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在初次内镜治疗和栓塞治疗失败后，通过内镜缝合成功止血复发性十二指肠溃疡出血。

Successful Hemostasis With Endoscopic Suturing of Recurrent Duodenal Ulcer Bleeding After Failed Initial Endoscopic Therapy and Embolization.

作者信息

Chuang Nelson T, Agarwal Amol, Kim Raymond

机构信息

Division of Gastroenterology and Hepatology, University of Maryland Medical Center, Baltimore, MD.

出版信息

ACG Case Rep J. 2020 Feb 20;7(2):e00275. doi: 10.14309/crj.0000000000000275. eCollection 2020 Feb.

DOI:10.14309/crj.0000000000000275
PMID:32309506
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7145181/
Abstract

Peptic ulcer bleeding is a common condition where endoscopic therapy offers a safe and definitive treatment. However, management of peptic ulcer bleeding can be more complex when there is large volume, recurrent bleeding in a critically ill patient. We present a patient with life-threatening, recurrent duodenal ulcer bleeding who failed both standard endoscopic therapy and transarterial embolization. Hemostasis was achieved through a combination of standard endoscopic therapy and endoscopic suturing.

摘要

消化性溃疡出血是一种常见病症，内镜治疗可提供安全有效的治疗方法。然而，对于危重症患者出现大量反复出血的情况，消化性溃疡出血的管理可能会更加复杂。我们报告一名患有危及生命的反复十二指肠溃疡出血的患者，其标准内镜治疗和经动脉栓塞治疗均失败。通过标准内镜治疗和内镜缝合相结合实现了止血。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc3f/7145181/c9253534e575/ac9-7-e00275-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc3f/7145181/b43e024e33f0/ac9-7-e00275-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc3f/7145181/a59027e41b56/ac9-7-e00275-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc3f/7145181/c9253534e575/ac9-7-e00275-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc3f/7145181/b43e024e33f0/ac9-7-e00275-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc3f/7145181/a59027e41b56/ac9-7-e00275-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc3f/7145181/c9253534e575/ac9-7-e00275-g003.jpg

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本文引用的文献

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2
Risk Factors Associated with Rebleeding in Patients with High Risk Peptic Ulcer Bleeding: Focusing on the Role of Second Look Endoscopy.高危消化性溃疡出血患者再出血的相关危险因素：聚焦二次内镜检查的作用
Dig Dis Sci. 2016 Feb;61(2):517-22. doi: 10.1007/s10620-015-3846-y. Epub 2015 Aug 22.
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Transcatheter arterial embolization for acute nonvariceal upper gastrointestinal bleeding: Indications, techniques and outcomes.
经导管动脉栓塞治疗急性非静脉曲张性上消化道出血：适应证、技术和结果。
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Endoscopic Suturing for Ulcer Exclusion in Patients With Massively Bleeding Large Gastric Ulcer.内镜缝合术用于大量出血的大型胃溃疡患者的溃疡封闭
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Meta-analysis: predictors of rebleeding after endoscopic treatment for bleeding peptic ulcer.Meta 分析：内镜治疗消化性溃疡出血后再出血的预测因素。
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Surgical salvage of bleeding peptic ulcers after failed therapeutic endoscopy.治疗性内镜检查失败后出血性消化性溃疡的手术挽救治疗
Dig Surg. 2009;26(3):243-8. doi: 10.1159/000226218. Epub 2009 Jun 26.
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