Hamada N, Ishizaki N, Shirahama K, Nakamura N, Murata R, Kadono J, Shimazaki T, Sameshima T, Misono T, Taira A
Second Department of Surgery, Faculty of Medicine, Kagoshima University, Japan.
J Gastroenterol. 2000;35(2):159-62. doi: 10.1007/s005350050030.
A case of massive intestinal blood loss from multiple duodeno-jejunal diverticula is described. A 39-year-old man was referred to our hospital because of recurrent bloody stool and worsening anemia. Upper and lower endoscopy, selective abdominal angiography, and radionuclide scanning were performed to seek the cause of the intestinal bleeding, but none of these studies revealed the source of bleeding. Small-bowel barium follow-through examination showed numerous diverticula in the distal duodenum and proximal jejunum. Excision of the duodenal diverticulum and resection of the involved portion of the jejunum cured the patient. On histopathological examination, an ulcerative lesion with an exposed vessel suggestive of the source of bleeding was seen in the resected duodenal diverticulum. Although duodeno-jejunal diverticula are rare, the importance of a careful search for this malformation in a patient with intestinal blood loss is stressed.
本文描述了一例因多发十二指肠-空肠憩室导致大量肠道失血的病例。一名39岁男性因反复便血和贫血加重被转诊至我院。进行了上消化道和下消化道内镜检查、选择性腹部血管造影以及放射性核素扫描以寻找肠道出血的原因，但这些检查均未发现出血源。小肠钡剂通过检查显示十二指肠远端和空肠近端有大量憩室。切除十二指肠憩室并切除空肠受累部分后，患者治愈。组织病理学检查显示，在切除的十二指肠憩室中可见一个溃疡性病变，有一处暴露的血管，提示为出血源。尽管十二指肠-空肠憩室罕见，但强调了对肠道失血患者仔细检查这种畸形的重要性。
