed.

출처 및 참조 문헌 Sources and references

  • NelsonTextbook of Pediatrics 22ND Ed
  • The Harriet Lane Handbook 22ND Ed
  • Growth and development of the children
  • Red Book 32nd Ed 2021-2024
  • Neonatal Resuscitation, American Academy Pediatrics
  • www.drleepediatrics.com제7권 소아청소년 감염병
  • www.drleepediatrics.com제9권 소아청소년 소화기 질환
  •  Red book 29th-31st edition 2021
  • Nelson Text Book of Pediatrics 19th — 21st Edition
  • The Johns Hopkins Hospital, The Harriet Lane Handbook, 22nd edition
  • Childhood Emergencies in the Office, Hospital and Community, American Academy of Pediatrics
  • Emergency Medical Service for Children, By Ross Lab. May 1989. p.10
  • Emergency care, Harvey grant, and Robert Murray
  • Emergency Care Transportation of Sick and Injured American Academy of Orthopaedic Surgeons
  • Emergency Pediatrics A Guide to Ambulatory Care, Roger M. Barkin, Peter Rosen
  • Immediate care of the acutely ill and injured, Hugh E. Stephenson, Jr
  • The Critically Ill Child, Diagnosis and Management, Edited by Clement A. Smith
  • Emergency Medical Services for Children: The Role of the Primary Care Provider, America Academy of Pediatrics
  • Quick Reference To Pediatric Emergencies, Delmer J. Pascoe, M.D., Moses Grossman, M.D. with 26 contributors
  • Manual of Emergency Care
  • 응급환자관리 정담미디어
  • 소아가정간호백과–부모도 반의사가 되어야 한다, 이상원
  • Neonatal Resuscitation American heart Association
  • Neonatology Jeffrey J.Pomerance, C. Joan Richardson
  • Pediatric Resuscitation Pediatric Clinics of North America, Stephen M. Schexnayder, M.D.
  • Pediatric Critical Care, Pediatric Clinics of North America, James P. Orlowski, M.D.
  • Preparation for Birth. Beverly Savage and Dianna Smith
  • Infectious disease of children, Saul Krugman, Samuel L Katz, Ann A. Gershon, Catherine Wilfert
  • The Harriet Lane Handbook 19th Edition
  • 소아과학  대한교과서
  • 제1권 소아청소년 응급의료 참조문헌과 출처
  • Other

Copyright ⓒ 2015 John Sangwon Lee, MD., FAAP

“부모도 반의사가 되어야 한다”-내용은 여러분들의 의사로부터 얻은 정보와 진료를 대신할 수 없습니다.

“The information contained in this publication should not be used as a substitute for the medical care and advice of your doctor. There may be variations in treatment that your doctor may recommend based on individual facts and circumstances. “Parental education is the best medicine.”