Melena

黑斑
  • 文章类型: Case Reports
    我们介绍了一个40岁的女性,她表现出腹痛,便血,和黑便在过去一周被诊断为从脾动脉中发出的假性动脉瘤。患者接受血管内氰基丙烯酸酯胶栓塞治疗,从而彻底解决了即将发生的灾难性失血性休克。
    We present the case of a 40-year-old female who presented with abdominal pain, hematochezia, and melena for the past week and was diagnosed with a pseudoaneurysm emanating from the mid-splenic artery. The patient was managed with endovascular cyanoacrylate glue embolization, resulting in the complete resolution of an impending catastrophic hemorrhagic shock.
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  • 文章类型: Case Reports
    肾细胞癌(RCC)是一种常见的肾脏恶性肿瘤,胃转移是罕见的。我们报告了一例82岁的男性患者,该患者在最初诊断为RCC后12年发生胃转移。患者接受了内镜全层切除术(EFTR),胃转移灶被成功切除.术后病理及免疫组化显示胃转移起源于RCC。尽管RCC的胃转移很少见,有RCC病史或胃肠道症状的患者应怀疑。EFTR与减少的创伤和更大的胃组织和功能保留有关。这是比手术切除更合适的选择;然而,它需要更多的内窥镜医师。
    Renal cell carcinoma (RCC) is a common malignant kidney tumor; however, gastric metastasis is rare. We report the case of an 82-year-old male patient who developed gastric metastasis 12 years after an initial diagnosis of RCC. The patient underwent endoscopic full-thickness resection (EFTR), and the gastric metastatic focus was successfully removed. Postoperative pathology and immunohistochemistry showed that the gastric metastasis originated from RCC. Although gastric metastasis of RCC is rare, it should be suspected in patients with a history of RCC or gastrointestinal symptoms. EFTR is associated with reduced trauma and greater retention of gastric tissue and function. It is a more appropriate choice than surgical resection; however, it requires more endoscopists.
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  • 文章类型: Case Reports
    背景:由于十二指肠GIST的稀有性,临床医生对其临床特征的信息很少,诊断,管理和预后。
    方法:我们报告了一例61岁的埃及男子迅速诊断为十二指肠GIST的病例,他表现为呕血和黑便的严重发作。进行了胃十二指肠上段内镜检查,发现十二指肠第一部分有大量溃疡性出血,应用了4个血液夹,止血良好。剖腹探查术和远端胃切除术,进行十二指肠切除术和胃空肠造口术。肿块的形态结合免疫组织化学与高危类型的十二指肠胃肠道间质瘤(GIST)一致。患者每天服用阿马替尼一片,他没有肿瘤复发的迹象。
    结论:尽管很少见,突发严重的紧急情况,危及生命的出血性休克十二指肠GIST可能是潜在致命性的上消化道和下消化道大出血的原因,这是这种罕见且具有挑战性的肿瘤的关键特征。
    BACKGROUND: Due to rarity of duodenal GISTs, clinicians have few information about its clinical features, diagnosis, management and prognosis.
    METHODS: We report a case of promptly diagnosed duodenal GIST in a 61-year-old Egyptian man presented shocked with severe attack of hematemesis and melena. Upper gastroduodenal endoscopy was done and revealed a large ulcerating bleeding mass at first part of duodenum 4 hemo-clips were applied with good hemostasis. An exploratory laparotomy and distal gastrectomy, duodenectomy and gastrojejunostomy were performed. The morphology of the mass combined with immunohistochemistry was consistent with duodenal gastrointestinal stromal tumours (GISTs) of high risk type. The patient is on amatinib one tablet daily and he was well with no evidence of tumor recurrence.
    CONCLUSIONS: despite being rare, emergency presentation with sudden severe, life-threatening hemorrhagic shock duodenal GISTs might be a cause of potentially lethal massive combined upper and lower gastrointestinal bleeding which is the key feature of this rare and challenging tumor.
