Janicki Adam, Van Ginkel Chad, Cohn Jamieson
Department of Emergency Medicine, Alpert Medical School of Brown University, Providence, RI.
R I Med J (2013). 2015 Sep 1;98(9):45-6.
In order to provide appropriate and timely treatment for an acute gastrointestinal bleed, it is vital to determine the site of hemorrhage. Historical clues and exam may be insufficient to differentiate upper from lower gastrointestinal bleeds and clinicians may utilize nasogastric lavage for diagnostic clarity. Nasogastric tube placement is a common procedure in the Emergency Department and is often viewed as benign. We present a patient presenting with hematochezia that developed pneumoperitineum secondary to nasogastric tube perforation of the gastric wall and discuss the literature regarding gastric lavage in the setting of gastrointestinal bleed.
为了对急性胃肠道出血进行恰当且及时的治疗,确定出血部位至关重要。病史线索和体格检查可能不足以区分上消化道出血和下消化道出血,临床医生可能会采用鼻胃管灌洗来明确诊断。鼻胃管置入是急诊科常见的操作,通常被视为无害。我们报告了一名出现便血的患者,该患者因鼻胃管导致胃壁穿孔而继发气腹,并讨论了在胃肠道出血情况下有关胃灌洗的文献。