Isono Yoshiaki, Baba Youichirou, Saito Tomonori, Kumazawa Hiroaki, Tanaka Hiroki, Matsusaki Shimpei, Sase Tomohiro, Okano Hiroshi, Mukai Katsumi
Department of Gastroenterology, Suzuka General Hospital.
Nihon Shokakibyo Gakkai Zasshi. 2015 Oct;112(10):1830-5. doi: 10.11405/nisshoshi.112.1830.
A 73-year-old man with a history of tarry stools was admitted to our hospital. Gastroduodenoscopy on admission revealed an ulcer with an exposed vessel at the duodenal bulb. During endoscopic clipping for prevention of re-bleeding, a large amount of bleeding from the vessel was observed. Hemostasis was achieved after the procedure. However, 7 days later, the patient passed a large amount of tarry stools and experienced hypovolemic shock. Endoscopic re-examination revealed a pulsatile aneurysmal vessel at the base of the duodenal ulcer. Abdominal contrast-enhanced computed tomography and abdominal angiography demonstrated an aneurysm of the gastroduodenal artery, which was successfully treated with transcatheter arterial embolization. Thus, here we report a rare case of an aneurysm of the gastroduodenal artery caused by a duodenal ulcer.
一名有黑便病史的73岁男性入住我院。入院时的胃十二指肠镜检查显示十二指肠球部有一个溃疡,有血管暴露。在内镜下夹闭以预防再次出血的过程中,观察到血管大量出血。术后实现了止血。然而,7天后,患者排出大量黑便并发生低血容量性休克。内镜复查显示十二指肠溃疡底部有一个搏动性动脉瘤样血管。腹部增强计算机断层扫描和腹部血管造影显示胃十二指肠动脉动脉瘤,经导管动脉栓塞成功治疗。因此,我们在此报告一例由十二指肠溃疡引起的胃十二指肠动脉动脉瘤罕见病例。