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  • 文章类型: Case Reports
    原发性胃伯基特淋巴瘤是一种侵袭性非霍奇金淋巴瘤,在文献中很少报道。大多数原发性胃淋巴瘤是弥漫性大B细胞淋巴瘤和粘膜相关淋巴组织(MALT)淋巴瘤。原发性胃伯基特淋巴瘤患者可表现为腹痛,呕血,Melena,穿孔,和阻塞。诊断是结合临床,放射学,和病理结果。由于报告的病例有限,治疗数据有限。我们介绍了一例47岁的女性,她表现为弥漫性腹痛,Melena,和咖啡磨呕吐,在上内窥镜检查发现的胃溃疡肿块进行活检后被诊断为原发性胃伯基特淋巴瘤。
    Primary gastric Burkitt\'s lymphoma is an aggressive non-Hodgkin\'s lymphoma that has been rarely reported in the literature. The majority of primary gastric lymphomas are diffuse large B-cell lymphomas and mucosa-associated lymphoid tissue (MALT) lymphomas. Patients with primary gastric Burkitt\'s lymphoma can present with abdominal pain, hematemesis, melena, perforation, and obstruction. Diagnosis is made with a combination of clinical, radiological, and pathological findings. Treatment data are limited due to the limited cases reported. We present a case of a 47-year-old female who presented with diffuse abdominal pain, melena, and coffee-ground emesis that was diagnosed with primary gastric Burkitt\'s lymphoma following biopsies taken from a gastric ulcerated mass found on upper endoscopy.
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  • 文章类型: Case Reports
    胃畸胎瘤是一种极为罕见的肿瘤,占所有小儿畸胎瘤的1%,通常表现为可触及的腹部肿块。新生儿和婴儿的上消化道出血很少见,主要由良性病变引起。
    我们介绍了一个3个月大的男孩,他经常出现呕血,呕吐,黑便在检查中发现了胃畸胎瘤。
    由于该实体的独特特征和极端稀有,准确的术前诊断仍然难以捉摸。
    UNASSIGNED: Gastric teratoma is an extremely rare tumor, representing <1% of all pediatric teratomas, and commonly manifests as a palpable abdominal mass. Upper gastrointestinal tract bleeding in newborns and infants is rare and is mostly caused by a benign lesion.
    UNASSIGNED: We present a 3-month-old boy who presented with recurrent attacks of hematemesis, vomiting, and melena which on work up revealed a gastric teratoma.
    UNASSIGNED: Owing to the unique characteristics and the extreme rarity of this entity, accurate preoperative diagnosis has remained elusive.
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  • 文章类型: Case Reports
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  • 文章类型: Journal Article
    背景:长管状重复是一种罕见的先天性肠道疾病,这可能会导致大量出血的紧急情况。然而,术前诊断和手术治疗具有挑战性.本报告介绍了术前图像,并详细介绍了长管状肠重复并发大出血的外科手术。
    方法:一名3岁男孩因黑便被送往急诊科。尽管一年前进行了Tc-99m高tech闪烁显像,这揭示了肠道某些部分增强的非特异性发现,增强腹部CT显示小肠水肿伴管腔外渗。患者接受了红细胞的输血;然而,他的血红蛋白水平没有改善.动脉造影和双气囊内窥镜检查没有明显发现。剖腹探查术显示小肠的一半长管状重复。利用Wrenn程序,我们成功切除了所有重复的粘膜。病理发现表明,几乎所有重复物都包含胃粘膜,并显示溃疡并有动脉血管破裂。他的症状得到了缓解,血红蛋白水平稳定.术后2个月,未出现手术并发症.
    结论:有效处理长肾小管重复合并大出血包括及时应用Wrenn手术。识别特定的影像学表现对于提示剖腹探查至关重要。确保最佳结果并防止治疗延误。
    BACKGROUND: Long tubular duplication is a rare congenital intestinal disease, that can lead to emergency situations marked by massive hemorrhage. However, preoperative diagnosis and surgical treatment are challenging. This report presents preoperative images and details a surgical procedure for long tubular intestinal duplications with massive hemorrhage.
    METHODS: A 3-year-old boy presented to the emergency department with melena. Despite undergoing a Tc-99m pertechnetate scintigraphy one year prior, which revealed nonspecific findings with enhancement of some parts of the intestine, enhanced abdominal CT revealed an edematous small intestine with luminal extravasation. The patient received a transfusion of red blood cells; however, his hemoglobin level did not improve. Arterial angiography and double-balloon endoscopy revealed no remarkable findings. Exploratory laparotomy revealed a long tubular duplication in half of the small intestine. Utilizing the Wrenn procedure, we successfully removed all duplicate mucosa. Pathological findings showed that almost all duplications contained gastric mucosa and revealed an ulcer with a ruptured arterial vessel. His symptoms were resolved, and the hemoglobin level stabilized. At 2 months postoperatively, no surgical complications were present.
    CONCLUSIONS: Effective management of long tubular duplications with massive hemorrhage involves timely application of the Wrenn procedure. Recognition of specific imaging findings is crucial to prompt exploratory laparotomy, ensuring optimal outcomes and preventing delays in treatment.
