Department of Radiology, Yamaguchi University School of Medicine, 1-1-1 Minamikogushi, Ube, Japan.
Jpn J Radiol. 2010 Jan;28(1):58-61. doi: 10.1007/s11604-009-0374-8. Epub 2010 Jan 30.
This is a case study of a 66-year-old woman who had a vascular malformation of the small bowel that was visualized on computed tomography enteroclysis (CTE). She presented with repeated tarry stool and severe anemia. Although the source of bleeding was not identified on upper and lower gastrointestinal endoscopy, active bleeding was revealed by capsule endoscopy in the deep jejunum. The cause of bleeding was not found on capsule endoscopy. CTE was requested as double-balloon endoscopy would have been difficult because of strong adhesion of the small intestine. A continual subtle vascular malformation of the jejunum, starting from the third jejunal branch end, was demonstrated on CTE with dynamic contrast enhancement. Because this vascular malformation was considered the cause of small intestinal bleeding, selective arterial coil embolization was performed. After embolization, the repeated tarry stool disappeared and the severe anemia dramatically improved. CTE may be a safe and useful method for determining the cause of small intestinal bleeding and for subsequent therapy.
这是一例 66 岁女性病例，其小肠存在血管畸形，在计算机断层小肠造影（CTE）中可见。她表现为反复黑便和严重贫血。虽然上消化道和下消化道内镜检查均未确定出血源，但胶囊内镜检查显示在空肠深部有活动性出血。胶囊内镜检查未发现出血原因。由于小肠强烈粘连，双气囊内镜检查较为困难，因此要求进行 CTE。CTE 动态增强显示，从小肠第三分支末端开始存在持续存在细微的血管畸形。由于这种血管畸形被认为是小肠出血的原因，因此进行了选择性动脉线圈栓塞术。栓塞后，反复黑便消失，严重贫血显著改善。CTE 可能是确定小肠出血原因和后续治疗的一种安全有效的方法。
