Hong Y K, Yoo W H
Division of Rheumatology, Department of Internal medicine, Chonbuk National University Medical School and Research Institute of Clinical Medicine, #634-18, Geumam-Dong, Deokjin-Gu, Jeonju, Chonbuk 561-712, South Korea.
Rheumatol Int. 2008 Sep;28(11):1151-4. doi: 10.1007/s00296-008-0578-8. Epub 2008 Apr 4.
Massive gastrointestinal bleeding is a very rare manifestation of gastrointestinal Behçet's disease, mainly from the gastrointestinal mucosal lesions. We report herein the case of a 50-year-old man with intestinal Behçet's disease who suffered massive hemorrhage from ruptured arterial aneurysm. Colonoscopy demonstrated large amount of fresh blood in the entire colon, but we were not able to localize bleeding focus anywhere in the colon. Angiography was performed and it revealed that a small aneurysm on the right ileocolic artery with apparent extravasation of contrast material. A guiding catheter was inserted to a right ileocolic artery and superselective arterial embolization using microcoils was successful. Following this procedure, the gastrointestinal bleeding gradually subsided and completely stopped within a few days. He is now treating with prednisolone and sulfasalazine without recurrent bleeding until now.
大量胃肠道出血是胃肠道白塞病非常罕见的表现，主要源于胃肠道黏膜病变。我们在此报告一例50岁患有肠道白塞病的男性患者，其因动脉动脉瘤破裂而发生大量出血。结肠镜检查显示整个结肠有大量新鲜血液，但我们无法在结肠的任何部位定位出血点。进行了血管造影，结果显示右回结肠动脉有一个小动脉瘤，并有明显的造影剂外渗。将引导导管插入右回结肠动脉，并使用微线圈成功进行了超选择性动脉栓塞。在此手术后，胃肠道出血逐渐消退，并在几天内完全停止。他目前正在接受泼尼松龙和柳氮磺胺吡啶治疗，至今未再出血。
