经过内镜下粘膜切割后的直肠伪动脉瘤出血,通过内镜超声波引导的可吸收的凝海绵注射进行管理
Agnieszka Maniak1, Ajaypal Singh1, Thomas Wang1
1Rush University Medical Center, Center for Interventional and Therapeutic Endoscopy, Division of Digestive Diseases and Nutrition, Chicago, Illinois, USA.
概括
在内镜下粘膜解剖 (ESD) 后从直肠伪动脉瘤出血是罕见的. 透视超声导向栓塞有效地治疗了耐火病例,阻止了复发性出血.
科学领域:
- 胃肠病学 胃肠病学
- 干预性内镜检查是干预性的内镜检查.
- 血管外科 血管外科
背景情况:
- 流血性伪动脉瘤是内镜下粘膜切割 (ESD) 的罕见并发症.
- 在ESD后的复发性血需要先进的治疗策略,当传统方法失败时.
研究的目的:
- 报告一个成功的内镜超声波引导栓塞的案例,用于耐火性动脉伪动脉瘤在ESD后出血.
- 突出ESS引导栓塞作为一种可行的治疗罕见但严重的ESD并发症.
主要方法:
- 一名74岁的妇女在ESD后经常出血,接受了CT血管造影,揭示了直肠伪动脉瘤.
- 内镜超声波 (EUS) 识别了伪动脉瘤和灌血管.
- 在EUS指导下,将可吸收的凝海绵注入伪动脉瘤和食器中.
主要成果:
- 在栓塞后观察到多普勒流的立即停止.
- 患者在手术后没有进一步的出血.
- 后续成像证实了伪动脉瘤的分辨率.
结论:
- 动脉伪动脉瘤在ESD后是一个重要的风险.
- 以EUS引导的栓塞为伪动脉瘤出血提供了一种有效的治疗选择,这种出血不耐标准内镜血静止.
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