宫外上层半肠静脉静脉破裂:一个病例报告
Haruka Nishida1, Yoshinori Matsuoka2, Jumpei Fujimoto3
1Department of Emergency Medicine, International University of Health and Welfare Narita Hospital, Narita, JPN.
Cureus
|August 6, 2025
概括
上层中腹静脉的破裂导致肝细胞癌患者的致命腹内出血. 这种罕见的出血原因强调了急诊医生需要在门高血压中考虑子宫外静脉的必要性.
科学领域:
- 胃肠病学 胃肠病学
- 血管外科 血管外科
- 紧急医疗 紧急医疗
背景情况:
- 宫外静脉瘤是胃食道区域外扩张的移植系统附带体.
- 虽然往往无症状,但它们会导致危及生命的腹腔内出血.
研究的目的:
- 报告一例罕见的巨大的腹内出血从破裂的上半腹静脉 (SMV) 变形.
- 在急诊室 (ED) 讨论子宫外水破裂的诊断和管理挑战.
- 强调考虑子宫外静脉作为已知门门高血压患者中休克的原因的重要性.
主要方法:
- 一个84岁的妇女的病例报告,患有末期肝细胞癌,呈现出震惊.
- 通过床边超声波进行初步评估,然后在ED中进行对比增强计算机断层扫描 (CT).
- 复苏措施包括输血和复苏性内血管气球阻塞大动脉.
主要成果:
- 与对比度增强的CT显示了SMV周围的大规模出血风和扩张.
- 尽管进行了复苏,但患者却经历了心肺骤停.
- 患者的病情阻止了进一步的侵入性干预,包括干预性放射学或手术.
结论:
- 从子宫外静脉,特别是SMV静脉引起的腹腔内出血是一种罕见但至关重要的紧急情况.
- 对应急医生来说,迅速识别和考虑这种病因是非常重要的,因为他们管理着患有门性高血压的患者.
- 虽然具有挑战性,但干预性放射技术,如通过栓塞的跨内肝移植系统分流 (TIPS),可能会提供可行的治疗选择.
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