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一名患有消化性溃疡病的老年患者反复出现胃肠道出血:通过多学科干预和密切监测成功治疗

Recurrent Gastrointestinal Bleeding in an Elderly Patient With Peptic Ulcer Disease: Successful Management Through Multidisciplinary Intervention and Close Monitoring.

作者信息

Ahmad Hamad, Khan Urooj, Jannat Hoore, Ahmad Noaman

机构信息

Internal Medicine, Westchester Medical Center, Valhalla, USA.

Internal Medicine, Khyber Medical University, Peshawar, PAK.

出版信息

Cureus. 2023 Jul 6;15(7):e41468. doi: 10.7759/cureus.41468. eCollection 2023 Jul.

Abstract

Upper gastrointestinal bleeding (UGIB) is a medical emergency with substantial morbidity and mortality worldwide. It is defined as bleeding originating in the gastrointestinal (GI) tract proximal to the ligament of Treitz and can be caused by various conditions, including peptic ulcers, gastritis, esophageal varices, Mallory-Weiss tears, and malignancies. Common complications include anemia, hemodynamic instability, perforation, and rebleeding. It is associated with high mortality and a poor prognosis, especially in high-risk populations. Management includes medical treatment, endoscopic intervention, endovascular arterial embolization, and surgery. We present an interesting case of an 87-year-old male with a history of duodenal ulcers who presented with a bleeding duodenal ulcer complicated by recurrent bleeding despite multiple hemostatic endoscopic interventions and arterial embolization. This case highlights the complexities involved in managing recurrent upper GI bleeding and emphasizes the significance of multidisciplinary approaches, timely interventions, and close monitoring.

摘要

上消化道出血(UGIB)是一种医疗急症,在全球范围内具有较高的发病率和死亡率。它被定义为起源于Treitz韧带近端胃肠道(GI)的出血,可由多种情况引起,包括消化性溃疡、胃炎、食管静脉曲张、Mallory-Weiss撕裂和恶性肿瘤。常见并发症包括贫血、血流动力学不稳定、穿孔和再出血。它与高死亡率和不良预后相关,尤其是在高危人群中。治疗方法包括药物治疗、内镜干预、血管内动脉栓塞和手术。我们报告了一例有趣的病例,一名87岁男性,有十二指肠溃疡病史,因十二指肠溃疡出血就诊,尽管进行了多次内镜止血干预和动脉栓塞,但仍反复出血。该病例突出了复发性上消化道出血管理的复杂性,并强调了多学科方法、及时干预和密切监测的重要性。

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