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一例罕见的由回肠胃肠道间质瘤引起的大量胃肠道出血病例。

A Rare Case of Massive Gastrointestinal Hemorrhage Caused by an Ileal Gastrointestinal Stromal Tumor.

作者信息

Jha Adarsh, Joshi Amey, Jha Divij K, Mui Ryan K, Tikaria Richa, Hiatt Tadd K

机构信息

Internal Medicine, Michigan State University, East Lansing, USA.

Gastroenterology, Michigan State University, East Lansing, USA.

出版信息

Cureus. 2025 Apr 11;17(4):e82094. doi: 10.7759/cureus.82094. eCollection 2025 Apr.

Abstract

Gastrointestinal stromal tumors (GISTs) are rare mesenchymal tumors of the gastrointestinal tract. Although gastrointestinal bleeding is a common complication of GISTs, life-threatening hemorrhage is rare, particularly with intestinal GISTs. We report a rare case of an ileal GIST in a 71-year-old female patient who presented with massive lower gastrointestinal bleeding. Initial CT angiography (CTA) demonstrated a brisk gastrointestinal bleed in the ileal region. Despite embolization of the associated distal ileal artery branches, the patient experienced persistent hemoglobin drops and hematochezia. Repeat CTA revealed a hyper-enhancing exophytic lesion in the proximal ileum. This 4.7cm ileal tumor had to be excised, and histopathology confirmed a low-grade GIST. This case highlights the diagnostic complexity of ileal GISTs and the importance of imaging modalities such as CTA in managing active gastrointestinal bleeding.

摘要

胃肠道间质瘤(GISTs)是胃肠道罕见的间充质肿瘤。虽然胃肠道出血是GISTs的常见并发症,但危及生命的大出血很少见,尤其是肠道GISTs。我们报告了一例罕见的71岁女性回肠GIST病例,该患者出现大量下消化道出血。最初的CT血管造影(CTA)显示回肠区域有活跃的胃肠道出血。尽管对相关的回肠远端动脉分支进行了栓塞,但患者仍持续出现血红蛋白下降和便血。重复CTA显示回肠近端有一个强化明显的外生性病变。这个4.7厘米的回肠肿瘤必须切除,组织病理学证实为低级别GIST。该病例突出了回肠GISTs的诊断复杂性以及CTA等成像方式在处理活动性胃肠道出血中的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23f3/12066142/d4ff61f1b45e/cureus-0017-00000082094-i01.jpg

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