Pediatric Gastroenterology, Hepatology & Nutrition

The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition (대한소아소화기영양학회)
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A Case of Ascending Colon Diverticulitis with Perforation in a Child

소아 상행 대장 게실염 천공 1예

  • Baek, Joon-Woo (Department of Pediatrics, College of Medicine, Hallym University, Kangnam Sacred Heart Hospital) ;
  • Shin, Jae-Young (Department of Pediatrics, College of Medicine, Hallym University, Kangnam Sacred Heart Hospital) ;
  • Lee, Jee-Hyun (Department of Pediatrics, College of Medicine, Hallym University, Kangnam Sacred Heart Hospital) ;
  • Jung, So-Young (Department of Surgery, College of Medicine, Hallym University, Kangnam Sacred Heart Hospital) ;
  • Jung, Ah-Young (Department of Radiology, College of Medicine, Hallym University, Kangnam Sacred Heart Hospital) ;
  • Kim, Jeong-Won (Department of Pathology, College of Medicine, Hallym University, Kangnam Sacred Heart Hospital) ;
  • Lee, Kon-Hee (Department of Pediatrics, College of Medicine, Hallym University, Kangnam Sacred Heart Hospital)
  • 백준우 (한림대학교 강남성심병원 소아과학교실) ;
  • 신재영 (한림대학교 강남성심병원 소아과학교실) ;
  • 이지현 (한림대학교 강남성심병원 소아과학교실) ;
  • 정소영 (한림대학교 강남성심병원 외과학교실) ;
  • 정아영 (한림대학교 강남성심병원 영상의학과교실) ;
  • 김정원 (한림대학교 강남성심병원 병리학교실) ;
  • 이건희 (한림대학교 강남성심병원 소아과학교실)
  • Received : 2010.08.06
  • Accepted : 2010.09.10
  • Published : 2010.09.30
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Abstract

A diverticulum is a blind pouch communicating with the gut. The term "diverticulitis" indicates inflammation of a diverticulum or diverticula, which is commonly accompanied by gross or microscopic perforation. Acute diverticuitis is a rare disorder in early childhood. Itis difficult to diagnose acute right colon diverticulitis from common causes of RLQ pain. We report a case of acute diverticulitis in the right colon in a 6-year-old girl. She complained of typical RLQ pain mimicking acute appendicitis,but was diagnosed with acute diverticulitis by CT scanning. Conservative treatment failed because of peritonitis due to perforation of an inflamed diverticulum. After the diverticulcetomy, the symptoms resolved.

우측 대장 게실은 주로 선천적으로 대장 바깥쪽으로 돌출된 소낭으로 지속적인 변비 등으로 인한 장내 압력에 의해 소낭이 돌출되는 퇴행성 변화에 의한 좌측 대장 게실과 구별된다. 따라서 좌측 대장 게실에 비하여 발견되는 연령이 10~20세 정도 낮은 편이지만, 20세 미만소아 발생률은 적고, 특히 어린 소아에서의 발생보고는 매우 드물다. 또한 우측 대장 게실염의 경우 우하복부 동통을 일으키는 많은 질환과 감별이 어렵고 급성 충수 돌기염으로 오진되는 경우가 드물지 않아서 실제 급성 충수 돌기염으로 생각하고 수술을 하였는데 수술해 보니 대장 게실염인 경우가 종종 보고되고 있다. 저자들은 심한 우하복부 통증으로 인해 급성 충수 돌기염으로 오인되었던 6세 여아에서 복부 전산화 단층 촬영으로 우측 대장에 분변 매복이 동반한 급성 게실염을 진단하고 게실 천공의 합병증으로 인해 수술적 치료를 시행한 예를 보고하는 바이다.

Keywords

References

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