Konno H, Sakaguchi S, Koizumi T, Aoki K
2nd Department of Surgery, Hamamatsu University, School of Medicine, Japan.
Nihon Geka Gakkai Zasshi. 1989 Aug;90(8):1266-9.
A case of the hemorrhagic gastric ulcer and post-operative stomal ulcer associated with the consumption coagulopathy in the dissecting aortic aneurysm is presented. A 68 year old man, who had diagnosed as having the dissecting aortic aneurysm (DeBakey III) in 1985 and had been attending to our hospital as an outpatient since then, was admitted to our hospital because of the hemorrhagic gastric ulcer on July 3rd, 1987. Although the wide resection of stomach was performed after the admission, the hemorrhagic stomal ulcer was developed 4 weeks after the operation. The administration of heparin in addition to antacids to improve the consumption coagulopathy, having been caused by thrombus formation in the aneurysm, was effective in control of the hemorrhage and also making the stomal ulcer scarred. It is suggested that ischemia of the stomach mucosa, which seemed to have been induced by the dissecting aortic aneurysm, was responsible for the development of the ulcers in this case and the hemorrhage from them was caused mainly by the consumption coagulopathy derived from thrombus formation in the aneurysm.
本文报告一例与主动脉夹层动脉瘤消耗性凝血病相关的出血性胃溃疡及术后吻合口溃疡。一名68岁男性，1985年被诊断为主动脉夹层动脉瘤（DeBakey III型），此后一直作为门诊患者在我院就诊。1987年7月3日，因出血性胃溃疡入住我院。入院后虽行胃大部切除术，但术后4周出现出血性吻合口溃疡。除使用抗酸剂外，加用肝素改善因动脉瘤内血栓形成所致的消耗性凝血病，对控制出血及促使吻合口溃疡瘢痕形成有效。提示本例中溃疡的发生可能是由于主动脉夹层动脉瘤导致胃黏膜缺血，而溃疡出血主要是由动脉瘤内血栓形成引起的消耗性凝血病所致。
