Sugár I, Szabó S, Joós A, Ondrejka P
Semmelweis Egyetem Budapest, Altalános Orvosi Kar II. sz. Sebészeti Klinika.
Magy Seb. 2000 Dec;53(6):279-82.
Diagnosis and treatment of massive gastrointestinal bleeding is sometimes very difficult problem in a surgical unit. Authors present a case of a 40 years old female with an atypical source of upper gastrointestinal bleeding. The origin of the bleeding was detected only by intraoperative enteroscopy. The source of the bleeding was a very rare benign tumour of the duodenum (Gangliocytic paraganglioma) which involved the papilla of Vater. During the operation resection of the pedunculated tumour was carried out, with choledochal--and Wirsungoplastyc, associated with external drainage of these ducts. According to the literature in preoperative diagnosis of this rare tumour endoscopy, angiography, and EUS are very useful. In case of malignancy, metastases radical operation-pancreatoduodenectomy--is indicated.
在外科病房，大量胃肠道出血的诊断和治疗有时是非常棘手的问题。作者介绍了一例40岁女性上消化道出血来源不典型的病例。出血源仅通过术中肠镜检查得以发现。出血源是一种非常罕见的十二指肠良性肿瘤（神经节细胞副神经节瘤），累及十二指肠乳头。手术中对带蒂肿瘤进行了切除，并进行了胆总管和胰管成形术，同时对这些管道进行了外引流。根据文献，在这种罕见肿瘤的术前诊断中，内镜检查、血管造影和超声内镜检查非常有用。如果是恶性肿瘤，则需行根治性手术——胰十二指肠切除术。
