Chen C Y, Lu C L, Lo S S, Yu I T, Chang F Y, Lee S D
Department of Medicine, Veterans General Hospital-Taipei, Taiwan, Republic of China.
J Gastroenterol Hepatol. 1997 May;12(5):382-4. doi: 10.1111/j.1440-1746.1997.tb00447.x.
Leiomyoma is a common benign intestinal tumour. Melaena is not rare in this tumour. Recently, rectal haematochezia has been considered as one of the very rare manifestations of leiomyoma. We report a case of jejunal leiomyoma showing life-threatening rectal bleeding. This 76-year-old man was admitted to hospital because of continuous rectal bleeding for 2 days. Haemorrhagic shock occurred and transfusion of 27 units of packed red blood cells failed to correct the shock. Emergent superior mesenteric angiography revealed a distal jejunal tumour showing evidence of active oozing. Segmental intestinal resection was performed to remove this jejunal tumour. Final pathological examination disclosed a jejunal leiomyoma with a ruptured artery responsible for the life-threatening bleeding. The patient recovered after tumour resection. Our presenting case was probably the second case of jejunal leiomyoma showing haematochezia. The diagnostic priority is discussed.
平滑肌瘤是一种常见的肠道良性肿瘤。黑便在这种肿瘤中并不罕见。最近,直肠便血被认为是平滑肌瘤非常罕见的表现之一。我们报告一例空肠平滑肌瘤表现为危及生命的直肠出血。这名76岁男性因持续直肠出血2天入院。发生了失血性休克,输注27单位浓缩红细胞未能纠正休克。紧急肠系膜上动脉造影显示空肠远端肿瘤有活动性渗血迹象。进行了节段性肠切除以切除该空肠肿瘤。最终病理检查显示为空肠平滑肌瘤,伴有一条破裂动脉导致危及生命的出血。患者在肿瘤切除后康复。我们报告的病例可能是第二例表现为便血的空肠平滑肌瘤。文中讨论了诊断的优先事项。