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上消化道出血的不常见病因。伴有文献复习的出血性十二指肠脂肪瘤病例报告。

Unusual cause of upper gastrointestinal bleeding. Report of the case of hemorrhagic duodenal lipoma with review of the literature.

出版信息

Ann Ital Chir. 2022 Sep 5;11:S2239253X22038014.

PMID:36065803
Abstract

Duodenal lipomas are uncommon and rare causes of gastrointestinal bleeding. Here, we present the case of a 45-yearold male patient who was admitted to University Clinical Centre because of melaena. After initial diagnostics, including echosonography, esophagogastroduodenoscopy revealed bleeding from protruding blood vessel at the polypoid submucosal change in the posterior duodenal bulb. Upon two urgent unsuccessful endoscopic hemostasis, a duodenotomy was performed. Definitive diagnosis was based on histological findings, describing duodenal lipoma with Bruner's gland hyperplasia. Upper GI bleeding is a serious challenge that requires adequate diagnostics necessary for the right choice of therapeutic approach. Unsuccessful endoscopic hemostasis could be followed by serious complications in bleeding duodenal lipoma when surgery should be always considered as the treatment of choice in patients with this kind of bleeding tumor. KEY WORDS: Bruner Glands Hyperplasia, Duodenal Lipoma, Upper Gastrointestinal Bleeding.

摘要

十二指肠脂肪瘤是胃肠道出血的不常见且罕见病因。在此,我们报告了 1 例 45 岁男性患者,因黑便入住大学临床中心。在初始诊断包括超声检查后,食管胃十二指肠镜检查显示在后十二指肠球部息肉样黏膜下改变处有突出血管出血。在两次紧急但不成功的内镜止血后,进行了十二指肠切开术。明确的诊断基于组织学发现,描述为伴有 Bruner 腺增生的十二指肠脂肪瘤。上消化道出血是一项严峻的挑战,需要进行充分的诊断,以选择正确的治疗方法。内镜止血失败可能导致出血性十二指肠脂肪瘤出现严重并发症,因此对于此类出血性肿瘤,手术应始终被视为首选治疗方法。

关键词

Bruner 腺增生、十二指肠脂肪瘤、上消化道出血。

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Ann Ital Chir. 2022 Sep 5;11:S2239253X22038014.
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