Arima Takahiro, Morimoto Kohei, Terai Kiyoshi, Kawamoto Ken, Muroya Ken, Koba Yuji, Omura Takashi
Department of Surgery Higashiyamato Hospital Higashiyamato Japan.
Department of Radiology National Disaster Medical Center Tachikawa Japan.
Acute Med Surg. 2022 Feb 11;9(1):e733. doi: 10.1002/ams2.733. eCollection 2022 Jan-Dec.
Small bowel bleeding is an uncommon cause of lower gastrointestinal bleeding, which may require different management.
A 37-year-old man presenting with hematochezia was promptly diagnosed with small bowel bleeding by computed tomography angiography. Transcatheter arterial embolization was carried out because the patient's hemodynamic status deteriorated. Hemostasis was achieved by embolization with imipenem/cilastatin, although superselective embolization failed. Capsule endoscopy revealed multiple ulcers and erosions. Drug-induced small bowel injury was suspected to be the cause of small bowel bleeding.
Computed tomography angiography can facilitate the management of lower gastrointestinal bleeding. Considering transcatheter arterial embolization and choosing an optimal embolic agent depending on the situation are important in the management of hemodynamically unstable patients.
小肠出血是下消化道出血的一种罕见原因，可能需要不同的处理方法。
一名37岁便血男性患者经计算机断层血管造影迅速诊断为小肠出血。由于患者血流动力学状态恶化，进行了经导管动脉栓塞术。尽管超选择性栓塞失败，但通过亚胺培南/西司他丁栓塞实现了止血。胶囊内镜检查发现多处溃疡和糜烂。怀疑药物性小肠损伤是小肠出血的原因。
计算机断层血管造影有助于下消化道出血的处理。对于血流动力学不稳定的患者，考虑经导管动脉栓塞术并根据情况选择最佳栓塞剂在处理中很重要。
