위장관 혈관성 병변 - gie.or.kr

1 2007;35(Suppl. 1):73-7773 . 1 1. (Angiodysplasia) 60 80 . (arterio venous malformation) . 80% . , 10% . , 5 mm . , . , .. , precapillary sphincter.

2 , , von Willebrand di-sease . , . 6% , 60 2 . , 15% .. 30 40% 10 15% . argon plasma coagulation (APC), heater probe coagula-tion, hemoclipping .. , estrogen . 2. Gastric antral vascular ectasia (GAVE) Watermelon stocmach.

3 , ( pernicious anemia GAVE ), VIP 5 hydroxytryptamine vasoactive . GAVE rugal folds . , fibrin thrombi, fibrohyalinosis, spindle cell formation . GAVE (PBC), scleroderma , pernicious anemia, , . , APC , . TIPS GAVE . 74 2007;35(Suppl. 1):73-77 3. Multiple phlebectasia.

4 Angiodysplasia , . cm , nodule . , .. phlebectasia treatment of choice . 4. Telangiectasia Telangiectasia . telangiectatic lesion radiation enteritis telangiectasia . telangiectasia . 1) Hereditary hemorrhagic telangiectsia (HHT, Osler Rendu Weber disease): 1 4 mm telangiectasia .. shunt . telangiectasia , telan-giectasia.

5 , , , , , , high outpup . , . Spider angioma blanch . 20 . 10 20% , , , telangiectasia . , . shunt , . shunt . 2) Turner s syndrome: 45 XO karyotype Turner telangiec-tasia, vascular ectasia, hemangioma . 3) Telangiectasia associated with connective tissue diseases: CREST (Calcinosis, Raynaud s, Esophageal dysmo-tility, Sclerodactyly, telangiectasia), systemic sclerosis, mixed connective tissue disease telangiectasia.

6 GAVE . telangiectasia . 5. Hemangiomas hemangioma . 10 % . (hamartoma) . , .. a. Cavernous hemangioma endothelial lining . phlebolith . 2 . Diffuse type circumscribed type . Diffuse infiltrating cavernous hemangioma .. Circumscribed cavernous hemangioma poly-poid projection.

7 B. Capillary hemangioma hyperplastic endothelium . , , . c. Mixed Capillary cavernous hemangioma . , 40%, 30%, 10% . phlebolith 75 .. diffuse infil-trating cavernous hemangioma , , , , . lymphangioma .. , interferon alpha anti angiogenic agent.

8 1) Peutz Jegher : Mucocutaneous pigmentation, . Peutz Jegher , . 2) Blue rubber bleb nevus : sporadic . , , , , , nevi cavernous hemagioma , bleb . , 1 2 cm blanching . , .. , , interferon 2 alpha, steroid .. 3) Klippel Trenaunay Weber : . , , , port wine hemangiomata.

9 Atresia, hypoplasia, obstruction bruits . , claudication, thrombophlebitis, lymphedema, lymphan-gioma, , . serosal vessel mixed cavernous hemangioma . Portal venous hypoplasia rectosigmoid varix . X ray phlebolith , . , . , . phase . consumptive coagulo-pathy , intravenous tranexamic acid.

10 6. Disorders of connective tissue affecting blood vessels 1) Pseudo xanthoma elasticum: elastin , , , , , , . Elastin , angioid streaks , medium sized vessel . , , . 10 20 . , , . friable eroded mucosa yellow cobble stone plaques nodule . tortuous mesenteric vessel .. 2) Ehlers Danlos : 10 subtype . Collagen , , easy bruising.