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[空肠憩室病:罕见的胃肠道出血原因。病例报告]

[Jejunal diverticulosis: a cause of infrequent gastrointestinal hemorrhage. Case report].

作者信息

Zapata R, Rojas C, Gaete F

机构信息

Departamentos de Medicina y de Anatomía Patológica, Facultad de Medicina, Universidad de Chile, Hospital del Salvador, Campus Oriente, Santiago de Chile.

出版信息

Rev Med Chil. 2000 Oct;128(10):1133-8.

Abstract

Jejunal diverticulosis is a very uncommon acquired disease. Clinical manifestations include acute life threatening complication such as perforation, obstruction and bleeding. Jejunal diverticulosis is an extremely rare site of origin of gastrointestinal bleeding, with fewer than seventy cases reported in the literature. We report a 77-year-old patient with a recurrent severe gastrointestinal bleeding manifested by melena and hematochaezia. During the hospitalization the tagged red blood cell scanning was positive for bleeding in the jejunum. At laparotomy, several large-mouthed diverticula at the proximal jejunum were identified. Approximately 30 centimeters of the involved segment was resected with primary end-to-end anastomosis. Postoperative 7 month evolution has been favorable, without any evidence of rebleeding. This report reviews the literature concerning this disease, discusses some diagnostic methods of studying small bowel bleeding and highlights the need to consider this diagnosis in old patients with a gastrointestinal hemorrhage of unknown origin (Rev Méd Chile 2000; 128: 1133-38).

摘要

空肠憩室病是一种非常罕见的后天性疾病。临床表现包括诸如穿孔、梗阻和出血等危及生命的急性并发症。空肠憩室病是胃肠道出血极为罕见的起源部位,文献报道的病例少于70例。我们报告一名77岁的患者,反复出现严重的胃肠道出血,表现为黑便和便血。住院期间,标记红细胞扫描显示空肠有出血阳性。剖腹手术时,在空肠近端发现了几个大口憩室。切除了约30厘米的受累肠段,并进行了一期端端吻合。术后7个月病情进展良好,没有再次出血的迹象。本报告回顾了有关该疾病的文献,讨论了一些研究小肠出血的诊断方法,并强调对于不明原因胃肠道出血的老年患者需要考虑这一诊断(《智利医学杂志》2000年;128: 1133 - 1138)。

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