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结肠多性动脉静脉形形 - - 一个出乎意料的血液形的原因
Inês R Simão1, Catarina Palma2, Natacha B Vieira2
1Gastrenterology, Unidade Local de Saúde Lisboa Ocidental, Portugal.
Revista espanola de enfermedades digestivas
|May 20, 2024
概括
一名70岁男性的严重直肠出血是由动脉静脉形 (AVM) 造成的. 这种血管损伤需要手术干预,因为内镜剪切未能实现持久的血静.
科学领域:
- 胃肠病学 胃肠病学
- 血管外科 血管外科
背景情况:
- 一名70岁的男性患有冠状动脉疾病和辐射前列病,呈现出严重的血和血液动力学不稳定性.
- 持续的胃肠道出血需要多次红细胞输血,突显了病情的严重性.
研究的目的:
- 报告由于动脉静脉形缺陷 (AVM) 导致严重直肠出血的病例,患者有显著的并发症.
- 讨论与AVM相关的大型出血管理的诊断和治疗挑战.
主要方法:
- 最初的诊断结肠镜检查发现了出血的病变.
- 试图使用血结器进行内镜血静止.
- 由于持续的出血和高风险因素,进行了新兴的哈特曼大肠切除术.
主要成果:
- 结肠镜检查显示,8毫米纤维性病变与凝块,导致活跃的喷射出血.
- 内镜剪切提供了暂时的血静,但再次出血的风险很高.
- 组织病理学证实了动脉静脉形 (AVM) 没有瘤变化.
结论:
- 动脉静脉形可能导致严重,危及生命的直肠出血.
- 虽然内镜切割可以提供暂时的控制,但在高风险患者中,手术切除可能是最终管理的必要条件.
- 这一案例强调了在对不清楚的胃肠道出血的差异诊断中考虑AVM的重要性.
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