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结肠巨大腔外平滑肌瘤致大量下消化道出血:病例报告

Massive lower gastrointestinal hemorrhage caused by a large extraluminal leiomyoma of the colon: report of a case.

作者信息

Chen Chuang-Wei, Jao Shu-Wen, Wu Chang-Chieh, Ou Jing-Jim, Hsiao Cheng-Wen, Chao Pei-Chieh

机构信息

Division of Colon and Rectal Surgery, Department of Surgery, Tri-Service General Hospital, No.325, Cheng-Kung Road, Sec.2, Taipei, 114, Taiwan, Republic of China.

出版信息

Dis Colon Rectum. 2008 Jun;51(6):975-8. doi: 10.1007/s10350-007-9190-3. Epub 2008 Apr 12.

Abstract

The occurrence of leiomyoma of the colon is uncommon. Most of these lesions are clinically silent and are found incidentally during laparotomy or endoscopic procedures for unrelated conditions. Symptomatic leiomyomas of the colon are encountered less frequently, with only sporadic reports in the literatures. We describe a heretofore unreported case of a large extraluminal leiomyoma of the sigmoid colon presenting as massive lower gastrointestinal hemorrhage. Because it was extraluminal in position, it was difficult to make an accurate diagnosis endoscopically and the condition was easily misdiagnosed as angiodysplasia of the colon until CT scan results were seen. Although rare and benign in nature, leiomyoma of the colon may cause life-threatening complications that require emergency surgery and should be included in the differential diagnosis of lower gastrointestinal hemorrhage.

摘要

结肠平滑肌瘤的发生并不常见。这些病变大多在临床上无明显症状,是在因无关疾病进行剖腹手术或内镜检查时偶然发现的。有症状的结肠平滑肌瘤较少见,文献中仅有零星报道。我们描述了一例迄今为止未报道过的病例,乙状结肠巨大腔外平滑肌瘤表现为大量下消化道出血。由于其位于腔外,内镜下难以做出准确诊断,在看到CT扫描结果之前,该病很容易被误诊为结肠血管发育异常。尽管结肠平滑肌瘤本质上罕见且为良性,但可能会引发危及生命的并发症,需要紧急手术,在诊断下消化道出血时应将其纳入鉴别诊断范围。

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