Koh Fang Ju, Khor Jen Lock, Chew Min Hoe
Department of Colorectal Surgery, Singapore General Hospital, 1 Hospital Drive, Singapore.
Department of Gastroenterology, Singapore General Hospital, 1 Hospital Drive, Singapore.
Int J Surg Case Rep. 2017;41:277-279. doi: 10.1016/j.ijscr.2017.10.056. Epub 2017 Nov 6.
Small bowel diverticulosis is rare with an incidence of 1-2% in the general population. It is an uncommon cause of gastrointestinal bleeding that ranges from obscure to overt bleeding. Large ileal diverticula are extremely rare and bleeding complications can result in high overall mortality. A young gentleman presented with persistent per-rectal bleeding and drop in hemoglobin level. He was recently diagnosed with acute myeloid leukemia and was undergoing chemotherapy. A computed tomography scan of the abdomen and pelvis revealed a giant ileal diverticulum. In view of on-going bleeding, he underwent double balloon enteroscopy which revealed active bleeding from an ulcer within the giant ileal diverticulum and successful hemostasis was performed with hemostatic clips. Small bowel diverticulosis though uncommon has to be considered during workup for gastrointestinal bleeding. Endoscopic treatment is a modern approach towards small bowel diverticular bleeding that is effective and less invasive.
小肠憩室病较为罕见，在普通人群中的发病率为1%-2%。它是胃肠道出血的一种不常见原因，出血情况从隐匿性到显性不等。大的回肠憩室极为罕见，出血并发症可导致较高的总体死亡率。一名年轻男性出现持续性直肠出血和血红蛋白水平下降。他最近被诊断出患有急性髓系白血病，正在接受化疗。腹部和盆腔的计算机断层扫描显示有一个巨大的回肠憩室。鉴于持续出血，他接受了双气囊小肠镜检查，结果显示巨大回肠憩室内的一个溃疡有活动性出血，使用止血夹成功止血。小肠憩室病虽然不常见，但在对胃肠道出血进行检查时必须予以考虑。内镜治疗是治疗小肠憩室出血的一种现代方法，有效且侵入性较小。
