Cavallero M, Pennazio M, Bertone A, Gemme C, Loverci C, Risio M, Spandre M, Rossini F P
Ospedale San Giovanni Antica Sede, Dipartimento di Oncologia, Torino.
Minerva Dietol Gastroenterol. 1990 Jan-Mar;36(1):47-50.
The paper reports a case of a 45-year-old female with long-standing anemia, recurrent abdominal pain and subocclusive crises. Following a negative endoscopy of the upper tract of the large intestine, barium enema and angiography, the patient underwent total colonoscopy. Massive bleeding from the ileal valve suggested an ileal pathology: a small intestine enema confirmed a polypoid proliferation 60 cm above the Bahuino valve with related ileal invagination 25 cm long. The patient underwent surgery and pathological findings revealed a 7 cm-wide ileal lipoma near a small angiodysplasia. The latter seemed to be the cause of bleeding. The diagnosis of small intestine tumours is made difficult by the fact that the only important signs are abdominal pain, intestinal bleeding and subocclusive crises, which are common symptoms in many pathologies. The authors stress the importance of a thorough endoscopic examination and selective angiography.
该论文报告了一例45岁女性病例，患者长期贫血、反复腹痛且有亚闭塞性危象。在大肠上段内镜检查、钡剂灌肠和血管造影均为阴性后，患者接受了全结肠镜检查。回肠瓣膜大量出血提示回肠病变：小肠灌肠证实距巴惠诺瓣膜上方60厘米处有息肉样增生，并伴有25厘米长的相关回肠套叠。患者接受了手术，病理检查结果显示在一个小血管发育异常附近有一个7厘米宽的回肠脂肪瘤。后者似乎是出血的原因。小肠肿瘤的诊断存在困难，因为唯一重要的体征是腹痛、肠道出血和亚闭塞性危象，而这些是许多疾病的常见症状。作者强调了全面内镜检查和选择性血管造影的重要性。
