Okuyama Yusuke, Kawakami Takumi, Ito Haruki, Otsuka Hirotomo, Enoki Yasuyuki, Nishimura Masahito, Yoshida Norimasa, Fujimoto Sotaro
Department of Gastroenterology, Toujinkai Hospital, Kyoto, Akashi, Japan.
Case Rep Gastroenterol. 2011 May;5(2):278-82. doi: 10.1159/000328442. Epub 2011 May 6.
A 74-year-old woman was admitted to our hospital with upper abdominal pain and bloody vomiting. An abdominal aneurysm compressed the third portion of the duodenum and the second portion of duodenum was distended with thickened walls as in superior mesenteric artery syndrome. Endoscopic examination showed an edematous mucosa with hemorrhagic erosions, shallow longitudinal ulcers, and star-shaped ulcers in the duodenum. We diagnosed this case as ischemic duodenitis associated with superior mesenteric artery syndrome caused by compression by an abdominal aortic aneurysm. The symptoms improved on treatment with bowel rest, total parenteral nutrition and administration of a proton pump inhibitor. We present here a rare case of ischemic duodenitis and summarize the previous medical literature on the disease.
一名74岁女性因上腹部疼痛和血性呕吐入院。腹主动脉瘤压迫十二指肠第三部,十二指肠第二部扩张,壁增厚,类似肠系膜上动脉综合征。内镜检查显示十二指肠黏膜水肿,有出血性糜烂、浅纵行溃疡和星形溃疡。我们将该病例诊断为与腹主动脉瘤压迫导致的肠系膜上动脉综合征相关的缺血性十二指肠球炎。经肠道休息、全胃肠外营养及质子泵抑制剂治疗后症状改善。我们在此报告一例罕见的缺血性十二指肠球炎病例,并总结该病既往医学文献。