内镜活检后表现为上消化道血肿和溃疡的嗜酸性粒细胞性胃肠炎：一例报告及文献复习
Eosinophilic gastroenteritis presenting as upper gastrointestinal hematoma and ulcers after endoscopic biopsy: A case report and literature review.
作者信息
Chen Biqin, Yang Zhao, Lu Heng, Wei Cheng, Wang Fangyu, Liu Chang
机构信息
Department of Gastroenterology and Hepatology, Jinling Hospital, School of Medicine, Southern Medical University Department of Gastroenterology and Hepatology, Jinling Hospital Department of Gastroenterology and Hepatology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, Jiangsu, China.
出版信息
Medicine (Baltimore). 2017 Sep;96(37):e8075. doi: 10.1097/MD.0000000000008075.
RATIONALE
Eosinphilic gastroenteritis (EG) is a gastrointestinal disorder characterized by eosinophilic infiltration with various manifestations. The diagnosis is usually confirmed by an endoscopic biopsy, which is considered a safe and routine procedure for the majority.
PATIENT CONCERNS
We report a 54-year-old male who was presented with intermittent periumbilical pain and melena, and only revealed verrucous gastritis by endoscopy.
DIAGNOSES
The patient's condition worsened two days after the endoscopic biopsy, and another endoscopy found hematoma and ulcers in upper gastrointestinal tract. He was diagnosed with EG by the pathological analysis of biopsy specimen.
INTERVENTIONS
Oral methylprednisolone and Montelukast were prescribed.
OUTCOMES
The patient got remission after initiation of the treatment.
LESSONS
This case highlights an extremely rare but potentially severe complication of endoscopic biopsies in patients with EG. Physicians should be cautious with hematoma or ulceration, and consider it in such patients who undergo this procedure.
理论依据
嗜酸性粒细胞性胃肠炎（EG）是一种以嗜酸性粒细胞浸润为特征且有多种表现的胃肠道疾病。诊断通常通过内镜活检来确认，对于大多数人来说，这被认为是一种安全的常规检查。
患者情况
我们报告一名54岁男性，他出现间歇性脐周疼痛和黑便，内镜检查仅发现疣状胃炎。
诊断
内镜活检两天后患者病情恶化，再次内镜检查发现上消化道有血肿和溃疡。通过活检标本的病理分析，他被诊断为EG。
干预措施
开具了口服甲泼尼龙和孟鲁司特。
结果
治疗开始后患者病情缓解。
经验教训
该病例突出了EG患者内镜活检一种极其罕见但可能严重的并发症。医生应对血肿或溃疡保持警惕，并在接受该检查的此类患者中加以考虑。
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