Gong Eun Jeong, Kim Do Hoon, Jung Hwoon Yong, Choi Kee Don, Song Ho June, Lee Gin Hyug, Kim Jin Ho, Park Ho Seop
Asan Digestive Disease Research Institute, Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Korea.
Korean J Gastroenterol. 2014 Jan 25;63(1):42-6. doi: 10.4166/kjg.2014.63.1.42.
A 51-year-old man visited the tertiary-care hospital with a 2-week history of dizziness and dyspnea on exertion. The initial hemoglobin level was 5.8 g/dL, without any history of hematochezia or melena. The esophagogastroduodenoscopy (EGD) was normal. During colonoscopic preparation, the patient experienced hematochezia and became hypotensive. On angiography, no extravasation of contrast media was observed. A CT scan with angiography showed a small high-density area in the jejunal lumen, suggesting extravasation of the contrast media. Capsule endoscopy was performed, and oozing bleeding was suspected in the proximal to mid jejunum. The patient was referred to our hospital. Repeated EGD and CT enterography did not reveal any significant bleeding. An antegrade double balloon endoscopy was performed, and an approximately 2-cm-sized submucosal tumor with ulceration and a non-bleeding exposed vessel was observed in the mid jejunum. The presumed diagnosis was jejunal gastrointestinal stromal tumor. The mass was surgically resected, and the final histopathological diagnosis was arterio-venous malformation.
一名51岁男性因劳力性头晕和呼吸困难2周就诊于三级医疗机构。初始血红蛋白水平为5.8 g/dL，无便血或黑便病史。食管胃十二指肠镜检查（EGD）正常。在结肠镜检查准备过程中，患者出现便血并发生低血压。血管造影未观察到造影剂外渗。CT血管造影显示空肠腔内有一个小的高密度区，提示造影剂外渗。进行了胶囊内镜检查，怀疑空肠近端至中段有渗血。患者被转诊至我院。重复的EGD和CT小肠造影未发现任何明显出血。进行了顺行双气囊内镜检查，在空肠中段观察到一个大小约2 cm的黏膜下肿瘤，伴有溃疡和一条无出血的裸露血管。推测诊断为空肠胃肠道间质瘤。该肿物经手术切除，最终组织病理学诊断为动静脉畸形。
