Kelay Arun, Morgan-Rowe Luke, Constantinou Jason, Malago Massimo, Ivancev Krassi
Department of Vascular Surgery, Royal Free London NHS Foundation Trust, London, England.
Department of Vascular Surgery, Royal Free London NHS Foundation Trust, London, England.
Ann Vasc Surg. 2016 Feb;31:209.e11-5. doi: 10.1016/j.avsg.2015.09.020. Epub 2015 Dec 2.
Midgut carcinoid tumors (MCTs) are responsible for a range of mesenteric vascular complications and may rarely manifest with gastrointestinal (GI) hemorrhage. Endovascular approaches are particularly useful for this population, as surgery is often technically difficult. We report a case of life-threatening upper GI bleeding in a 50-year-old man previously diagnosed with an MCT in the small bowel mesentery. Computed tomography angiogram revealed an MCT obstructing the superior mesenteric vein (SMV) associated with multiple large collateral vessels. The patient underwent retrograde stenting of the obstructed SMV using a combined open and endovascular approach to successfully terminate the persistent GI bleeding.
中肠类癌肿瘤（MCTs）可引发一系列肠系膜血管并发症，且很少表现为胃肠道（GI）出血。血管内治疗方法对这类患者尤为有用，因为手术在技术上往往具有挑战性。我们报告一例50岁男性患者，此前被诊断为小肠系膜MCT，出现危及生命的上消化道出血。计算机断层血管造影显示一个MCT阻塞了肠系膜上静脉（SMV），并伴有多条粗大的侧支血管。该患者采用开放手术与血管内治疗相结合的方法，对阻塞的SMV进行逆行支架置入，成功终止了持续的胃肠道出血。
