Tohma Takayuki, Okabe Yasuyuki, Ushio Masaya, Saito Masaya
Department of Acute Care Surgery, Chiba Emergency Medical Center, Chiba, Japan.
Life Support and Emergency Center, Nagaoka Red Cross Hospital, Niigata, Japan.
J Surg Case Rep. 2022 Dec 30;2022(12):rjac606. doi: 10.1093/jscr/rjac606. eCollection 2022 Dec.
Arteriovenous malformation (AVM) of the small bowel is a rare disease and can be sometimes difficult to treat due to the diagnostic difficulty. We herein report a case of small intestinal bleeding of AVM successfully treated with double-balloon enteroscopy (DBE) and laparoscope-assisted resection. A 44-year-old man complained of hematochezia and visited the previous doctor. He underwent gastroscopy and colonoscopy, but no bleeding site was detected. However, he rebled 2 days later and became hypotensive. Abdominal computed tomography revealed a hypervascular nodule in the jejunum. He was transferred to our institution for further treatment. DBE was performed and revealed a small pulsatile lesion with a tiny mucosal break. We then injected a marking tattoo. Two days later, he underwent an operation. We were able to easily locate the tattooed lesion laparoscopically and performed jejunal partial resection. His postoperative course was uneventful. DBE enabled a precise diagnosis and minimal invasive surgery.
小肠动静脉畸形（AVM）是一种罕见疾病，有时由于诊断困难而难以治疗。我们在此报告一例通过双气囊小肠镜（DBE）和腹腔镜辅助切除成功治疗的小肠AVM出血病例。一名44岁男性主诉便血，曾就诊于前一位医生。他接受了胃镜和结肠镜检查，但未发现出血部位。然而，两天后他再次出血并出现低血压。腹部计算机断层扫描显示空肠有一个高血管结节。他被转到我们机构接受进一步治疗。进行了DBE检查，发现一个小的搏动性病变，伴有微小的黏膜破损。然后我们注射了标记纹身。两天后，他接受了手术。我们能够通过腹腔镜轻松定位纹身病变，并进行了空肠部分切除。他的术后过程顺利。DBE实现了精确诊断和微创手术。
