Chu K M, Lai E C, Ng I O
Department of Surgery, University of Hong Kong, Queen Mary Hospital.
Am J Gastroenterol. 1993 Jul;88(7):1116-9.
We report a Chinese lady with hereditary hemorrhagic telangiectasia who presented with multiple episodes of gastrointestinal bleeding requiring transfusion. Gastroscopy, colonoscopy, isotope-labeled red blood cell scan, and selective arteriography were performed, but could not locate the source of bleeding. A bleeding lesion in the ampulla of Vater was seen when endoscopic retrograde cholangiopancreatography was attempted. She had an uneventful pylorus-preserving Whipple's operation with no further evidence of gastrointestinal bleeding. This is the first case report to show that the vascular ectasia of patients with hereditary hemorrhagic telangiectasia could manifest at the ampulla of Vater.
我们报告了一位患有遗传性出血性毛细血管扩张症的中国女性，她出现多次胃肠道出血，需要输血治疗。进行了胃镜、结肠镜、同位素标记红细胞扫描和选择性动脉造影检查，但均未能确定出血源。在尝试进行内镜逆行胰胆管造影时，发现了十二指肠乳头处的一个出血病变。她接受了保留幽门的胰十二指肠切除术，术后恢复顺利，未再有胃肠道出血的迹象。这是首例表明遗传性出血性毛细血管扩张症患者的血管扩张可出现在十二指肠乳头的病例报告。
