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肠道静脉畸形的外科急症

Surgical Emergencies in Intestinal Venous Malformations.

作者信息

Romo Muñoz Martha Isabel, Bueno Alba, De La Torre Carlos, Cerezo Vanesa Nuñez, Rebolledo Bryant Noriega, Cervantes Manuel Gomez, Dore Mariela, Gomez Javier Jimenez, Santamaria Manuel Lopez, Martinez Leopoldo, Lopez-Gutierrez Juan Carlos

机构信息

Department of Pediatric Surgery, Hospital Universitario La Paz, Madrid, Spain.

Department of Anesthesia, Hospital Universitario La Paz, Madrid, Spain.

出版信息

Eur J Pediatr Surg. 2018 Feb;28(1):101-104. doi: 10.1055/s-0037-1606846. Epub 2017 Sep 25.

Abstract

BACKGROUND

Venous malformations (VMs) can occur in any part of the body; however, the gastrointestinal tract is a frequent location. These are usually asymptomatic, thus, representing a challenge to diagnosis. Intestinal location of VMs can be associated with severe complications that ultimately require an emergency surgery. Our aim was to analyze all patients with an intestinal VM with special focus on those who required emergency surgery.

MATERIALS AND METHODS

A retrospective study of patients presenting complication caused by intestinal VM was performed. Clinical records, associated anomalies, physical findings, and treatment were assessed.

RESULTS

Twenty-one patients had a diagnosis of intestinal VM, 16 (76%) were associated to blue rubber bleb nevus syndrome (BRBNS) and 5 (24%) were isolated. Only four (19%) of the total cases presented an episode of acute abdomen with hemodynamic instability that required an emergency surgery. Findings included two gastrointestinal bleedings, one volvulus, and one intussusception of small bowel. All patients underwent an uneventful recovery and are presently doing well.

CONCLUSION

Intestinal VM can be challenging to diagnose in emergency situations, such as gastrointestinal situation or acute abdomen. The complications associated with it must be kept in mind, regardless of its low incidence.

摘要

背景

静脉畸形(VMs)可发生于身体的任何部位;然而,胃肠道是常见的发病部位。这些通常无症状,因此对诊断构成挑战。VMs发生于肠道时可伴有严重并发症,最终需要进行急诊手术。我们的目的是分析所有肠道VM患者,特别关注那些需要急诊手术的患者。

材料与方法

对因肠道VM引起并发症的患者进行回顾性研究。评估临床记录、相关异常、体格检查结果和治疗情况。

结果

21例患者被诊断为肠道VM,其中16例(76%)与蓝色橡皮疱痣综合征(BRBNS)相关,5例(24%)为孤立性。所有病例中只有4例(19%)出现伴有血流动力学不稳定的急腹症发作,需要进行急诊手术。表现包括2例胃肠道出血、1例肠扭转和1例小肠套叠。所有患者术后恢复顺利,目前情况良好。

结论

在诸如胃肠道情况或急腹症等紧急情况下,肠道VM的诊断可能具有挑战性。无论其发病率如何,都必须牢记与之相关的并发症。

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