von Rahden Burkhard H A, Stigler Brigitte, Weiss Wolfgang, Stein Hubert J
Department of Surgery, Paracelsus Medical University, Muellnerhauptstr 48, A-5020 Salzburg, Austria.
J Gastrointest Surg. 2007 Jul;11(7):945-7. doi: 10.1007/s11605-007-0118-y.
Management of upper gastrointestinal bleeding because of erosion of vessels by esophageal cancer may be challenging. We present herein the angiographic images of a 49-year-old patient who was admitted with massive bleeding from a tumor-eroded inferior thyroid artery. Attempts to control the bleeding by means of flexible endoscopy and insertion of a Sengstaken-Blakemore tube had failed. The diagnosis was impressively demonstrated by multislice computed tomography with intravenous contrast in the arterial phase and multiplanar reconstructions (computed tomography angiography) and by digital subtraction angiography. The bleeding was successfully treated with superselective catheterization and coiling of the eroded vessel.
因食管癌侵蚀血管导致的上消化道出血的管理可能具有挑战性。我们在此展示一名49岁患者的血管造影图像，该患者因肿瘤侵蚀甲状腺下动脉而出现大量出血入院。通过软性内镜检查和插入Sengstaken - Blakemore管来控制出血的尝试均告失败。在动脉期经静脉注射造影剂的多层计算机断层扫描及多平面重建（计算机断层血管造影）以及数字减影血管造影均清晰地显示了诊断结果。通过对侵蚀血管进行超选择性插管和栓塞成功治疗了出血。
