Monk J E, Smith B A, O'Leary J P
Department of Surgery, Baylor University Medical Center, Dallas, Tex. 75246.
South Med J. 1989 Jan;82(1):18-22. doi: 10.1097/00007611-198901000-00006.
Arteriovenous malformations of the small intestine are an uncommon cause of gastrointestinal hemorrhage. When we reviewed the records of 406 patients admitted to the hospital because of gastrointestinal blood loss, we found nine patients who had AVMs of the small intestine. We have developed an algorithm that presents a rational diagnostic approach to patients with hemorrhage from the small intestine. Single contrast barium roentgenograms were not helpful in this series. Endoscopy is not helpful unless the scope can be passed to the area of involvement. Arteriography is the most helpful diagnostic maneuver and should be considered early in the work-up for suspected intestinal AVMs. In addition, arteriography can be useful in localizing the precise area of bleeding so that resection can be limited to the involved areas.
小肠动静脉畸形是胃肠道出血的罕见原因。当我们查阅因胃肠道失血而入院的406例患者的记录时，发现有9例患者患有小肠动静脉畸形。我们制定了一种算法，为小肠出血患者提供了一种合理的诊断方法。在本系列研究中，单对比钡剂造影X线片并无帮助。除非内镜能通过到受累区域，否则内镜检查也无帮助。动脉造影是最有用的诊断手段，对于疑似肠道动静脉畸形的检查应尽早考虑。此外，动脉造影有助于定位出血的精确区域，以便手术切除可局限于受累区域。
