Department of Gastroenterology, Southern-Tohoku General Hospital, Japan.
Department of Gastroenterology, Dokkyo Medical University School of Medicine, Japan.
Intern Med. 2023 Nov 1;62(21):3137-3142. doi: 10.2169/internalmedicine.1180-22. Epub 2023 Mar 22.
A 74-year-old man was admitted to our hospital with severe hematochezia. Abdominal enhanced computed tomography (CT) demonstrated extravasation of contrast material from the descending colon. Colonoscopy revealed recent bleeding in the descending colon diverticulum. Bleeding was stopped using detachable snare ligation. Eight days later, the patient developed abdominalgia, and CT revealed free air caused by delayed perforation. The patient underwent emergency surgery. Perforation at the ligation site was detected using intraoperative colonoscopy. This report is the first to describe a case of delayed perforation after endoscopic detachable snare ligation for colonic diverticular hemorrhage.
一位 74 岁男性因严重血便入住我院。腹部增强 CT 显示降结肠外渗造影剂。结肠镜检查显示降结肠憩室有近期出血。使用可分离圈套结扎术止血。8 天后,患者出现腹痛,CT 显示延迟穿孔导致的游离气体。患者行急诊手术。术中结肠镜检查发现结扎部位穿孔。本报告首次描述了内镜下可分离圈套结扎治疗结肠憩室出血后迟发性穿孔的病例。