Idiopathic Small Intestinal Varicose Vein as a Rare Cause of Obscure Gastrointestinal Bleeding: Report of 2 Cases with a Literature Review

特發性小腸靜脈瘤引起不明原因腸胃道出血之病例報告二例與文獻回顧

蘇炫安(Hsuan-An Su) ； 陳志榮(Chih-Jung Chen) ； 蘇子誠(Tzu-Cheng Su) ； 顏旭亨(Hsu-Heng Yen)

《The Changhua Journal of Medicine》 14卷4期 (2016/12) Pp. 213-219

https://doi.org/10.6501/CJM.1404.07

摘要

An ectopic varix of the small intestine is a very rare vascular abnormality, characterised by obscure gastrointestinal bleeding outside of common locations. Idiopathic ectopic varices are cases without known risk factors, such as portal hypertension, venous thrombosis or previous surgery. Only a few cases have ever been reported in the literature. In this study, we present two cases of idiopathic jejunoileal varices with microscopic evidence, with similar cases reviewed from the literature. The aetiology, diagnosis and treatment of idiopathic small intestinal varices are also reviewed in this report. A pan-endoscopy and colonoscopy usually reveal negative results in such patients, and angiography and contrast abdominal computed tomography are often used for timely diagnosis. Surgical intervention is mostly performed, as it is an efficient treatment method with a good prognosis.

關鍵字

ectopic varicose vein ； obscure ； gastrointestinal ； bleeding ； small intestinal ； bleeding

並列摘要

小腸的異位性靜脈瘤是一種非常罕見的血管異常疾病，造成好發部位以外的不明原因消化道出血。特發性異位性靜脈瘤的患者缺乏罹病之危險因子，如門脈高壓、靜脈栓塞或手術史等等，且目前文獻中僅有少數病例報導。本文將討論兩例特發性空腸迴腸靜脈瘤之病例，包含病因、診斷以及治療，並回顧文獻中的類似病例。對此類病人，上消化道內視鏡與大腸鏡檢查通常沒有發現，診斷上需要使用血管造影或腹部對比電腦斷層掃描；處置上，手術是常見且有效的治療方法，病人也能有較好的預後。

並列關鍵字

特發性腸道靜脈瘤 ； 隱晦性腸胃道出血 ； 小腸出血