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空肠胃肠道间质瘤致小肠出血 1 例报告

Jejunal Gastrointestinal Stromal Tumor as a Source of Small Bowel Bleeding: A Case Report.

机构信息

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.

出版信息

Perm J. 2021 May;25. doi: 10.7812/TPP/20.257.

Abstract

INTRODUCTION

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.

CASE PRESENTATION

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.

摘要

简介

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。

病例介绍

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。

相似文献

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本文引用的文献

1
Diagnosis and therapeutic strategies for small bowel vascular lesions.小肠血管病变的诊断与治疗策略。
World J Gastroenterol. 2019 Jun 14;25(22):2720-2733. doi: 10.3748/wjg.v25.i22.2720.
3
Neoadjuvant and adjuvant therapy for gastrointestinal stromal tumors.胃肠道间质瘤的新辅助和辅助治疗
Ann Gastroenterol Surg. 2018 Sep 27;3(1):43-49. doi: 10.1002/ags3.12211. eCollection 2019 Jan.
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Current clinical management of gastrointestinal stromal tumor.胃肠道间质瘤的当前临床管理。
World J Gastroenterol. 2018 Jul 14;24(26):2806-2817. doi: 10.3748/wjg.v24.i26.2806.
7
What is New in Gastrointestinal Stromal Tumor?胃肠道间质瘤有哪些新进展?
Adv Anat Pathol. 2017 Sep;24(5):259-267. doi: 10.1097/PAP.0000000000000158.
8
CARE guidelines for case reports: explanation and elaboration document.病例报告的CARE指南:解释与阐述文件。
J Clin Epidemiol. 2017 Sep;89:218-235. doi: 10.1016/j.jclinepi.2017.04.026. Epub 2017 May 18.
10
ACG Clinical Guideline: Diagnosis and Management of Small Bowel Bleeding.美国胃肠病学会临床指南:小肠出血的诊断与管理
Am J Gastroenterol. 2015 Sep;110(9):1265-87; quiz 1288. doi: 10.1038/ajg.2015.246. Epub 2015 Aug 25.

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