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不明原因胃肠道出血的诊断与处理

Diagnosis and management of obscure gastrointestinal bleeding.

作者信息

Tarin D, Allison D J, Modlin I M, Neale G

出版信息

Br Med J. 1978 Sep 9;2(6139):751-4. doi: 10.1136/bmj.2.6139.751.

DOI:10.1136/bmj.2.6139.751
PMID:308828
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1607610/
Abstract

Twelve consecutive patients presenting with unexplained recurrent gastrointestinal bleeding were investigated by selective visceral angiography. A cause for the bleeding was shown in all 12 cases, and in eight the lesion responsible was diagnosed radiologically as an area of angiodysplasia. Abnormal areas were pinpointed by fluoroscopy and examination of the resected bowel with a dissecting microscope after injecting the vessels with barium. Histologically these areas had various microvascular abnormalities. Angiodysplasia is a useful descriptive radiological term, but does not seem to represent a single pathological entity.

摘要

对12例不明原因复发性胃肠道出血的连续患者进行了选择性内脏血管造影检查。所有12例均显示出出血原因,其中8例经放射学诊断,出血病变为血管发育异常区域。通过荧光透视定位异常区域,并在向血管内注入钡剂后,用解剖显微镜检查切除的肠段。组织学上,这些区域有各种微血管异常。血管发育异常是一个有用的描述性放射学术语,但似乎并不代表单一的病理实体。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a3d/1607610/1c15e52d342b/brmedj00143-0043-c.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a3d/1607610/ded87f48dcb9/brmedj00143-0042-a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a3d/1607610/0c322f3ffec6/brmedj00143-0042-b.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a3d/1607610/9abeb67ba73d/brmedj00143-0043-a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a3d/1607610/a3976140daf8/brmedj00143-0043-b.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a3d/1607610/1c15e52d342b/brmedj00143-0043-c.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a3d/1607610/ded87f48dcb9/brmedj00143-0042-a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a3d/1607610/0c322f3ffec6/brmedj00143-0042-b.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a3d/1607610/9abeb67ba73d/brmedj00143-0043-a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a3d/1607610/a3976140daf8/brmedj00143-0043-b.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a3d/1607610/1c15e52d342b/brmedj00143-0043-c.jpg

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1
Diagnosis and management of obscure gastrointestinal bleeding.不明原因胃肠道出血的诊断与处理
Br Med J. 1978 Sep 9;2(6139):751-4. doi: 10.1136/bmj.2.6139.751.
2
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引用本文的文献

1
Angiodysplasias of the colon.结肠血管发育异常
J Clin Pathol. 1982 Aug;35(8):824-9. doi: 10.1136/jcp.35.8.824.
2
Gastric angiodysplasia in an elderly man.一名老年男性的胃血管发育异常
J R Soc Med. 1981 Aug;74(8):624-5. doi: 10.1177/014107688107400814.
3
Massive bleeding from the large bowel.大肠大量出血。

本文引用的文献

1
The preoperative radiographic demonstration of intra-abdominal bleeding from undetermined sites by percutaneous selective celiac and superior mesenteric arteriography.术前通过经皮选择性腹腔动脉造影和肠系膜上动脉造影对不明部位的腹腔内出血进行影像学显示。
Surgery. 1965 Nov;58(5):797-805.
2
Angiodysplasia of the cecum: colonoscopic diagnosis.盲肠血管发育异常:结肠镜诊断
Gastrointest Endosc. 1976 Feb;22(3):177-9. doi: 10.1016/s0016-5107(76)73741-6.
3
On the nature and etiology of vascular ectasias of the colon. Degenerative lesions of aging.
Br Med J. 1980 May 31;280(6227):1320-1. doi: 10.1136/bmj.280.6227.1320-b.
4
Angiodysplasia--an uncommon cause of colonic bleeding: colonoscopic evaluation of 1,050 patients with rectal bleeding and anaemia.血管发育异常——结肠出血的罕见原因:对1050例直肠出血和贫血患者的结肠镜检查评估
Int J Colorectal Dis. 1987 Nov;2(4):218-22. doi: 10.1007/BF01649509.
5
Preoperative and intraoperative localisation of gastrointestinal bleeding of obscure origin.不明原因胃肠道出血的术前及术中定位
Gut. 1987 Jul;28(7):869-77. doi: 10.1136/gut.28.7.869.
6
The importance of laparotomy in the diagnosis and management of intestinal bleeding of obscure origin.剖腹探查术在不明原因肠道出血的诊断和治疗中的重要性。
Ann R Coll Surg Engl. 1986 Sep;68(5):245-8.
7
Intraoperative endoscopic localization of jejunal angiodysplasia as a source of massive rectal bleeding.
Surg Endosc. 1989;3(1):56-9; discussion 59-60. doi: 10.1007/BF00591319.
Gastroenterology. 1977 Apr;72(4 Pt 1):650-60.