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慢性肠系膜缺血导致的严重缺血性胃炎。

Severe ischemic gastritis caused by chronic mesenteric ischemia.

作者信息

Ribas Bruno Moraes, Rebolho Eduardo Camargo, Ferronatto Guilherme Figueiró, Bragato Pedro Henrique, Akahane Hugo Genki Kagawa, Ramos Eduardo José Brommelstroet, Lima Thienis Maria da Costa, Moreira Barbara D'agnoluzzo

机构信息

Hospital Nossa Senhora das Graças - HNSG, Curitiba, PR, Brasil.

Hospital Marcelino Champagnat, Curitiba, PR, Brasil.

出版信息

J Vasc Bras. 2023 Aug 11;22:e20230002. doi: 10.1590/1677-5449.202300022. eCollection 2023.

DOI:10.1590/1677-5449.202300022
PMID:37790892
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10545228/
Abstract

Ischemic gastritis is a rare illness caused by localized or systemic vascular insufficiency. This condition is rarely seen in medical practice due to the vast arterial collateral blood supply to the stomach through the celiac trunk and superior mesenteric artery and also because other etiologies are much more frequent. The classic presentation of chronic ischemia is comprises the triad of postprandial pain, weight loss, and abdominal bruit. Intervention is indicated in symptomatic patients and endovascular treatment is an alternative to surgery in patients with high comorbidity that offers good results. We report a case of a 71-year-old female patient with severe ischemic gastritis with ulcers and bleeding caused by chronic mesenteric ischemia with occlusion of the celiac trunk and inferior mesenteric artery and critical stenosis of the superior mesenteric artery. The diagnosis was confirmed by imaging, and the patient underwent endovascular treatment. This is a rare condition that is difficult to diagnose and treat and a multidisciplinary team is needed for proper management.

摘要

缺血性胃炎是一种由局部或全身血管供血不足引起的罕见疾病。由于通过腹腔干和肠系膜上动脉为胃提供了丰富的动脉侧支血液供应，而且其他病因更为常见，这种情况在医疗实践中很少见。慢性缺血的典型表现包括餐后疼痛、体重减轻和腹部血管杂音三联征。有症状的患者需要进行干预，对于合并症高的患者，血管内治疗是手术的替代方法，效果良好。我们报告一例71岁女性患者，患有严重的缺血性胃炎，伴有溃疡和出血，由慢性肠系膜缺血导致腹腔干和肠系膜下动脉闭塞以及肠系膜上动脉严重狭窄引起。通过影像学检查确诊，患者接受了血管内治疗。这是一种罕见的疾病，难以诊断和治疗，需要多学科团队进行妥善管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f689/10545228/ac07b1cd7d1a/jvb-22-e20230002-g06.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f689/10545228/ac07b1cd7d1a/jvb-22-e20230002-g06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f689/10545228/e93dcb92bd85/jvb-22-e20230002-g01-en.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f689/10545228/b66bdbeef375/jvb-22-e20230002-g02-en.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f689/10545228/76c3d3b90cd7/jvb-22-e20230002-g03-en.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f689/10545228/ab9b734d3960/jvb-22-e20230002-g04-en.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f689/10545228/ffbeec14f86b/jvb-22-e20230002-g05-en.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f689/10545228/ac07b1cd7d1a/jvb-22-e20230002-g06-en.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f689/10545228/e93dcb92bd85/jvb-22-e20230002-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f689/10545228/b66bdbeef375/jvb-22-e20230002-g02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f689/10545228/76c3d3b90cd7/jvb-22-e20230002-g03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f689/10545228/ab9b734d3960/jvb-22-e20230002-g04.jpg
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Chronic mesenteric ischemia: Clinical practice guidelines from the Society for Vascular Surgery.慢性肠系膜缺血：血管外科学会临床实践指南。
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A Case of Gastric Ischemia: Management and Prognosis.一例胃缺血病例：治疗与预后
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Comparison of covered stents versus bare metal stents for treatment of chronic atherosclerotic mesenteric arterial disease.覆膜支架与裸金属支架治疗慢性动脉粥样硬化性肠系膜动脉疾病的比较。
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