Fantin A C, Zala G, Risti B, Debatin J F, Schöpke W, Meyenberger C
Department of Internal Medicine, University Hospital, Zurich, Switzerland.
Gut. 1996 Jun;38(6):932-5. doi: 10.1136/gut.38.6.932.
A patient with severe recurrent rectal bleeding from anorectal varices due to portal hypertension because of hepatitis C virus related liver cirrhosis is presented. As illustrated by the report, it is essential to differentiate bleeding anorectal varices from bleeding haemorrhoids because treatment is different. In our patient, implantation of a transjugular intrahepatic portosystemic shunt (TIPS) led to an impressive regression of the anorectal varices, which could be demonstrated by sigmoidoscopy, endosonography, and magnetic resonance imaging. Recurrent rectal bleeding in a patient with portal hypertension should alert the physician to consider anorectal varices. Endoscopic ultra-sound and magnetic resonance imaging are new and non-invasive modalities for diagnosis and post-treatment control.
本文介绍了一名因丙型肝炎病毒相关性肝硬化导致门静脉高压引起严重复发性直肠出血的肛门直肠静脉曲张患者。如报告所示，区分出血性肛门直肠静脉曲张和出血性痔疮至关重要，因为治疗方法不同。在我们的患者中，经颈静脉肝内门体分流术（TIPS）植入导致肛门直肠静脉曲张明显消退，这可通过乙状结肠镜检查、内镜超声检查和磁共振成像证实。门静脉高压患者出现复发性直肠出血应提醒医生考虑肛门直肠静脉曲张。内镜超声和磁共振成像是用于诊断和治疗后控制的新型非侵入性检查方法。
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