Madácsy L, Molnár T, Nagy I, Tiszlavicz L, Lonovics J
First Dept. of Internal Medicine, University of Szeged, 6725 Korányi f.8, PO Box 469, Szeged, Hungary.
Endoscopy. 2003 Mar;35(3):230-3. doi: 10.1055/s-2003-37255.
In this case report, we describe the rare situation of a patient with nonvariceal upper gastrointestinal bleeding induced by gastric and duodenal involvement of Schistosoma mansoni infection. In this unique case severe, recurrent upper gastrointestinal bleeding was induced by central ulcerations of gastric pseudopolypoid and duodenal polypoid lesions. However, very atypically, there were no signs of portal hypertension, coagulopathy, or variceal bleeding, and no macroscopic evidence of lower gastrointestinal tract involvement. Neither anti-ulcer therapy nor endoscopic hemostasis methods were effective in preventing recurrent bleeding episodes. Finally, typical histological and serological tests (positive for S. mansoni hemagglutination) led to the correct diagnosis, and the patient was completely cured by specific antischistosomal therapy.
在本病例报告中，我们描述了一例罕见情况，即一名因曼氏血吸虫感染累及胃和十二指肠而导致非静脉曲张性上消化道出血的患者。在这一独特病例中，胃假息肉样和十二指肠息肉样病变的中央溃疡引发了严重的、反复的上消化道出血。然而，非常不典型的是，没有门静脉高压、凝血功能障碍或静脉曲张出血的迹象，也没有下消化道受累的宏观证据。抗溃疡治疗和内镜止血方法均无法有效预防出血复发。最后，典型的组织学和血清学检查（曼氏血吸虫血凝试验呈阳性）得出了正确诊断，患者通过特异性抗血吸虫治疗完全治愈。
