一例罕见的大量胃肠道出血病例。
A unique case of massive gastrointestinal bleeding.
作者信息
Kida Akihiko, Matsuda Koichiro, Matsuda Mitsuru, Sakai Akito, Noda Yatsugi
机构信息
Department of Internal Medicine, Toyama Prefectural Central Hospital, Toyama City, Japan.
出版信息
SAGE Open Med Case Rep. 2017 Mar 17;5:2050313X17700345. doi: 10.1177/2050313X17700345. eCollection 2017.
OBJECTIVES
Lipomas are the second most common benign tumors of the small bowel, and most lipomas are asymptomatic. However, lipomas with diameters of >20 mm tend to be symptomatic, for example, to cause bleeding, obstructive jaundice, abdominal pain, intestinal obstruction, intussusception, and/or perforation.
METHODS/RESULTS: We report a case of massive gastrointestinal bleeding from a jejunal lipoma combined with intussusception. A preoperative diagnosis of gastrointestinal bleeding derived from a jejunal lipoma combined with intussusception was made based on double-balloon enteroscopy and contrast-enhanced computed tomography, and partial resection of the small intestine was performed. After surgery, there was no additional gastrointestinal bleeding.
CONCLUSION
There have only been a few reports about cases of jejunal lipoma involving simultaneous bleeding and intussusception. Double-balloon enteroscopy is useful for preoperatively diagnosing bleeding from a lipoma. Our case highlights that jejunal lipoma can cause massive unexplained gastrointestinal bleeding.
目的
脂肪瘤是小肠第二常见的良性肿瘤，大多数脂肪瘤无症状。然而，直径>20毫米的脂肪瘤往往有症状，例如引起出血、梗阻性黄疸、腹痛、肠梗阻、肠套叠和/或穿孔。
方法/结果：我们报告一例空肠脂肪瘤合并肠套叠导致大量胃肠道出血的病例。基于双气囊小肠镜检查和增强计算机断层扫描，术前诊断为源于空肠脂肪瘤合并肠套叠的胃肠道出血，并进行了小肠部分切除术。术后未再发生胃肠道出血。
结论
关于空肠脂肪瘤同时合并出血和肠套叠的病例报告仅有少数。双气囊小肠镜检查有助于术前诊断脂肪瘤出血。我们的病例突出表明空肠脂肪瘤可导致大量不明原因的胃肠道出血。
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