Lu Zhongting, Qin Chenhui, Zhang Mingxuan, Li Tao
Graduate School, Ningxia Medical University, Ningxia, China.
The General Hospital of Taiyuan Central Hospital, Shanxi, China.
J Med Case Rep. 2024 Apr 25;18(1):218. doi: 10.1186/s13256-024-04531-1.
Postoperative delayed bleeding of gastric cancer is a complication of radical gastrectomy with low incidence rate and high mortality.
This case report presents the case of a 63-year-old female patient of Mongolian ethnicity who was diagnosed with gastric malignancy during a routine medical examination and underwent Billroth's I gastric resection in our department. However, on the 24th day after the surgery, she was readmitted due to sudden onset of hematemesis. Gastroscopy, abdominal CT, and digital subtraction angiography revealed postoperative anastomotic fistula, rupture of the duodenal artery, and bleeding from the abdominal aorta. The patient underwent three surgical interventions and two arterial embolizations. The patient's condition stabilized, and she was discharged successfully.
Currently, there are no specific guidelines for the diagnosis and treatment of pseudoaneurysms in the abdominal cavity resulting from gastric cancer surgery. Early digital subtraction angiography examination should be performed to assist in formulating treatment plans. Early diagnosis and treatment contribute to an improved overall success rate of rescue interventions.
胃癌术后迟发性出血是根治性胃切除术后的一种并发症，发病率低但死亡率高。
本病例报告介绍了一名63岁蒙古族女性患者，她在常规体检中被诊断为胃恶性肿瘤，并在我科接受了毕罗Ⅰ式胃切除术。然而，术后第24天，她因突然呕血再次入院。胃镜、腹部CT和数字减影血管造影显示术后吻合口瘘、十二指肠动脉破裂和腹主动脉出血。患者接受了三次手术干预和两次动脉栓塞。患者病情稳定，成功出院。
目前，对于胃癌手术所致腹腔假性动脉瘤的诊断和治疗尚无具体指南。应尽早进行数字减影血管造影检查以协助制定治疗方案。早期诊断和治疗有助于提高抢救干预的总体成功率。
