van Noord Désirée, Mensink Peter B, Ter Borg Pieter C, Pattynama Peter M, Verhagen Hence J, Kuipers Ernst J
Erasmus MC - University Medical Center, Gastroenterology and Hepatology, Gravendijkwal 230, Rotterdam, 3015 CE, Netherlands.
BMJ Case Rep. 2009;2009. doi: 10.1136/bcr.07.2008.0501. Epub 2009 Mar 5.
The classical triad of postprandial pain, weight loss and an abdominal bruit is thought to be the most common presentation of chronic gastrointestinal ischaemia. We describe a patient with severe diarrhoea as an uncommon presenting symptom of small bowel ischaemia, suggesting a mesenteric steal phenomenon due to a significant atherosclerotic coeliac artery stenosis. The stenosis and concomitant steal effect was successfully treated by stent placement. The latter is supported by the patient's uneventful course after stent placement. This case illustrates that chronic gastrointestinal ischaemia has to be considered in patients with otherwise unexplained diarrhoea.
餐后疼痛、体重减轻和腹部血管杂音的经典三联征被认为是慢性胃肠道缺血最常见的表现。我们描述了一名患者,其以严重腹泻作为小肠缺血的罕见表现症状,提示由于显著的动脉粥样硬化性腹腔动脉狭窄导致的肠系膜盗血现象。通过支架置入成功治疗了狭窄及伴随的盗血效应。支架置入后患者病情平稳支持了这一治疗效果。该病例表明,对于腹泻原因不明的患者必须考虑慢性胃肠道缺血。