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一例表现为黏膜下肿瘤样改变的小肠动脉瘤出血病例。

A case of small bowel aneurysm hemorrhage with submucosal tumor-like findings.

作者信息

Banjoya Susumu, Minato Yohei, Kimoto Yoshiaki, Kano Yuki, Sakuno Takashi, Ono Kohei, Osawa Marie, Horiuchi Hajime, Morikawa Teppei, Ohata Ken

机构信息

Department of Gastrointestinal Endoscopy NTT Medical Center Tokyo Tokyo Japan.

Department of Radiology NTT Medical Center Tokyo Tokyo Japan.

出版信息

DEN Open. 2024 Jan 22;4(1):e335. doi: 10.1002/deo2.335. eCollection 2024 Apr.

Abstract

A 51-year-old woman visited our hospital with the chief complaint of tarry stools. Contrast-enhanced abdominal computed tomography revealed leakage of contrast medium into the lumen of the small intestine. Subsequently, a double-balloon endoscopy was performed, which revealed a submucosal mass-like lesion in the jejunum. Although hemostasis was attempted with clips, complete hemostasis was difficult to achieve, and angiographic embolization was performed. Nevertheless, the anemia progressed, and a small bowel resection was performed. Histopathological examination led to a diagnosis of a ruptured submucosal aneurysm of the small intestine. Endoscopic hemostasis is often difficult to achieve for submucosal aneurysms in the intestine. The submucosal tumor-like finding observed on endoscopy in submucosal aneurysms is termed an "SMT-like sign" and is considered an important finding to diagnose aneurysms.

摘要

一名51岁女性因黑便为主诉前来我院就诊。腹部增强计算机断层扫描显示造影剂漏入小肠肠腔。随后进行了双气囊内镜检查,发现空肠有一个黏膜下肿块样病变。尽管尝试用夹子止血,但难以实现完全止血,于是进行了血管造影栓塞术。然而,贫血仍进展,遂行小肠切除术。组织病理学检查诊断为小肠黏膜下动脉瘤破裂。对于肠道黏膜下动脉瘤,内镜止血往往难以实现。黏膜下动脉瘤内镜检查时观察到的黏膜下肿瘤样表现被称为“类SMT征”,被认为是诊断动脉瘤的重要表现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/388c/10803887/78ab9bcd51f8/DEO2-4-e335-g004.jpg

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