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因胃和脾脏不常见动静脉畸形(AVM)导致的呕血:一例报告。

Exsanguinating upper GI bleeds due to Unusual Arteriovenous Malformation (AVM) of stomach and spleen: a case report.

机构信息

Department of surgery, Islamic International Medical College, Rawalpindi, Pakistan.

出版信息

World J Emerg Surg. 2009 May 1;4:15. doi: 10.1186/1749-7922-4-15.

Abstract

BACKGROUND

In this paper we are reporting one case of exsanguinating upper gastrointestinal tract (GIT) bleed requiring massive blood transfusion and immediate life saving surgery.

CASE PRESENTATION

A 30 years old female, 12 weeks pregnant was referred to our hospital from the earth-quake affected area of Kashmir with history of upper abdominal pain, haematemesis and melaena for one week. After stabilizing the patient, upper gastro-intestinal endoscopy was performed. It revealed gastric ulcer just distal to the gastro-esophageal junction on the lesser curvature. Biopsy from the ulcer edge led to profuse spurting of the blood and patient went into state of shock. Immediate resuscitation led to rebleeding and recurrence of post haemorrahagic shock.

CONCLUSION

The patient was immediately explored and total gastrectectomy with splenectomy concluded as life saving procedure. A review of literature was conducted to make this report possible.

摘要

背景

本文报告了一例上消化道(GI)大出血病例,患者需要大量输血和立即进行救生手术。

病例介绍

一名 30 岁女性,12 周妊娠,来自克什米尔地震灾区,有上腹痛、呕血和黑便史 1 周。在稳定患者病情后,进行了上消化道内镜检查。结果显示胃小弯处胃食管交界处以下有胃溃疡。溃疡边缘的活检导致大量喷血,患者出现休克状态。立即复苏导致再次出血和出血性休克后再次发生。

结论

患者立即接受探查,全胃切除术和脾切除术被认为是救生手术。进行了文献复习,以使本报告成为可能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fda8/2687422/d711f26e576d/1749-7922-4-15-1.jpg

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