Michigan State University Internal Medicine Residency, Sparrow Hospital, East Lansing, MI.
Sparrow Hospital/Michigan State University College of Human Medicine Gastroenterology Fellowship, Michigan Gastroenterology Institute, East Lansing, MI.
Perm J. 2021 May;25. doi: 10.7812/TPP/20.257.
In a minority of patients with gastrointestinal bleeding, the offending lesion is not able to be identified using colonoscopy or esophagogastroduodenoscopy (EGD). For these patients, video capsule endoscopy has become a cornerstone for the diagnosis of gastrointestinal bleeding in the territory not accessible by colonoscopy or EGD. One uncommon cause of bleeding from the small bowel is a gastrointestinal stromal tumor.
We present the case of a 76-year-old man who presented with 2 weeks of melena that began after starting dual antiplatelet therapy with aspirin and clopidogrel after undergoing coronary artery stenting. After EGD and colonoscopy failed to identify the culprit, the patient underwent video capsule endoscopy, which identified a suspicious area concerning for intussusception. Computed tomography enterography was then performed and showed a short segment of bowel wall thickening. The patient underwent laparoscopic small bowel resection and was found to have a gastrointestinal stromal tumor.
在少数胃肠道出血患者中,结肠镜或食管胃十二指肠镜(EGD)无法确定出血部位。对于这些患者,胶囊内镜已成为结肠镜或 EGD 无法到达的胃肠道出血诊断的基石。小肠出血的一个不常见原因是胃肠道间质瘤。
我们报告了一例 76 岁男性的病例,该患者在冠状动脉支架置入术后开始使用阿司匹林和氯吡格雷双联抗血小板治疗后出现 2 周黑便。在 EGD 和结肠镜检查未能确定病因后,患者进行了胶囊内镜检查,发现疑似肠套叠的可疑区域。随后进行了计算机断层扫描小肠造影,显示一小段肠壁增厚。患者接受了腹腔镜小肠切除术,发现存在胃肠道间质瘤。