Department of Internal Medicine, Kiryu Kosei General Hospital, Kiryu, Japan.
J Gastrointestin Liver Dis. 2011 Dec;20(4):435-8.
Endoscopic hemostasis is a useful treatment modality for gastric ulcer bleeding. However, it is sometimes difficult to achieve hemostasis in cases with arterial bleeding, especially those complicated with vascular abnormalities. We describe a case with gastric ulcer bleeding from a variant left gastric artery accompanied by congenital absence of the splenic artery. A 50-year-old female was admitted to our hospital with dizziness and tarry stools. Upper gastrointestinal endoscopy revealed bleeding from a gastric ulcer, and endoscopic hemostasis by endoscopic clipping was carried out. Computed tomography and abdominal angiography revealed the variant left gastric artery running below the gastric ulcer. In spite of endoscopic hemostasis and medication, re-bleeding from the gastric ulcer occurred. A transcatheter coil embolization for the variant left gastric artery was performed and successfully achieved hemostasis. This case was accompanied by congenital absence of the splenic artery, which is an extremely rare condition. We herein describe this rare case and review previously reported cases.
内镜止血是治疗胃溃疡出血的有效方法。然而,对于动脉性出血,尤其是伴有血管异常的病例,有时难以达到止血效果。我们描述了一例由变异左胃动脉引起的胃溃疡出血,同时伴有脾动脉先天性缺失。一名 50 岁女性因头晕和柏油样便而入院。上消化道内镜检查显示胃溃疡出血,并进行了内镜夹闭止血。计算机断层扫描和腹部血管造影显示变异左胃动脉在胃溃疡下方运行。尽管进行了内镜止血和药物治疗,但胃溃疡仍再次出血。对变异左胃动脉进行了经导管线圈栓塞治疗,并成功止血。该病例同时伴有脾动脉先天性缺失,这是一种极其罕见的情况。我们在此描述这一罕见病例,并回顾以往报道的病例。
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