- 期刊
Transcatheter Intra-arterial Vasopressin for Infusion Gastric Pouch Bleeding after Roux-en-Y Gastric Bypass: Report of a Case
胃繞道術後胃囊出血處置：病例報告
摘要
腹腔鏡Roux-en-Y胃繞道手術已被視爲病態性肥胖患者標準治療的項目之一。在術後早期階段，胃腸道出血是的相當複雜的一種情況，必須根據病患的臨床狀況來給予不同的處置。持續觀察、輸血、內視鏡治療或者再手術是一般被採取的方法。我們報告一位51歲的病態性肥胖患者在術後出現胃囊出血。輸血、藥物和內視鏡都不能止血。我們經由左胃動脈輸注入血管收縮劑而順利地止血，也是台灣的第一例報告。在考慮再手術之前，這個方法應可接受爲治療方式的選項之一。
關鍵字
無資料並列摘要
Roux-en-Y gastric bypass has been accepted as one of standard treatment procedures for morbidly obese patients. During the early postoperative stage, gastrointestinal hemorrhage is a complicated condition to manage. Management involves different strategies according to the patient's condition. Observation, blood transfusion, endoscopic hemostasis, or re-operation is the most frequently adopted method. Here, we report on a 51-year-old morbidly obese patient who developed early postoperative hemorrhage from the gastric pouch. Neither medical treatment nor endoscopy succeeded in stopping the bleeding. In order to obviate the possibility of embolization of the only arterial supply to the gastric pouch from the left gastric artery (LGA), we infused transcatheter intra-arterial vasopressin and successfully achieved hemostasis. We believe, this is the first case using this type of intervention to manage gastric pouch hemorrhage after laparoscopic Roux-en-Y gastric bypass (LRYGB). We advocate that this method be accepted as one of the treatment modalities before considering re-operation.
延伸閱讀
- Huang, H. H., Chan, S. W., & Tyan, Y. S. (2006). 食道重建術後胃管破裂導致心包積氣：病例報告. 中華放射線醫學雜誌, 31(4), 183-188. https://www.airitilibrary.com/Article/Detail?DocID=10188940-200608-31-4-183-188-a
- Wu, W. C., Wang, L. Y., Yu, F. J., Wang, W. M., Chen, S. C., Chuang, W. L., & Chang, W. Y. (2002). 胃食道靜脈瘤結紮術後發生十二指腸靜脈瘤出血 ─ 病例報告. The Kaohsiung Journal of Medical Sciences, 18(11), 578-581. https://doi.org/10.6452/KJMS.200211.0578
- Hsu, L. S., Tsai, Y. H., Wang, W. K., & Yang, B. Y. (2008). 胃幽門部潰瘍穿孔以包膜下肝膿瘍來表現：病例報告. 中華放射線醫學雜誌, 33(2), 103-107. https://www.airitilibrary.com/Article/Detail?DocID=10188940-200806-33-2-103-107-a
- Jan, W. L., Wu, C. H., Chang, C. C., & Chen, H. C. (2020). 食道重建術後胃管慢性狹窄及救援手術－個案報告及文獻回顧. 臺灣整形外科醫學會雜誌, 29(1), 54-60. https://www.airitilibrary.com/Article/Detail?DocID=a0000593-202003-202005070009-202005070009-54-60
- 韓克文、許中嚴、許中華、廖麗蘭（2009）。胃繞道術後納差腹脹之中醫診療病例報告。中醫內科醫學雜誌，7(2)，51-59。https://doi.org/10.7102/JTCIM.200912.0051