内視鏡的治療が奏功した十二指腸水平部静脈瘤破裂 Hemorrhagic shock due to rupture of duodenal varices

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症例は61歳女性.全身痙攣を主訴に当院救急外来に搬送された.来院時は出血性ショック状態であった.全身状態が安定した後腹部血管造影検査,computed tomography during arterial portography(CTAP)を施行し,上腸間膜静脈を流入路,左卵巣静脈を流出路とする異常拡張血管を認めた.上部消化管内視鏡検査を施行して十二指腸水平部静脈瘤を確認した.経皮経肝門脈側副血行路塞栓術,内視鏡的cyanoacrylate局注療法を行い,異常血管は消失した.<br>

A 61-year-old woman was admitted to our hospital for melena and convulsion in shock state. Laboratory data on admission indicated severe anemia and marked liver dysfunction. She improved clinically, after received a large blood transfusion.<br> Angiographic study was performedCand portography revealed duodenal varices supplied via superior mesenteric artery and drained to the left ovarian vein. An endoscopic examination was performed, and large nodular varices were observed in the third portion of the duodenum.<br> The varices were treated by percutaneous transhepatic obliteration of portal systemic collaterals (PTO), and endoscopic injection sclerotherapy (EIS) with n-butyl-2-cyanoacrylate (Histoacryl). After complection of EIS, no further bleeding occurred, and the patients hemoglobin level was stabilized.<br> No recurrence of the duodenal varices has been detected during the follow-up period of five months after EIS with N-butyl-2-cyanoacrylate.<br>

収録刊行物

  • 日本消化器病學會雜誌 = The Japanese journal of gastro-enterology  

    日本消化器病學會雜誌 = The Japanese journal of gastro-enterology 103(5), 529-536, 2006-05-05 

    The Japanese Society of Gastroenterology

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各種コード

  • NII論文ID(NAID)
    10018072338
  • NII書誌ID(NCID)
    AN00192124
  • 本文言語コード
    JPN
  • 資料種別
    NOT
  • ISSN
    04466586
  • データ提供元
    CJP書誌  J-STAGE 
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