- 期刊
Dieulafoy's Lesion in the Jejunum Causing Massive Gastrointestinal Bleeding: Report of a Case
空腸Dieulafoy病灶引起大量消化道出血：一病例報告
摘要
Dieulafoy病灶是引起大量消化道出血少見的原因。病理上，它包含了位於黏膜下的大血管，並經由微小的黏膜缺損穿出。診斷常需要很多的方法幫助，包括內視鏡，核子醫學，血管攝影，和外科手術。我們報告一個位於空腸的Dieulafoy病灶，以大量消化道出血為表現。起始的內視鏡發現胃幽門部漬瘍，並經內視鏡止血治療。由於再發性的出血，第二次內視鏡發現癒合中的漬瘍，但並無發現任何出血的病灶。核子醫學RBC scan顯示一個位於空腸出血點。外科手術後，病理進一步證實Dieulafoy病灶。
並列摘要
Dieulafoy's maformation is an uncommon cause of massive GI bleeding. It consists of a large caliber-persistent artery in the submucosa, producing a minute protruding mucosal defect. Diagnosis typically requires multiple investigative modalities including endoscopy, nuclear RBC scan, angiography and laparotomy. We report a case of Dieulafoy's lesion in the jejunum, where the patient presented with hematochezia and hemodynamic instability. Initial endoscopy revealed a gastric ulcer and the patient underwent endoscopic hemostasis. Second-look endoscopy was performed due to persistent GI bleeding but the other bleeder was not detected. Nuclear RBC scan eventually revealed the bleeder in the jejunum, which was subsequently proved by laparotomy. Histopathology further confirmed the diagnosis of Dieualfoy's lesion in the jejunum.
延伸閱讀
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