Hashiguchi M, Tsuji H, Shimono J, Azuma K, Fujishima M
Second Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Hepatogastroenterology. 1999 May-Jun;46(27):1751-4.
Bleeding from duodenal varices is a rare and life-threatening complication of cirrhosis. The diagnosis and management of this disease remains problematic. We herein report an autopsy case of a patient who suffered from recurrent bleeding from duodenal varices. A 48 year-old man with cirrhosis presented with upper gastrointestinal bleeding. He had three episodes of massive melena during the 6 months prior to admission. However, the source of bleeding was not known. Emergent endoscopy revealed jet bleeding from varices in the second to third portion of the duodenum. Endoscopic ethanol injection sclerotherapy was attempted but rebleeding occurred and the patient died.
十二指肠静脉曲张出血是肝硬化一种罕见且危及生命的并发症。该疾病的诊断和治疗仍存在问题。我们在此报告一例十二指肠静脉曲张反复出血患者的尸检病例。一名48岁肝硬化男性出现上消化道出血。入院前6个月内他发生过3次大量黑便。然而,出血来源不明。急诊内镜检查发现十二指肠第二至第三段静脉曲张喷射性出血。尝试了内镜下乙醇注射硬化治疗,但再次出血,患者死亡。