由细胞巨乳病毒十二指肠炎引起的反复出现的胃肠道出血
Ivo Mendes1, Francisco Vara-Luiz2, Sofia Carralas Antunes3
1Gastroenterology , Hospital Garcia de Orta, Portugal.
一名患有晚期癌症的患者因十二指肠而出现严重的胃肠道出血. 细胞巨乳病毒 (CMV) 感染被确定为病因,但由于患者的预后不佳,拒绝了抗病毒治疗.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 传染性疾病 传染性疾病
背景情况:
- 一名78岁的男性患有转移性前列腺癌,患有急性胃肠道出血.
- 患者呈现出血,黑色素和低血压,需要因肺炎住院治疗.
研究的目的:
- 在免疫功能低下的患者中调查严重上部胃肠道出血的原因.
- 在晚期恶性瘤和感染的背景下,评估胃肠道出血的管理策略.
主要方法:
- 上部肠道内镜检查发现一个出血的十二指肠 (Forrest IIa).
- 静血疗法包括上腺素,聚多卡诺尔和剪贴放置.
- 活检证实了由于细胞巨乳病毒 (CMV) 感染的慢性十二指肠炎.
主要成果:
- 最初的内镜血静得到了实现,但复发性出血需要重新干预和输血.
- 组织病理学揭示了细胞巨核病毒 (CMV) 是十二指甲状腺炎的潜在原因.
- 由于患者的表现不佳和成功的血液静止,抗病毒治疗被推迟.
结论:
- 细胞巨乳病毒 (CMV) 感染可以在免疫功能低下的患者中引起显著的胃肠道出血.
- 关于抗病毒治疗的管理决策应考虑患者的整体临床状况和预后.
- 晚期癌症患者的十二指肠出血需要及时的内镜干预.
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