Chen S C, Lee P H, Chang K J, Hsu C Y
Department of Surgery, National Taiwan University Hospital, Taipei, R.O.C.
J Formos Med Assoc. 1992 Nov;91(11):1102-6.
From October 1978 to April 1991, seven patients presenting at the National Taiwan University Hospital with gastrointestinal tract hemorrhage were diagnosed by colonofibroscopy or angiography as having angiodysplasia of the colon and small intestine. There were two men and five women; their ages ranged from 23 to 65 years, with a mean age of 50.3 years. None of these patients were diagnosed by barium enema. Only two patients were diagnosed by colonofibroscopy, and six patients were diagnosed by angiography. Therefore, angiography was the most effective method for diagnosing angiodysplasia. A vascular tuft was the most frequent finding. Six patients with lesions on the right side of the colon underwent a right hemicolectomy, one patient with a lesion on the jejunum underwent a right hemicolectomy initially with segmental resection of the jejunum later. The postoperative courses were smooth, and there has been no further evidence of gastrointestinal blood loss or anemia in the follow-up period. A right hemicolectomy is the treatment of choice because these lesions are frequently multiple; the lesions are found primarily on the right side of the colon.
1978年10月至1991年4月,国立台湾大学医院收治了7例因胃肠道出血就诊的患者,经结肠镜检查或血管造影诊断为结肠和小肠血管发育异常。其中男性2例,女性5例;年龄在23岁至65岁之间,平均年龄为50.3岁。这些患者均未通过钡剂灌肠诊断出来。只有2例患者通过结肠镜检查确诊,6例患者通过血管造影确诊。因此,血管造影是诊断血管发育异常最有效的方法。血管簇是最常见的表现。6例结肠右侧有病变的患者接受了右半结肠切除术,1例空肠有病变的患者最初接受了右半结肠切除术,随后进行了空肠节段性切除术。术后病程顺利,随访期间未再有胃肠道失血或贫血的迹象。由于这些病变常为多发,且主要位于结肠右侧,因此右半结肠切除术是首选的治疗方法。