PDF(Pubmed)
Abstract：
A 78-year-old man was admitted to our hospital with a tarry stool. Esophagogastroduodenoscopy identified tiny oozing on the greater curvature at the antrum. Despite repeated endoscopic hemostasis by coagulation and clipping, rebleeding occurred. On the third rebleeding, we performed endoscopic hand suturing to completely close the ulcer surface. Biopsy showing massive infiltration of eosinophils at the ulcer edge indicated eosinophilic gastritis. After the endoscopic closure by endoscopic hand suturing, the patient had no symptoms of bleeding thereafter and was discharged 19 days after the procedure by taking oral prednisolone. The patient remained well and was continuously treated with a small dose of steroids in outpatient. This is the first case report of the successful application of endoscopic hand suturing to a refractory hemorrhagic ulcer. Further accumulation of clinical experiences is desired to confirm the usefulness of this technique for the prevention of refractory ulcer bleeding.
摘要：
一名78岁的男子因粪便被送进我们医院。食管胃十二指肠镜检查发现胃窦曲率较大的微小渗出。尽管通过凝固和夹闭反复进行内镜止血,再出血发生。第三次出血时，我们进行了内窥镜手缝合以完全闭合溃疡表面。活检显示溃疡边缘嗜酸性粒细胞大量浸润，提示嗜酸性粒细胞性胃炎。在通过内窥镜手缝合进行内窥镜闭合后，此后，患者没有出血症状，并在手术后19天通过口服泼尼松龙出院。患者保持良好状态，并在门诊连续接受小剂量类固醇治疗。这是成功应用内窥镜手缝合治疗难治性出血性溃疡的首例报道。希望进一步积累临床经验以证实该技术用于预防难治性溃疡出血的有用性。
