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[内镜下硬化剂治疗食管静脉曲张后壁内血肿夹层所致食管狭窄]

[Esophageal stenosis due to a dissecting intramural hematoma following the endoscopic sclerotherapy of esophageal varices].

作者信息

De Sola C, Cano F, De Teresa J, López de Hierro M, Espinosa D, Suárez J F, Pleguezuelo J

机构信息

Servicio Aparato Digestivo, Ciudad Sanitaria Virgen de las Nieves, Granada.

出版信息

Rev Esp Enferm Dig. 1993 Apr;83(4):270-2.

PMID:8494656
Abstract

The dissecting intramural hematoma of the esophagus (DEH) is a rare complication of endoscopic variceal sclerotherapy (EVS). We present a 37 years male with Laennec's cirrhosis who developed a submucosal hematoma with complete obstruction of the esophagus 24 h. after the second session of EVS diagnosed by endoscopy. After conservative treatment the patient recovered well with complete resolution of the lesion. The review of the literature shows no correlation between DEH and type or volume of sclerosant, site of injection or previous number of sessions. Unknown in children. Most of these patients had abnormal hemostasis. We have performed EVS in 227 patients (879 sessions), with only a case of DEH (rate 0.13%). In this case the bad tolerance and movements during of EVS were very important.

摘要

食管壁内剥离性血肿(DEH)是内镜下静脉曲张硬化治疗(EVS)的一种罕见并发症。我们报告一名37岁男性,患有Laennec肝硬化,在第二次EVS治疗24小时后,经内镜诊断发生了黏膜下血肿并导致食管完全梗阻。经过保守治疗,患者恢复良好,病变完全消退。文献回顾显示,DEH与硬化剂的类型或剂量、注射部位或既往治疗次数之间无相关性。儿童病例尚不清楚。这些患者大多存在止血异常。我们对227例患者进行了EVS治疗(共879次),仅发生1例DEH(发生率0.13%)。在该病例中,EVS期间耐受性差和患者活动是非常重要的因素。

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