Sierro C, Steiner A, Rüttimann S
Medizinische Abteilung, Kantonsspital Schaffhausen.
Praxis (Bern 1994). 2000 May 18;89(21):925-8.
This 83-year-old patient was admitted to the emergency room after a sudden and abundant rectal bleeding without any other abdominal symptoms. The physical examination showed normal abdominal findings. However, digital rectal examination revealed dark red blood. Upper and lower endoscopic examination did not show an active bleeding source. A diagnosis of an acute lower gastrointestinal bleeding probably originating from a diverticulum was made. The patient was dismissed two days later without any signs of further bleeding. However, the same day he was readmitted again because of acute rebleeding. Emergency colonoscopy was not conclusive because of massive hemorrhage. Angiography of the abdominal arteries was performed which showed marked active bleeding in the coecal region. Ileocoecal resection was performed and histopathological examination showed a solitary coecal diverticulum.
这位83岁的患者在突发大量直肠出血且无其他腹部症状后被送入急诊室。体格检查显示腹部检查结果正常。然而,直肠指检发现暗红色血液。上下内镜检查未发现活动性出血源。诊断为急性下消化道出血,可能起源于憩室。患者两天后出院,无进一步出血迹象。然而,同一天他因急性再次出血再次入院。由于大量出血,急诊结肠镜检查未得出明确结论。进行了腹部动脉血管造影,显示盲肠区域有明显的活动性出血。进行了回盲部切除术,组织病理学检查显示为孤立性盲肠憩室。