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胃肠道出血罕见病因的非典型内镜表现：肠系膜上静脉阻塞导致结肠静脉曲张

Atypical Endoscopic Appearance of a Rare Cause of Gastrointestinal Bleeding: Superior Mesenteric Vein Occlusion Causing Colon Varices.

作者信息

Gautam Misha, Jahagirdar Vinay, Zoraghchi Kimia, Cunningham Thomas, Ahmed Mohamed, Aziz Ben, Saucier Nathan, Campbell John P

机构信息

Department of Internal Medicine, University of Missouri-Kansas City School of Medicine, Kansas City, MO.

University of Missouri-Kansas City School of Medicine, Kansas City, MO.

出版信息

ACG Case Rep J. 2025 Apr 30;12(5):e01680. doi: 10.14309/crj.0000000000001680. eCollection 2025 May.

DOI:10.14309/crj.0000000000001680
PMID:40309560
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12043337/
Abstract

Colonic varices (CV) are an uncommon cause of gastrointestinal bleeding, with an incidence of only 0.07%. We present a case of a 34-year-old woman with chronic superior mesenteric vein occlusion after pancreatoduodenectomy, leading to diffuse colonic varices with an atypical appearance needing further evaluation. Subsequent angiography confirmed CV, which were treated with catheter-based superior mesenteric vein stenting and variceal coiling. The patient's bleeding was controlled, with plans for continued surveillance. This case emphasizes the diagnostic challenges, treatment complexities, and the need for individualized management strategies for CV, highlighting the urgent need for established guidelines.

摘要

结肠静脉曲张（CV）是胃肠道出血的一种罕见病因，发病率仅为0.07%。我们报告一例34岁女性病例，该患者在胰十二指肠切除术后发生慢性肠系膜上静脉闭塞，导致弥漫性结肠静脉曲张，其外观不典型，需要进一步评估。随后的血管造影证实为CV，采用基于导管的肠系膜上静脉支架置入术和曲张静脉圈套术进行治疗。患者的出血得到控制，并计划继续进行监测。该病例强调了CV的诊断挑战、治疗复杂性以及个性化管理策略的必要性，突出了制定既定指南的迫切需求。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4ec/12043337/2cf46638aa48/ac9-12-e01680-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4ec/12043337/953ebe3eb71e/ac9-12-e01680-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4ec/12043337/36386e319ec6/ac9-12-e01680-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4ec/12043337/2cf46638aa48/ac9-12-e01680-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4ec/12043337/953ebe3eb71e/ac9-12-e01680-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4ec/12043337/36386e319ec6/ac9-12-e01680-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4ec/12043337/2cf46638aa48/ac9-12-e01680-g003.jpg

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本文引用的文献

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Rupture of ectopic varices of the ascending colon occurring after pancreatic cancer surgery: A case report and literature review.胰腺癌手术后发生升结肠异位静脉曲张破裂：一例报告及文献复习
DEN Open. 2023 Jul 10;4(1):e255. doi: 10.1002/deo2.255. eCollection 2024 Apr.
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Treatment of colonic varices with a superior mesenteric venous stent: a case report describing a unique approach.使用肠系膜上静脉支架治疗结肠静脉曲张：一例描述独特方法的病例报告。
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3
Colonic varices treated with embolization after pancreatoduodenectomy with portal vein resection: a case report.
胰十二指肠切除联合门静脉切除术后经栓塞治疗的结肠静脉曲张：一例报告
Surg Case Rep. 2020 Jun 3;6(1):126. doi: 10.1186/s40792-020-00888-9.
4
Endoscopic band ligation for transverse colonic variceal bleeding: case report and review of the literature.内镜套扎治疗横结肠静脉曲张出血：病例报告及文献复习。
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Balloon-occluded retrograde transvenous obliteration of colonic varices: a case report.球囊闭塞逆行经静脉封堵结肠静脉曲张：一例报告
CVIR Endovasc. 2020 Mar 16;3(1):17. doi: 10.1186/s42155-020-00108-3.
6
[Ascending Colon Variceal Bleeding in Cirrhotic Patient with Emergent Endoscopic Variceal Obturation with N-butyl-2-cyanoacrylate].[肝硬化患者升结肠静脉曲张破裂出血并急诊内镜下用氰基丙烯酸正丁酯闭塞曲张静脉]
Korean J Gastroenterol. 2018 Jul 25;72(1):37-41. doi: 10.4166/kjg.2018.72.1.37.
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Clin J Gastroenterol. 2018 Oct;11(5):343-347. doi: 10.1007/s12328-018-0857-1. Epub 2018 Apr 25.
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Hepatobiliary and Pancreatic: Management of bleeding colonic varices in liver disease.
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