Gismant Marco, Ceratti Pasquale, Valenza Venanzio, Ricci Riccardo, Rapaccini Gian Ludovico, Gasbarrini Giovanni
Institute of Internal Medicine, Catholic University of the Sacred Heart A. Gemelli, Rome, Italy.
Hepatogastroenterology. 2004 Jul-Aug;51(58):1069-72.
We report the case of recurrent hemorrhagic shock manifested by massive melena and hematemesis in a 67-year-old patient, previously operated in another hospital for an abdominal aortic aneurysm two weeks before. During hospitalization the red blood cell scintigraphy was positive for bleeding in the jejunum. Intraoperative endoscopy was performed to identify a solitary diverticulum at the proximal jejunum. Approximately 70 cm of the involved segment was resected by an end-to-end anastomosis. Postoperative one-year evolution has been favorable, without any evidence of rebleeding. A review of the literature concerning this disease indicates the rarity of a massive bleeding from solitary jejunal diverticulum and the need to consider this condition in patients with gastrointestinal hemorrhage.
我们报告了一例67岁患者复发性出血性休克的病例，该患者表现为大量黑便和呕血，两周前曾在另一家医院因腹主动脉瘤接受手术。住院期间，红细胞闪烁扫描显示空肠出血呈阳性。术中进行内镜检查，发现空肠近端有一个孤立性憩室。通过端端吻合术切除了约70厘米的受累肠段。术后一年病情进展良好，无再次出血迹象。对有关该疾病的文献综述表明，孤立性空肠憩室大量出血罕见，对于胃肠道出血患者需要考虑这种情况。
