消化性潰瘍所致之陣發性頭暈之病例報告

Episodic Dizziness from Peptic Ulcer: A Case Report

陳建志(Jiann-Jy Chen) ； 劉智仰(Chih-Yang Liu) ； 陳瑞昌(Jeil-Chung Chen) ； 楊菁華(Chin-Hua Yang) ； 陳登郎(Dem-Lion Chen)

《中山醫學雜誌》 21卷2期 (2010/06) Pp. 201-208

https://doi.org/10.30096/CSMJ.201006.0007

摘要

消化性潰瘍所致之慢性出血可能會加重海洋性貧血之貧血狀況，造成陣發性的頭暈。一68歲女性，有海洋性貧血、高血壓、胃食道逆流與消化性潰瘍之過去病史。苦於陣發性頭暈已3年，曾8次急診於本院，總是感到上腹不適、吞嚥不順及偶爾解黑便。理學檢查、聽力檢查、眼振電圖、溫差測試、心電圖及頸椎X光均無異常發現，血液學檢查呈現小球性低血色素型貧血，糞便潛血為陽性。擴散加權磁振造影顯示可能有中腦與小腦的病變，飛行時間效應顯示椎基底動脈扭曲。上消化道內視鏡檢查顯示十二指腸潰瘍。結果，在服用氫鉀幫浦拮抗劑後1週，陣發性頭暈即痊癒。追蹤迄今已3個月，情況依然穩定，糞便潛血為陰性，貧血也已改善。

關鍵字

消化性潰瘍 ； 海洋性貧血 ； 陣發性頭暈

並列摘要

Chronic bleeding from a peptic ulcer can exacerbate the anemia associated with thalassemia leading to episodic dizziness (ED). A 68-year-old female suffering from thalassemia, hypertension, gastroesophageal disease and peptic ulcers had reported experiencing ED for three years. In addition, she had often complained of epigastralgia, mild dysphagia, and occasional tarry stool. Physical examination, audiometry, electronystagmogram, caloric test, electrocardiogram and cervical X-ray were normal. Blood examination reported microcytic-hypochromic anemia. Stool occult blood test was positive. Diffusion weighted image revealed possible lesions over midbrain and cerebellum. Time of flight magnetic resonance angiogram revealed tortuous vertebrobasilar artery. Upper digestive tract endoscopy showed a duodenal ulcer, for which she prescribed a proton pump inhibitor. One week later the ED was subsided. At three months, follow up was uneventful. Stool occult blood tests were negative and anemia had subsided.

並列關鍵字

peptic ulcer ； thalassemia ； episodic dizziness