70세 남성이 6개월간의 만성적인 철 결핍성 빈혈(IDA)과 전신 쇠약감을 주소로 내원했다. 대변 잠혈 검사 양성이었다. 대장 내시경 검사상 맹장(cecum)에 궤양을 동반한 융기성 종괴가 관찰되었고, 조직검사상 선암(Adenocarcinoma)으로 진단되었다. 이 환자에게 필요한 근치적 수술은?

맹장(Cecum), 상행 결장(Ascending colon), 간 만곡부(Hepatic flexure)에 위치한 암(우측 결장암)의 표준 근치적 수술은, 회장 말단부 10cm, 횡행 결장 일부, 그리고 관련 림프절(Ileocolic, Right colic, Middle colic a. 분지)을 포함하는 우측 결장 절제술입니다.

KMLE 핵심 해설 이 환자는 만성 철결핍성 빈혈과 대변 잠혈 양성으로 내원하여, 대장 내시경에서 맹장(Cecum)의 선암(Adenocarcinoma)이 확인된 경우입니다.

증상 분석 및 진단 (Diagnosis): 우측 결장암(맹장암)은 종양이 궤양을 형성하며 만성적으로 출혈하여 철결핍성 빈혈을 유발하는 전형적인 증상을 보입니다. 좌측 결장암이 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