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[空肠憩室所致消化道出血:一例报告及文献复习]

[Digestive bleeding due to jejunal diverticula: A case report and literature review].

作者信息

Blake-Siemsen Jorge Cuauhtémoc, Kortright-Farías Marisol, Casale-Menier Dante Rafael, Gámez-Araujo Jesús

机构信息

Servicio de Cirugía General y Aparato Digestivo, Hospital Ángeles Ciudad Juárez, Ciudad Juárez, Chihuahua,, México.

Servicio de Cirugía General y Aparato Digestivo, Hospital Ángeles Ciudad Juárez, Ciudad Juárez, Chihuahua,, México.

出版信息

Cir Cir. 2017 Dec;85 Suppl 1:34-39. doi: 10.1016/j.circir.2016.11.011. Epub 2017 Jan 3.

Abstract

BACKGROUND

Bleeding from the small bowel is a rare pathology that represents 5-10% of gastrointestinal bleeding; 0.06% to 5% of cases are due to the presence of diverticula of the small intestine. The majority of diverticula are asymptomatic and present symptoms when there is a complication.

CLINICAL CASE

We present the case of a 53-year-old male with a history of chronic renal failure and hypertension. While he was hospitalized due to cerebrovascular disease he recurrently presented lower gastrointestinal bleeding that required blood transfusion on several occasions. Upper gastrointestinal bleeding and colon bleeding were ruled out by endoscopy. It was not until an arteriography was performed that we identified bleeding at proximal jejunum level, and therefore we performed a laparotomy. We present the studies and management that the patient underwent.

CONCLUSION

Although jejunal diverticula are rare, they must be included in the differential diagnosis of lower gastrointestinal bleeding when present in a patient. Arteriography is a study of great use in locating the site, provided the bleeding is more than 0.5ml/minute.

摘要

背景

小肠出血是一种罕见的病理情况,占胃肠道出血的5%-10%;0.06%至5%的病例是由小肠憩室引起的。大多数憩室无症状,出现并发症时才会出现症状。

临床病例

我们报告一例53岁男性病例,有慢性肾衰竭和高血压病史。他因脑血管疾病住院期间反复出现下消化道出血,多次需要输血。经内镜检查排除了上消化道出血和结肠出血。直到进行了动脉造影,我们才确定在空肠近端水平有出血,因此进行了剖腹手术。我们介绍了患者所接受的检查和治疗。

结论

尽管空肠憩室罕见,但当患者出现时,必须将其纳入下消化道出血的鉴别诊断中。如果出血速度超过0.5毫升/分钟,动脉造影在定位出血部位方面非常有用。

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