Murata Atsuhiko, Osoegawa Takashi, Yodoe Kentaro, Yoshimura Daisuke, Ochiai Toshiaki, Kabemura Teppei, Nakamura Kazuhiko
Department of Gastroenterology, Saiseikai Fukuoka General Hospital, Fukuoka 810-0001, Japan.
Fukuoka Igaku Zasshi. 2008 Feb;99(2):42-5.
We herein report successful endoscopic hemostasis in a patient with a bleeding from acquired ileal diverticulum. A 65-year-old woman was introduced to our hospital after the sudden onset of painless hematochezia. When emergency colonoscopy was performed, the site of bleeding could not be identified because of extensive blood pooling in the colon and ileocecal region. After admission, repeat colonoscopy with a transparent hood device after bowel preparation disclosed oozing of blood from an ileal diverticulum approximately 15 cm proximal to the ileocecal junction. We performed endoscopic therapy with injection of a hypertonic saline-epinephrine solution and placement of additional hemoclips in the diverticulum. Since the latter treatment, the patient had no recurrent hematochezia, and occult blood tests in stool had been negative. In cases of lower gastrointestinal bleeding, bleeding from an acquired ileal diverticulum should be considered and the terminal ileum carefully observed.
我们在此报告1例后天性回肠憩室出血患者经内镜止血成功的病例。一名65岁女性因突发无痛性便血被送至我院。急诊结肠镜检查时，由于结肠和回盲部广泛积血，出血部位无法确定。入院后，肠道准备后使用透明帽装置重复结肠镜检查，发现距回盲部约15 cm处的回肠憩室有渗血。我们对憩室注射高渗盐水-肾上腺素溶液并额外放置止血夹进行内镜治疗。自后一种治疗方法实施以来，患者未再出现便血，粪便潜血试验呈阴性。在下消化道出血病例中，应考虑后天性回肠憩室出血，并仔细观察回肠末端。