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  • 文章类型: Case Reports
    由于钩虫侵染而引起的黑斑是一种罕见的临床表现。由于失血缓慢,通常表现为缺铁性贫血的症状。在这里,我们介绍了一例45岁的男性,他有一年的间歇性黑便病史,需要多次输血。不同中心的初步内窥镜检查正常。十二指肠中的钩虫的存在仅在重复的上内镜检查中被检测到是失血的原因,阿苯达唑治疗成功治愈患者。
    Melaena due to hookworm infestation is a rare clinical presentation. It usually presents with symptoms of iron-deficiency anaemia owing to slow blood loss. Here we present a case of 45-year male who presented with a one-year history of intermittent melena requiring multiple blood transfusions. Preliminary endoscopies at different centres were normal. The presence of hookworm in the duodenum was only detected on repeat upper endoscopy as the cause of blood loss, and treatment with albendazole was successful in curing the patient.
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  • 文章类型: Case Reports
    背景:布伦纳腺腺瘤(BGA)是一种罕见的良性十二指肠肿瘤,本质上是腺瘤样病变,而不是实际的肿瘤。不同腺瘤大小的患者有各种临床表现,具有非特异性临床症状。这里,我们报告一例以黑便和贫血为主要表现的BGA。
    方法:一名年轻女性患者因黑便和贫血入院。进行内窥镜手术以明确诊断,切除内镜下肿瘤样病变。
    方法:患者诊断为十二指肠Brunner腺瘤,并接受相关治疗。
    结果:治疗后,患者症状改善,他出院了.
    结论:Brunner十二指肠腺瘤是一种罕见的十二指肠良性肿瘤。本报告描述了一例以黑便和贫血为主要表现的BGA,随后进行内镜切除和治疗。对十二指肠Brunner腺瘤的文献进行了分析和讨论。临床医生应注意根据不典型症状进行鉴别。
    BACKGROUND: Brunner gland adenoma (BGA) is a rare benign duodenal tumor that is an adenomatoid lesion in nature rather than an actual tumor. Patients with different adenoma sizes have various clinical manifestations with nonspecific clinical symptoms. Here, We report a case of BGA with black stool and anemia as the primary manifestations.
    METHODS: A young female patient was admitted to the hospital because of black stool and anemia. Endoscopic surgery was performed to a definitive diagnosis, and endoscopic tumor-like lesions were resected.
    METHODS: The patient was diagnosed with duodenal Brunner adenoma and received related treatment.
    RESULTS: After treatment, the patient symptoms improved, and he was discharged.
    CONCLUSIONS: Brunner adenoma of the duodenum is a rare benign duodenum tumor. This report paper describes a case of BGA with black stool and anemia as the primary manifestations, followed by endoscopic resection and treatment. The literature on Brunner adenoma of the duodenum has been analyzed and discussed. Clinicians should pay attention to differentiating the disease based on atypical symptoms.
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  • 文章类型: Case Reports
    胃脾瘘(GSF)是一种罕见的事件,可能发生在患有各种胃或脾疾病的患者中。虽然与胃和脾恶性肿瘤相关的GSF在文献中有很好的记载,由脾脓肿引起的GSF病例极为罕见。我们经历了一名49岁的男子,有三尖瓣心脏瓣膜置换术史,患有感染性心内膜炎,突然出现贫血和黑便。在成像和内窥镜的帮助下,诊断为原发性脾脓肿并发自发性GSF。进行了快速脾切除术和部分胃切除术。GSF是与高发病率和死亡率风险相关的严重事件。早期识别与脾脓肿相关的GSF对于预防严重并发症至关重要。对于使用GSF治疗大脓肿,通常首选手术切除和脾切除和部分胃切除。
    Gastrosplenic fistula (GSF) is an unusual event that might occur in patients with various gastric or splenic diseases. While GSF related to gastric and splenic malignancies is well-documented in the literature, cases of GSF due to a splenic abscess are extremely rare. We experienced the case of a 49-year-old man with a medical history of tricuspid cardiac valve replacement for infective endocarditis who presented with a sudden onset of anemia and melena. With the assistance of imaging and endoscopy, a primary splenic abscess complicated by spontaneous GSF was diagnosed. A prompt splenectomy with partial gastrectomy was performed. GSF is a serious occurrence associated with a high risk of morbidity and mortality. The early recognition of GSF related to a splenic abscess is crucial to prevent major complications. Surgical resection with splenectomy and partial gastrectomy is frequently preferred for the treatment of large abscesses with GSF.
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