Department of Gastroenterology, Nanjing Central Hospital of Nanjing Military Command of Chinese PLA, Nanjing 210002, Jiangsu Province, China.
World J Gastroenterol. 2010 Mar 28;16(12):1548-52. doi: 10.3748/wjg.v16.i12.1548.
Klippel-Trenaunay syndrome is a congenital vascular anomaly characterized by a triad of varicose veins, cutaneous capillary malformation, and hypertrophy of bone and (or) soft tissue. Gastrointestinal vascular malformations in Klippel-Trenaunay syndrome may present with gastrointestinal bleeding. The majority of patients with splenic hemangiomatosis and/or left inferior vena cava are asymptomatic. We herein report a case admitted to the gastroenterology clinic with life-threatening hematochezia and symptomatic iron deficiency anemia. Due to the asymptomatic mild intermittent hematochezia, splenic hemangiomas and left inferior vena cava, the patient did not seek any help for gastrointestinal bleeding until his admittance to our department for evaluation of massive gastrointestinal bleeding. He was referred to angiography because of his serious pathogenetic condition and inefficiency of medical therapy. The method showed that hemostasis was successfully achieved in the hemorrhage site by embolism of corresponding vessels. Further endoscopy revealed vascular malformations starting from the stomach to the descending colon. On the other hand, computed tomography revealed splenic hemangiomas and left inferior vena cava. To the best of our knowledge, this is the first Klippel-Trenaunay syndrome case presenting with gastrointestinal bleeding, splenic hemangiomas and left inferior vena cava. The literature on the evaluation and management of this case is reviewed.
克莱佩尔-特伦纳伊恩综合征是一种先天性血管畸形,其特征为静脉曲张、皮肤毛细血管畸形、骨骼和(或)软组织肥大三联征。克莱佩尔-特伦纳伊恩综合征的胃肠道血管畸形可表现为胃肠道出血。大多数脾血管瘤和/或下腔静脉左支患者无症状。我们在此报告一例因危及生命的血便和症状性缺铁性贫血而就诊于消化科的病例。由于无症状性间歇性血便、脾血管瘤和下腔静脉左支,该患者直到因大量胃肠道出血而就诊于我科时才寻求任何胃肠道出血的帮助。由于病情严重且药物治疗无效,该患者被转至血管造影。该方法显示,通过相应血管栓塞成功止血于出血部位。进一步的内镜检查显示,血管畸形从胃延伸至降结肠。另一方面,计算机断层扫描显示脾血管瘤和下腔静脉左支。据我们所知,这是首例克莱佩尔-特伦纳伊恩综合征伴胃肠道出血、脾血管瘤和下腔静脉左支的病例。我们对该病例的评估和管理的文献进行了回顾。