Iannamorelli Michael, Bowling Adam, Semaan Elie
Department of Surgery, Berkshire Medical Center, 725 North St., Pittsfield MA 01201, USA.
J Surg Case Rep. 2019 Aug 22;2019(8):rjz234. doi: 10.1093/jscr/rjz234. eCollection 2019 Aug.
Here, we describe the case of a 56-year-old African American male who initially presented to the emergency department with 2 days of abdominal cramping, epigastric pain, loss of consciousness, melena and hematochezia. He underwent coil embolization of his gastroduodenal artery by the interventional radiology team after it was felt he was a high risk for rebleed. The patient then returned to the hospital with 3 weeks of epigastric pain, lightheadedness and melanotic stool. An upper endoscopy revealed a metallic coil embedded into the duodenal bulb. This coil was believed to be from prior embolization to the gastroduodenal artery. The patient then underwent a laparoscopic distal gastrectomy and partial duodenectomy with antecolic antegastric Roux-en-Y reconstruction bypassing the area where erosion occurred.
在此，我们描述了一名56岁非裔美国男性的病例，他最初因腹部绞痛、上腹部疼痛、意识丧失、黑便和便血2天而就诊于急诊科。在被认为有再次出血的高风险后，介入放射科团队对其胃十二指肠动脉进行了弹簧圈栓塞术。随后，患者因上腹部疼痛、头晕和黑色粪便3周后再次入院。上消化道内镜检查发现十二指肠球部嵌入一个金属弹簧圈。这个弹簧圈被认为来自之前对胃十二指肠动脉的栓塞。患者随后接受了腹腔镜远端胃切除术和部分十二指肠切除术，并进行了结肠前胃前Roux-en-Y重建术，绕过了发生糜烂的区域。
