Mukthinuthalapati V V Pavan Kedar, Attar Bashar, Mutneja Hemant, Syed Moinuddin, Gandhi Seema
Division of Internal Medicine, John H. Stroger Jr. Hospital of Cook County, Chicago, IL.
Division of Gastroenterology, John H. Stroger Jr. Hospital of Cook County, Chicago, IL.
ACG Case Rep J. 2018 Oct 24;5:e76. doi: 10.14309/crj.2018.76. eCollection 2018.
A 53-year-old man presented with melena 3 months after microwave ablation of a renal mass. Esophago-gastroduodenoscopy and radiological imaging revealed that a fistulous tract extended from the duodenum to the right kidney. The patient had a hemorrhage that originated from a branch of the renal artery and bled through the fistulous tract into the duodenal lumen. Angiography was used in the successful coiling of the bleeding vessel to control the bleeding. Consideration of a fistulous tract as a source of gastrointestinal bleeding should be included in a clinician's differential diagnosis when dealing with patients who had a recent ablative procedure.
一名53岁男性在肾肿块微波消融术后3个月出现黑便。食管胃十二指肠镜检查和影像学检查显示,一条瘘管从十二指肠延伸至右肾。患者出血源自肾动脉的一个分支,通过瘘管流入十二指肠腔。血管造影成功地对出血血管进行了栓塞以控制出血。在处理近期接受过消融手术的患者时,临床医生的鉴别诊断应考虑瘘管作为胃肠道出血的一个来源。