Fujii Takaaki, Morita Hiroki, Sutoh Toshinaga, Takada Takahiro, Tsutsumi Soichi, Kuwano Hiroyuki
Department of General Surgical Science, Gunma University Graduate School of Medicine, Maebashi, Japan.
Case Rep Gastroenterol. 2014 Oct 17;8(2):324-8. doi: 10.1159/000367591. eCollection 2014 Sep.
Gastrointestinal bleeding that originates in the small intestine is often difficult to diagnose. When successful diagnosis reveals a lesion that can be localized preoperatively, the laparoscopic approach is an appropriate and beneficial treatment modality for small bowel resection. A 69-year-old man presented with a 6-month history of gastrointestinal bleeding and symptomatic transfusion-dependent anemia. Upper and lower endoscopy were normal. Double-balloon endoscopy established the source of the bleeding as a 0.5-cm polypoid mass appearing as a submucosal tumor with redness and pulsation in the lower ileum, suggesting a vascular lesion. Laparoscopic small bowel resection was successful in removing the mass in the ileum. Histological evaluation of the mass revealed an arteriovenous malformation. Preoperative small bowel endoscopy can be useful for diagnosing the cause and localization of arteriovenous malformation in the small intestine.
源自小肠的胃肠道出血通常难以诊断。当成功诊断出可在术前定位的病变时，腹腔镜手术是小肠切除的一种合适且有益的治疗方式。一名69岁男性，有6个月胃肠道出血病史，并有依赖输血的症状性贫血。上消化道和下消化道内镜检查均正常。双气囊内镜检查确定出血源为回肠下段一个0.5厘米的息肉样肿物，表现为黏膜下肿瘤，伴有发红和搏动，提示血管病变。腹腔镜小肠切除术成功切除了回肠肿物。肿物的组织学评估显示为动静脉畸形。术前小肠内镜检查有助于诊断小肠动静脉畸形的病因和定位。
