Elste C, Adamek H E, Weber W, Arnold J C, Riemann J F
Medizinische Klinik C, Klinikum der Stadt Ludwigshafen.
Aktuelle Radiol. 1998 Nov;8(6):299-301.
Most of intestinal diverticula are found in the jejunum, followed by the terminal ileum. Therefore they can easily be detected either by enteroscopy or ileocolonoscopy. Mostly the patients are asymptomatic so that it is a surprising finding without therapeutic consequences. But if a patient has an unclear enemea or malabsorption problems for which no explanation has been found in upper or lower gastrointestinal endoscopy, it is suggested to do an enteroscopy. We present the case of a 62-year-old woman who presented to our clinic with a first episode of melena. Although she needed blood transfusions no source of bleeding was found in the common diagnostic examinations such as upper and lower endoscopy and X-ray of the intestine. However, in the X-ray and the enteroscopy jejunal diverticula were seen on which angiodysplasias, detected in mesenteric angiography, projected. Because of the impossibility of stopping the bleeding by endoscopic interventions, the patient was referred to surgery and made an uneventful recovery. The hemoglobin done three months later was stabile and the patient was without any symptoms.
大多数肠憩室位于空肠,其次是回肠末端。因此,通过小肠镜检查或回结肠镜检查很容易检测到它们。大多数患者无症状,所以这是一个令人惊讶的发现,无需治疗。但是,如果患者出现不明原因的便血或吸收不良问题,而上消化道或下消化道内镜检查均未发现原因,则建议进行小肠镜检查。我们报告一例62岁女性患者,她首次因黑便前来我院就诊。尽管她需要输血,但在常见的诊断检查如上下内镜检查和肠道X线检查中均未发现出血源。然而,在X线检查和小肠镜检查中发现了空肠憩室,肠系膜血管造影显示在这些憩室上有血管发育异常。由于内镜干预无法止血,该患者被转诊至外科,术后恢复顺利。三个月后血红蛋白稳定,患者无任何症状。