小腸多發性血管瘤：二病例報告

兩病人，病例一是一位4歲男童，主訴間歇性腹痛有4個月之久，曾至其他醫院求診，並接受大腸X光攝影及腹部超音波檢查均無異常。入院後，理學檢查結膜較白及整個腹部都有壓痛反應外，其他無異常現象，也接受身體其他系統檢查，仍無特殊發現，但腹痛逐漸明顯且併有發燒症狀，後來經剖腹術證實為小腸多發性血管瘤。病例二在產前檢查確定有胎兒腹水及羊水過多症，剖腹產出生，體重3,238公克，出生後發現沒有呼吸且有發紺現象，並接受腹部超音波和膀胱尿道排泄攝影檢查，但腹水原因仍未查出，經剖腹術證實為小腸多發性血管瘤。由兩病例可提醒我們，小腸血管瘤之臨床症狀是變化多端的，病例一以腹痛及解黑便；病例二以胎兒腹水為症狀，更暗示著小腸血管瘤亦可能是小孩反覆性腹痛、黑便及腹水的原因之一，詳細的理學檢查及高度的警覺性，才能使這類引起腹痛的原因，得以儘早診斷與治療。

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並列摘要

Hemangioma of the small intestine is a rare disease which is sometimes very difficult to diagnose because of its anatomical location. This report concerns two cases of multiple intestinal hemangiomas treated surgically. The first case was a four-year-old boy who suffered from recurrent abdominal pain and progressive hemorrhage from the gastrointestinal tract for four months. The character of his abdominal pain was non-specific. On physical examination, whole abdominal tenderness was evident. Serial laboratory and radiological examinations, including abdominal sonogram, barium enema, Tc-99m pertechnetate scan, upper gastrointestinal series failed to reveal abnormality. Multiple intestinal hemangiomas were found at exploratory laparotomy. The second case was a newborn suffering from fetal ascites. Abdominal sonogram, barium enema, voiding cystourethrography were performed without significant findings, and the diagnose of multiple intestinal hemangiomas was proved by laparotomy. In both, symptoms improved after segmental resection of the bowels. The purpose of this paper is to draw attention to the possibility of intestinal hemangioma as a source of recurrent abdominal pain, tarry stool or ascites in children.

並列關鍵字

multiple intestinal hemangioma

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小腸多發性血管瘤：二病例報告

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