- 期刊
- OpenAccess
Endoscopic Alcohol Injection Therapy for Angiodysplasia of Colon with Occult Bleeding-A Case Report
以內視鏡注射法治療大腸血管發育不良合併潛在性出血－一病例報告
摘要
大腸血管發育不良目前所知為老年人下消化道出血的常見原因，這種疾病通常在鋇劑顯影X光檢查不易發現，甚至於大腸鏡及選擇性血管攝影也有假陰性的結果。因此對於覆發性下消化道出血的患者重複性的檢查是需要的。大腸血管發育不良併發出血的治療的方法包括小於一公分的少數病灶可以使用荷爾蒙，電燒，雷射或注射等方法，而數目較多或是面積較廣的病灶則需外科手術切除。我們報告一病例為35歲男性主訴為慢性下腸胃道出血而導致貧血，大腸內視鏡檢查顯示在橫結腸近肝曲處五處滲血性血管發育不病灶，直腸亦有三處未出血性病灶，以純酒精行內視鏡注射止血術結果相當成功。一個月後大腸內視鏡追蹤檢查未有任何病灶同時止血處有疤痕形成。六個月後追蹤血色數為12g/dl，且未有糞便潛血反應。大腸血管發育不良以純酒精行內視鏡局部注射止血術為一有效，安全且方便之方法。
並列摘要
Colonic angiodysplasia is now recognized as a frequent cause of gastrointestinal bleeding in aged patient. The lesions are not evident on barium studies. Even colonoscopy and selective colonic angiography may give false negative results. Therefore, repeated studies for recurrent episodes of bleeding are often necessary. There are a lot of methods of treatment which includes hormonal therapy, electrocoagulation, laser or local sclerosing agent injection for few and small lesions (less than 1cm) and surgical treatment for large and extensive lesions.We report a young man, aged 35, presented with chronic anemia due to lower gastrointestinal bleeding, was found to have several small actively oozing angiodysplasias over the transverse colon near the hepatic flexure during colonoscopic examination. Another 3 small lesions without bleeding were also found over rectum. Endoscopic injection therapy for hemostasis with pure alcohol was performed successfully in all lesions. Follow-up colonoscopy one month later revealed no more bleeding and some scars formation were detected. The hemoglobin (Hgb) was stable at about 12g/dl and no more fecal occult blood has been detected in the 6 months follow-up peroid. Endoscopic local injection therapy is an effective, safe and convenient therapy for small angiodysplasias in the colon.
延伸閱讀
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