- 期刊
腎臟結石術後罕見之晚期併發症繼發性十二指腸舔室合併出血病例報告
Bleeding Secondary Duodenal Diverticulum: A Rare Late Complication Following Nephrolithotomy
摘要
繼發性十二指腸憩室大都因慢性十二指腸潰瘍或膽囊疾病造成，但因腎臟截石術後晚期併發症而引起的繼發性十二指腸憩室合併大量出血則頗為少見，本文報告一例63歲男性，10年及8年前曾因右腎結石接受過兩右側腎臟結石截除術，此次突發大量上胃腸道出血，術前上消化道攝影及內視鏡檢查發現除有慢性十二指腸潰瘍外，另在十二指腸第二部分有一不尋常的憩室形成，其內並充滿了血塊，經手術治癒，由於此合併病少見，僅就此病例的處理經過及文獻回顧，來討論此合併症的致病機轉，診斷及治療。
關鍵字
無資料並列摘要
Secondary duodenal diverticula are due primarily to traction upon that section from some other cause such as ulcer, cholecystitis and so forth. It accounts for 1.6 to 20% of all duodenal diverticula. Numerous reports of gastrointestinal hemorrhage from duodenal diverticula have appeared in the literature. But massive UGI bleeding due to secondary duodenal diverticulum, caused by nephrolitho-tomy, was a rare late complication. Here we present a case of a 64-year-old male patient who underwent a right side nephrolithotomy 10 and 8 years previously, then developed massive UGI bleeding suddenly. Pre-operative UGI series and gastroscopy showed chronic duodenal ulcer and duodenal diverticulum at second section where much blood clot was noted. In time, a successful operation was performed. This complication of secondary duodenal diverticulum aws rare, so considera-tion regarding management and surgical ap-proach was discussed.
延伸閱讀
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