Matsuoka Wakato, Kaku Noriyuki, Hirata Yuichiro, Lee Sooyoung, Akahoshi Tomohiko, Sugimori Hiroshi, Hayashida Makoto, Souzaki Ryota, Fujita Norihiro, Asayama Yoshiki, Taguchi Tomoaki, Takada Hidetoshi, Maehara Yoshihiko
Emergency and Critical Care Center Kyushu University Hospital Fukuoka Japan.
Department of Pediatrics Graduate School of Medical Sciences Kyushu University Fukuoka Japan.
Acute Med Surg. 2016 May 13;3(4):415-418. doi: 10.1002/ams2.213. eCollection 2016 Oct.
CASE: We report a 2-year-old boy with duodenal ulcer with active bleeding that occurred as a result of norovirus gastroenteritis. On admission, the patient presented with shock accompanied with vomiting and melena. Abdominal contrast enhanced computed tomography scan showed signs of duodenal bleeding. OUTCOME: He was successfully treated with emergent transcatheter arterial embolization. After the treatment, endoscopic examination revealed duodenal ulcer and the stool norovirus antigen test was found to be positive. The patient recovered completely without any sequelae. CONCLUSION: Life-threatening duodenal ulcer bleeding in children can be caused by viral gastroenteritis. When endoscopic therapy is unsuccessful or difficult, in cases of small children, angiographic intervention can be a safe alternative treatment option of gastrointestinal bleeding.
病例:我们报告一名2岁男孩,因诺如病毒肠胃炎引发十二指肠溃疡并伴有活动性出血。入院时,患者出现休克并伴有呕吐和黑便。腹部增强CT扫描显示十二指肠出血迹象。 结果:他通过紧急经导管动脉栓塞术成功治愈。治疗后,内镜检查发现十二指肠溃疡,粪便诺如病毒抗原检测呈阳性。患者完全康复,无任何后遗症。 结论:儿童危及生命的十二指肠溃疡出血可能由病毒性肠胃炎引起。当内镜治疗不成功或困难时,对于小儿病例,血管造影介入可作为胃肠道出血的一种安全替代治疗选择。
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