穿孔胃潰瘍與腸道出血,是囊性動脈的次要病變
Akhil Tanwar1, Surbhi Singh1, Jennifer Hubert1
1Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
Case reports in radiology
|July 11, 2025
概括
这一案例研究突出了一个罕见的上胃肠道出血的例子,由一个囊性动脉伪动脉瘤引起的老年患者. 通过成像和有针对性的栓塞即时诊断对于成功管理至关重要.
科学领域:
- 胃肠病学 胃肠病学
- 血管外科 血管外科
- 放射学 放射学是一门学科.
背景情况:
- 患有慢性腹痛和使用NSAID的老年患者有患上上部胃肠道出血的风险.
- 血流和黑色素是潜在的胃肠道出血的关键指标.
研究的目的:
- 在患有UGIB的老年患者中呈现一个封闭的胃穿孔和囊性动脉伪动脉瘤的病例.
- 突出多相CT血管学在识别UGIB罕见原因的诊断实用性.
- 讨论涉及保守措施和干预放射学的管理策略.
主要方法:
- 采用一种案例研究方法,专注于一名87岁的女性患者.
- 记录了临床表现,病史 (包括NSAID使用) 和体检结果.
- 诊断成像,特别是多相CT血管造影,用于确定出血源.
- 治疗涉及保守治疗 (输液抗生素,质子抑制剂) 和干预性血栓塞的伪动脉瘤.
主要成果:
- 患者呈现出血和黑色素,表明UGIB.
- 电脑图像扫描揭示了包含的远部胃破裂和4.2毫米的囊性动脉伪动脉瘤.
- 尽管有穿孔的,但没有显著的肺上皮或血上皮,证实了封闭的穿孔.
- 囊性动脉的成功栓塞是在低胆囊缺血风险的情况下进行的.
结论:
- 这一案例强调了对患有UGIB的老年患者进行及时诊断和干预的重要性.
- 多相CT血管造影对于准确地定位出血源至关重要,包括像伪动脉瘤这样的罕见实体.
- 结合保守管理和干预放射学的多学科方法可以有效地治疗内置胃肠道穿孔的复杂病例.
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