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小肠憩室伴出血:病例报告及文献综述

Small intestinal diverticulum with bleeding: Case report and literature review.

作者信息

Zhao Lifang, Lu Wei, Sun Yinping, Liang Junrong, Feng Shanshan, Shi Yongquan, Wu Qiong, Wang Jianhong, Wu Kaichun

机构信息

Emergency Room of Digestive Diseases, National Clinical Research Center for Digestive Diseases and Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an The Outpatient Internal Medicine Department of Beijing Veteran Cadre Service Administration, Central Military Commission Logistics Support Department, Beijing, China.

出版信息

Medicine (Baltimore). 2018 Mar;97(9):e9871. doi: 10.1097/MD.0000000000009871.

Abstract

RATIONALE

Small intestinal diverticulum with bleeding is an important reason for obscure gastrointestinal bleeding (OGB) , in addition to tumor and vascular diseases. Small intestinal diverticulum with bleeding is difficult to detect by barium meal and angiographic methods and has been regarded as an important cause of obscure gastrointestinal tract bleeding in adolescents. Because of its complicated etiology and non-specific clinical manifestations, it is relatively difficult to detect small intestinal diverticulum with bleeding, especially in patients with a large amount of bleeding and hemodynamic instability.

PATIENT CONCERNS

This retrospective study collects clinical statistics of 19 patients admitted to our hospital from January 2010 to December 2016. Patients who had small intestinal diverticulum patients with bleeding were included in this study. Patients who were taking anticoagulants were excluded DIAGNOSES:: Small intestinal diverticulum patients with bleeding.

INTERVENTIONS

This retrospective study describes the clinical features of patients with small intestinal diverticulum whose main symptom was gastrointestinal bleeding and analyze the literature on this topic, with particular reference to the clinical characteristics, pathological features, and choice of examination methods.

LESSONS

Small intestinal diverticulum with bleeding is a common cause of obscure gastrointestinal bleeding, but it is difficult to detect using normal examination methods. For patients with repeated gastrointestinal bleeding and no positive results found on gastroscopy and colonoscopy, endoscopy of the small intestine and CTE with contrast can be considered as a diagnostic modality.

摘要

理论依据

除肿瘤和血管疾病外,小肠憩室伴出血是不明原因消化道出血(OGB)的重要原因。小肠憩室伴出血通过钡餐和血管造影方法难以检测,一直被视为青少年不明原因消化道出血的重要原因。由于其病因复杂且临床表现不具特异性,检测伴出血的小肠憩室相对困难,尤其是对于大量出血和血流动力学不稳定的患者。

患者情况

本回顾性研究收集了2010年1月至2016年12月期间我院收治的19例患者的临床统计数据。纳入本研究的患者为患有小肠憩室伴出血的患者。排除正在服用抗凝剂的患者。

诊断

小肠憩室伴出血患者。

干预措施

本回顾性研究描述了以消化道出血为主要症状的小肠憩室患者的临床特征,并分析了关于该主题的文献,特别提及了临床特征、病理特征和检查方法的选择。

经验教训

小肠憩室伴出血是不明原因消化道出血的常见原因,但使用常规检查方法难以检测。对于反复消化道出血且胃镜和结肠镜检查无阳性结果的患者,可考虑小肠内镜检查和增强CTE作为诊断方式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ebd/5851745/b10e9f74668a/medi-97-e9871-g002.jpg

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Many faces of Meckel's diverticulum and its complications.梅克尔憩室及其并发症的多面性。
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