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使用亚胺培南/西司他丁作为栓塞材料,通过经导管动脉栓塞成功治疗小肠大面积多处微出血。

Successful treatment of multiple microbleeds in a large area of the small bowel by transcatheter arterial embolization using imipenem/cilastatin as embolization material.

作者信息

Hiraki Sakiko, Sato Fumie, Okada Ichiro, Osugi Masaya, Watanabe Yoshiya, Ichinose Yoshiaki

机构信息

Department of Radiology, National Hospital Organization Disaster Medical Center, 3256, Midoricho, Tachikawa, Tokyo, 190-0014, Japan.

Department of Critical Care Medicine and Trauma, National Hospital Organization Disaster Medical Center, Tachikawa, Tokyo, Japan.

出版信息

Radiol Case Rep. 2023 Jun 21;18(9):3026-3031. doi: 10.1016/j.radcr.2023.06.020. eCollection 2023 Sep.

Abstract

A 44-year-old man with chronic idiopathic pseudo-intestinal obstruction and lumbar disc herniation presented with orthostatic dizziness, black vomiting, and stools. He was suspected to have an ulcer caused by nonsteroidal anti-inflammatory drugs and treated conservatively but continued to have transfusion-dependent anemia. Trans-arterial contrast-enhanced computed tomography showed multiple microbleeds in the small intestine. We diffusely embolized 7 small intestine branches of the superior mesenteric artery using imipenem/cilastatin on 2 separate occasions. This stopped the bleeding, and the patient progressed well without ischemic complications and was discharged on the 25th postoperative day. Transcatheter arterial embolization with imipenem/cilastatin may be a viable treatment option for patients with multiple small bowel bleeds in a large area of the small intestine that are unresponsive to conservative treatment or endoscopic methods.

摘要

一名患有慢性特发性假性肠梗阻和腰椎间盘突出症的44岁男性出现体位性头晕、黑色呕吐物和黑便。他被怀疑患有非甾体抗炎药引起的溃疡,并接受了保守治疗,但仍持续存在依赖输血的贫血。经动脉对比增强计算机断层扫描显示小肠有多处微出血。我们在两个不同的时间使用亚胺培南/西司他丁对肠系膜上动脉的7个小肠分支进行了弥漫性栓塞。出血停止,患者恢复良好,无缺血性并发症,术后第25天出院。对于小肠大面积多处出血且对保守治疗或内镜方法无反应的患者,经导管动脉内注入亚胺培南/西司他丁栓塞术可能是一种可行的治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb65/10333106/0805d0f9838b/gr1.jpg

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本文引用的文献

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Acute Med Surg. 2022 Feb 11;9(1):e733. doi: 10.1002/ams2.733. eCollection 2022 Jan-Dec.
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