Mansoor Muhammad Sohail, Usmani Ashar
Yale-New Haven Hospital, New Haven, USA.
Conn Med. 2013 Oct;77(9):529-32.
The most common etiologies of lower gastrointestinal bleeding include ischemia, diverticulosis, and angiodysplasia. A Dieulafoy's lesion, an uncommon cause of upper gastrointestinal bleeding, is even more rare as an etiology of lower gastrointestinal bleeding. We report a case of an elderly patient with abrupt hematochezia requiring stabilization and blood transfusions. The presumptive diagnosis was diverticulosis or an arteriovenous malformation, but colonoscopy revealed that the source of bleeding was a Dieulafoy's lesion in the ascending colon. The lesion was injected with epinephrine, followed by placement of clips to achieve hemostasis. There were no subsequent interventions and the patient was safely discharged.
下消化道出血最常见的病因包括缺血、憩室病和血管发育异常。Dieulafoy病是上消化道出血的罕见病因，作为下消化道出血的病因则更为罕见。我们报告一例老年患者，突发便血，需要进行稳定治疗和输血。初步诊断为憩室病或动静脉畸形，但结肠镜检查显示出血源是升结肠的Dieulafoy病损。对病损注射肾上腺素，随后放置夹子以实现止血。此后未进行其他干预，患者安全出院。
