Uchida Daisuke, Kawai Yoshinari, Kato Hironari, Okada Hiroyuki
Department of Gastroenterology, Okayama University Hospital, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan.
Department of Gastroenterology, Onomichi Municipal Hospital, Hiroshima, Japan.
Clin J Gastroenterol. 2019 Aug;12(4):301-306. doi: 10.1007/s12328-019-00942-6. Epub 2019 Jan 29.
A 74-year-old man presented to the emergency department with acute abdominal pain in addition to anemia and melena, which were suspected to be due to gastrointestinal bleeding. Computed tomography (CT) revealed a blood-filled duodenum and acute pancreatitis. We prioritized treatments for pancreatitis, as the vital signs were stable, and temporary hemostasis was achieved. Two days later, esophagogastroduodenoscopy revealed a duodenal ulcer with an exposed vessel, and endoscopic hemostasis was performed. We urge clinicians to consider the possibility of pancreatitis associated with massive bleeding due to a duodenal ulcer.
一名74岁男性因急性腹痛、贫血和黑便就诊于急诊科，怀疑是胃肠道出血所致。计算机断层扫描（CT）显示十二指肠积血和急性胰腺炎。由于生命体征稳定，我们优先治疗胰腺炎，并实现了暂时止血。两天后，食管胃十二指肠镜检查发现十二指肠溃疡并有血管外露，遂进行了内镜止血。我们敦促临床医生考虑十二指肠溃疡伴大量出血相关胰腺炎的可能性。
