Medina V, Alarcó A, Martín A, De las Casas P, Díaz F, Márquez M, Bravo A, Meneses M, Afonso J, González F
Servicio de Cirugía General y Digestiva, Hospital Universitario de Canarias, Universidad de la Laguna, Tenerife.
Rev Esp Enferm Dig. 1995 Apr;87(4):323-6.
Upper digestive bleeding caused by an isolated gastric hemangioma is a rather rare occurrence, even in cases of Osler-Weber-Rendu syndrome. The case reported here, which brings to 40 the number reported in the world literature, is that of a 68-year-old patient who presented with upper digestive bleeding. Endoscopy led us to suspect a hemangioma due to the abnormally large lesion, a suspicion that was confirmed preoperatively through arteriography, which detected a hypervascular mass of 6 x 4 cm dependent on the gastroduodenal artery. This finding was in turn confirmed by the surgical intervention. Diagnostic difficulties based on barium studies, endoscopy and surgical exploration have meant that preoperative diagnosis has been rare in the cases published to date. We consider that a more liberal use of arteriography could reverse this tendency, as indeed our case has shown. Furthermore, we feel that arteriography is indicated in cases of upper digestive bleeding of obscure origin, which might be due to small angiomas that may be overlooked in other diagnostic tests.
孤立性胃血管瘤引起的上消化道出血相当罕见，即便在遗传性出血性毛细血管扩张症（Osler-Weber-Rendu综合征）患者中亦是如此。本文报告的这例病例使世界文献报道的此类病例数增至40例，患者为一名68岁出现上消化道出血的患者。内镜检查因病变异常巨大使我们怀疑为血管瘤，术前通过动脉造影证实了这一怀疑，动脉造影检测到一个依赖于胃十二指肠动脉的6×4cm高血运肿块。这一发现随后通过手术干预得到证实。基于钡餐检查、内镜检查和手术探查的诊断困难意味着迄今为止已发表的病例中术前诊断很少见。我们认为更广泛地使用动脉造影可以扭转这种趋势，正如我们的病例所示。此外，我们认为对于不明原因的上消化道出血病例应进行动脉造影，因为可能存在其他诊断检查中被忽视的小血管瘤。
