流血下坡食道静脉与良性上静脉卡瓦综合征相关:一个病例报告
Linvydas Ivaskevicius1, Sena Bluemel2, Tim Sebastian1
1Department of Angiology, University Hospital of Zürich, Zürich, CHE.
Cureus
|December 17, 2025
概括
无法解释的上部胃肠道出血可能源于下坡食道静脉,通常与中央静脉阻塞有关. 通过血管造形术和支架等手术恢复静脉外流,有效地解决了血液透析患者的出血.
科学领域:
- 胃肠病学 胃肠病学
- 血管外科 血管外科
- 腎臟病學 (nephrology) 是一種醫學專業.
背景情况:
- 下坡食道静脉瘤是上部胃肠道出血的罕见原因.
- 它们经常被忽视,特别是在没有肝病的患者中.
- 中枢静脉阻塞可以导致这些变形体.
研究的目的:
- 报告一名血液透析患者中由中央静脉阻塞引起的下坡食道静脉的病例.
- 要突出与上 vena cava 相关的静脉的诊断和治疗方法.
- 强调考虑静脉外流恢复为止血的重要性.
主要方法:
- 内镜评估以确定近端食道静脉.
- 图像学研究 (如静脉学) 用于诊断中心胸静脉封闭.
- 内血管重建包括血管整形,支架和导管更换.
主要成果:
- 成功识别了慢性导管诱导的中央静脉阻塞的次要下坡食道静脉.
- 内血管干预实现了稳定的静脉通透性.
- 在随访期间,复发的上部胃肠道出血完全停止.
结论:
- 在无法解释的上部胃肠道出血的情况下,应考虑与上腔静脉相关的静脉动脉.
- 阻塞静脉通路的内血管重建是一种有效的治疗方法.
- 恢复静脉外流可以导致出血的持久临床解决.
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