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超乎常见病因:阑尾出血成为下消化道出血的惊人病因

Beyond the Usual Suspects: Appendiceal Bleeding as the Surprising Cause of Lower Gastrointestinal (GI) Bleeding.

作者信息

Siddiqui Asher, Zafar Nowera, Hakiminezhad Mahdi, Jamal Zohaib, Alam Imran, Khawaja Zeeshan

机构信息

Department of Surgery, Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, GBR.

Department of Radiology, Mersey and West Lancashire Teaching Hospitals NHS Foundation Trust, Lancaster, GBR.

出版信息

Cureus. 2024 Dec 31;16(12):e76663. doi: 10.7759/cureus.76663. eCollection 2024 Dec.

Abstract

Lower gastrointestinal bleeding (LGIB) is a common clinical condition typically associated with diseases like diverticular disease, inflammatory bowel disease, and cancer. However, rarer etiologies such as appendiceal hemorrhage can present similarly, complicating diagnosis and management. This case report discusses a 42-year-old male who presented with severe rectal bleeding. Despite a comprehensive diagnostic workup, including colonoscopy and CT angiography, the underlying cause was identified as an obscure appendiceal hemorrhage. This atypical presentation underscores the importance of considering a broad differential diagnosis, even in cases with seemingly straightforward clinical features. While laparoscopic appendectomy is the standard surgical approach for managing appendiceal hemorrhage, a conservative management strategy was successfully employed in this particular case, highlighting the importance of individualized patient care and judicious clinical decision-making. This case report emphasizes the necessity of a multidisciplinary approach, involving careful clinical assessment, advanced imaging, and endoscopic evaluation, to accurately diagnose and manage complex cases of gastrointestinal bleeding. By recognizing and addressing uncommon etiologies, clinicians can improve patient outcomes and minimize unnecessary interventions.

摘要

下消化道出血(LGIB)是一种常见的临床病症,通常与憩室病、炎症性肠病和癌症等疾病相关。然而,诸如阑尾出血等较为罕见的病因也可能表现出相似症状,使诊断和治疗变得复杂。本病例报告讨论了一名42岁男性,他出现了严重的直肠出血。尽管进行了包括结肠镜检查和CT血管造影在内的全面诊断检查,但根本原因被确定为隐匿性阑尾出血。这种非典型表现强调了即使在临床特征看似简单的病例中,考虑广泛鉴别诊断的重要性。虽然腹腔镜阑尾切除术是治疗阑尾出血的标准手术方法,但在这个特殊病例中成功采用了保守治疗策略,突出了个体化患者护理和明智临床决策的重要性。本病例报告强调了多学科方法的必要性,包括仔细的临床评估、先进的影像学检查和内镜评估,以准确诊断和治疗复杂的胃肠道出血病例。通过识别和处理罕见病因,临床医生可以改善患者预后并减少不必要的干预。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/793c/11686933/a61734815105/cureus-0016-00000076663-i01.jpg

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