Kawamura M, Shimizu K, Takayama M, Ishida H, Honma S, Tani M, Hirose N, Nakamura Y
Department of Geriatric Medicine, Keio University School of Medicine.
Nihon Ronen Igakkai Zasshi. 1993 Nov;30(11):969-73. doi: 10.3143/geriatrics.30.969.
Angiodysplasia is one cause of chronic gastrointestinal tract bleeding that can not be difficult to detect. In particular, angiodysplasia in the small intestine is very rare and has seldom been reported. An 80-year-old man complained of hematochezia and was admitted to other hospital on October 1991. However, no bleeding sites in the gastrointestinal tract could be revealed by radiographic and endoscopic examinations. After 8 months, he was admitted to our hospital with the same symptom on June 1992. He suffered hemorrhagic shock due to continuous bleeding. Hypotension and anemia progressed in spite of immediate blood transfusion. Emergency angiography revealed extravasation from a peripheral branch of the jejunal artery, in addition tortuous and dilated ileal arteries. Embolization was performed with the catheter inserted superselectively into the nearest arcade of the segmental branch of the vasa recta. After embolization, no complications were occurred. He was discharged and is being followed up as an outpatient.
血管发育异常是慢性胃肠道出血的一个病因，可能不难发现。特别是小肠血管发育异常非常罕见，鲜有报道。一名80岁男性主诉便血，于1991年10月入住其他医院。然而，影像学和内镜检查均未发现胃肠道出血部位。8个月后，他于1992年6月因同样症状入住我院。由于持续出血，他发生了失血性休克。尽管立即输血，低血压和贫血仍在进展。急诊血管造影显示空肠动脉外周分支有造影剂外渗，此外还有迂曲扩张的回肠动脉。通过将导管超选择性插入直小血管节段分支的最近弓状动脉进行栓塞。栓塞后未发生并发症。他出院后作为门诊病人接受随访。
