露面胃肠道出血次要的左下门动脉伪动脉瘤胃旁路手术后的胃肠道出血
Mei-Ting Chen1,2, Kay Tai Choy3,4, Ferdinand Ong5,4
1Queensland Health, Brisbane, Queensland, Australia meiting.chen1@uq.net.au.
BMJ case reports
|January 3, 2024
概括
内脏动脉伪动脉瘤 (VAPAs) 在减肥手术后可能导致罕见但严重的胃肠道出血. 早期诊断至关重要,因为可以错过小或间歇性出血的伪动脉瘤,从而导致血液动力学妥协.
科学领域:
- 胃肠病学 胃肠病学
- 血管外科 血管外科
- 腹部外科手术并发症 腹部外科手术并发症
背景情况:
- 内脏动脉伪动脉瘤 (VAPAs) 是稀有的,但是在减肥手术后的严重并发症.
- 患者可能呈现出各种胃肠道 (GI) 出血症状或血液动力学不稳定性.
研究的目的:
- 为了突出诊断的挑战,与识别VAPAs在减肥手术后.
- 提高人们对不太常见的胃绕道术后并发症的认识,特别是不清晰或间歇性出血.
主要方法:
- 一个40多岁的男性患者的病例报告,呈现出巨大的胃肠道出血.
- 诊断评估包括CT血管图,内镜和腹腔镜.
- 专注于诊断间歇性出血模式的小伪动脉瘤的挑战.
主要成果:
- 由于VAPA,该患者经历了大量的胃肠道出血和血液动力学不稳定.
- 标准的诊断调查最初产生了不起眼的发现,使诊断复杂化.
- 这种伪动脉瘤源于最近的减肥手术期间的血管损伤.
结论:
- VAPAs代表了一个显著的,尽管不常见的,减肥手术后并发症.
- 诊断的警是必不可少的,特别是从绕过的胃中间歇性出血.
- 临床医生应考虑VAPAs在无法解释的胃肠道出血的微分诊断后腹腔外科手术.
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