Quinn Michael T, Lakshminarasimhan Venu, Orpiano Christopher, Kang Gurjeet, Staffetti Joseph
Gastroenterology, Regional Medical Center Bayonet Point, Hudson, USA.
Cureus. 2019 May 17;11(5):e4696. doi: 10.7759/cureus.4696.
A 65-year-old woman presented with right lower quadrant (RLQ) abdominal pain of three days duration. During her hospitalization, she underwent computed tomography (CT) of the abdomen, duplex ultrasound of the abdomen, esophagogastroduodenoscopy (EGD), and colonoscopy as part of a diagnostic workup. The workup identified high-grade obstructions of the celiac artery (CA), superior mesenteric artery (SMA), atypical appearing gastric ulcers, and a diffusely ulcerated cecum, which created a mass-like appearance. The patient developed cecal perforation despite mesenteric vessel stenting and ultimately required right hemicolectomy for definitive management. This case report represents a rare presentation of simultaneous gastric ischemia and cecal ischemia with necrosis in a patient with underlying peripheral vascular disease.
一名65岁女性因右下象限(RLQ)腹痛持续三天前来就诊。住院期间,作为诊断检查的一部分,她接受了腹部计算机断层扫描(CT)、腹部双功超声、食管胃十二指肠镜检查(EGD)和结肠镜检查。检查发现腹腔干(CA)、肠系膜上动脉(SMA)存在高度梗阻,出现非典型胃溃疡,以及弥漫性溃疡的盲肠,形成肿块样外观。尽管进行了肠系膜血管支架置入术,患者仍发生了盲肠穿孔,最终需要进行右半结肠切除术以进行确定性治疗。本病例报告展示了一名患有潜在外周血管疾病的患者同时出现胃缺血和盲肠缺血伴坏死的罕见表现。