Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan.
Surg Today. 2010 Nov;40(11):1088-92. doi: 10.1007/s00595-009-4180-9. Epub 2010 Nov 3.
Small intestinal bleeding is difficult to detect and can be life-threatening. Capsule endoscopy (CE) is a new, minimally invasive diagnostic procedure designed to detect gastrointestinal (GI) bleeding. We report the successful management of idiopathic ileal varices by capsule endoscopy and laparoscopic surgery. Massive bleeding occurred suddenly with intermittent melena, and the patient was finally admitted to a local hospital in hypovolemic shock. Her condition was stabilized with conservative therapy but the site of bleeding was not defined by endoscopy, computed tomography, scintigraphy, or angiography. Thus, she was transferred to our hospital. On admission, CE revealed idiopathic ileal varices, so we performed laparoscopic partial ileal resection immediately. Follow-up CE has shown no evidence of recurrence in the 2 years since surgery. Idiopathic ileal varices are rare, difficult to diagnose, and often fatal. Capsule endoscopy is a minimally invasive diagnostic procedure that detects this disorder in time for laparoscopic surgery to be performed effectively and safely.
小肠出血难以检测，可能危及生命。胶囊内镜（CE）是一种新的微创诊断程序，旨在检测胃肠道（GI）出血。我们报告了通过胶囊内镜和腹腔镜手术成功治疗特发性回肠静脉曲张。大量出血突然发生，间歇性黑便，患者最终因低血容量休克入住当地医院。通过保守治疗稳定了患者的病情，但内镜、计算机断层扫描、闪烁扫描或血管造影均未确定出血部位。因此，她被转至我院。入院时，CE 显示特发性回肠静脉曲张，因此我们立即进行了腹腔镜部分回肠切除术。手术后 2 年的随访 CE 未显示复发迹象。特发性回肠静脉曲张罕见，难以诊断，且常致命。胶囊内镜是一种微创诊断程序，可及时发现这种疾病，以便有效、安全地进行腹腔镜手术。
