Roux-en-Y肝空肠吻合术引起的出血性病变：1.9/1.5μm双发射激光成功联合止血

Bleeding Lesion from Roux-en-Y Hepaticojejunostomy: A Successful Combined Hemostasis with Dual Emission Laser 1.9/1.5 μm.

作者信息

Marinoni Beatrice, Elli Luca, Tontini Gian Eugenio, Scaramella Lucia, Penagini Roberto, Vecchi Maurizio, Nandi Nicoletta

机构信息

Center for Prevention and Diagnosis of Celiac Disease, Gastroenterology and Endoscopy Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy.

Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy.

出版信息

Diagnostics (Basel). 2022 Aug 30;12(9):2107. doi: 10.3390/diagnostics12092107.

DOI:10.3390/diagnostics12092107

PMID:36140508

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9497802/

Abstract

A 28-year-old woman, with a history of liver transplantation with Roux-en-Y hepaticjejunostomy, was admitted for melena and severe anemia. Bidirectional endoscopy was normal. Capsule endoscopy demonstrated fresh blood in the efferent limb downstream of the jejuno-jejunostomy. Anterograde double-balloon enteroscopy (DBE) showed an adherent clot with a visible vessel oozing next to the hepaticojejunostomy. Bleeding was treated firstly with argon plasma coagulation and endoclips and further treated with dual emission laser, achieving complete hemostasis. At the 3 months follow-up, hemoglobin was stable without evidence of re-bleeding.

摘要

一名28岁女性，有肝移植及Roux-en-Y肝空肠吻合术病史，因黑便和严重贫血入院。双向内镜检查正常。胶囊内镜显示空肠空肠吻合术下游输出袢有新鲜血液。顺行双气囊小肠镜检查（DBE）显示在肝空肠吻合术旁有一个附着的血凝块，可见血管渗血。首先用氩离子凝固术和内镜夹治疗出血，然后用双发射激光进一步治疗，实现了完全止血。在3个月的随访中，血红蛋白稳定，无再次出血迹象。