Chaudhary Sachin Mahendrakumar, Singh Ajay, Chavan Manisha, Das Arghadip, Bathvar Pinank Kiritkumar
Department of General Surgery, SMT. NHL Municipal Medical College, Ahmedabad, Gujarat, India.
Department of General Surgery, Sri Ram MurtiSmarak Institute of Medical Sciences, Bareilly, Uttar Pradesh, India.
Intractable Rare Dis Res. 2023 Feb;12(1):13-21. doi: 10.5582/irdr.2022.01128.
Upper gastrointestinal bleeding (UGB) is a potentially fatal consequence of digestive disorders. There is a wide range of rare causes for UGB that can lead to misdiagnosis and occasionally catastrophic outcomes. The lifestyles of those who are afflicted are mostly responsible for the underlying conditions that result in the hemorrhagic cases. The development of a novel approach targeted at raising public awareness of the issue and educating the public about it could significantly contribute to the elimination of gastrointestinal bleeding with no associated risks and to a nearly zero mortality rate. There are reports of UGB related to Sarcina ventriculi, gastric amyloidosis, jejunal lipoma, gastric schwannoma, hemobilia, esophageal varices, esophageal necrosis, aortoenteric fistula, homosuccus pancreaticus, and gastric trichbezoar in the literature. The common feature of these rare causes of UGB is that the diagnosis is difficult to establish before surgery. Fortunately, UGB with a clear lesion in the stomach itself is a clear sign for surgical intervention, and the diagnosis can only be verified by pathological examination with the help of immunohistochemical detection of a particular antigen for a specific condition. The clinical traits, diagnostic techniques, and the therapeutic, or surgical options of unusual causes of UGB reported in the literature are compiled in this review.
上消化道出血(UGB)是消化系统疾病潜在的致命后果。UGB存在多种罕见病因,可能导致误诊,偶尔还会造成灾难性后果。患病者的生活方式大多是导致出血病例的潜在病因。开发一种旨在提高公众对该问题的认识并对公众进行相关教育的新方法,可能会极大地有助于消除无相关风险的胃肠道出血,并使死亡率几乎为零。文献中有关于胃八叠球菌、胃淀粉样变性、空肠脂肪瘤、胃神经鞘瘤、胆道出血、食管静脉曲张、食管坏死、主动脉肠瘘、胰腺同型分泌液以及胃毛石引起的上消化道出血的报道。这些UGB罕见病因的共同特点是术前难以确诊。幸运的是,胃本身有明确病变的UGB是手术干预的明确指征,且只有借助针对特定病症的特定抗原的免疫组化检测进行病理检查才能确诊。本文综述了文献中报道的UGB不常见病因的临床特征、诊断技术以及治疗或手术选择。