一种小肠动脉瘤出血的病例,具有下膜瘤样的发现
Susumu Banjoya1, Yohei Minato1, Yoshiaki Kimoto1
1Department of Gastrointestinal Endoscopy NTT Medical Center Tokyo Tokyo Japan.
DEN open
|January 24, 2024
概括
一个破裂的小肠动脉瘤在一个病人身上引起了焦油便. 这种罕见的疾病,呈现为下质瘤的迹象,通常需要手术干预,因为难以内镜血静.
科学领域:
- 胃肠病学 胃肠病学
- 血管外科 血管外科
- 诊断成像 诊断成像 诊断成像
背景情况:
- 小肠子粘膜下动脉瘤是罕见的,但可能导致严重的胃肠道出血.
- 早期诊断和适当的治疗对于患者的治疗结果至关重要.
研究的目的:
- 报告一个破裂的尾下膜动脉瘤的病例.
- 要突出诊断挑战和治疗策略的这种情况.
- 为了强调"类似SMT的标志"在内镜诊断中的意义.
主要方法:
- 一名51岁的女性患者接受了melena.
- 诊断工作包括对比度增强的腹部计算机断层扫描 (CT) 和双气球内镜.
- 治疗涉及内镜剪切,血管学栓塞,并最终进行手术切除.
主要成果:
- 扫描显示了对比物流到小肠的泄漏.
- 内镜检查发现了膜下面的粘膜下质体样病变.
- 尽管进行了初步干预,但持续的贫血需要小肠切除.
- 组织病理学证实了破裂的亚粘膜动脉瘤.
结论:
- 肠下粘膜动脉瘤的内镜血静通常具有挑战性.
- "类似SMT的标志"是诊断膜下动脉瘤的关键内镜发现.
- 破裂小肠动脉瘤可能需要包括手术在内的多式治疗.
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