Intramural Duodenal Hematoma after Endoscopic Therapy for a Bleeding Duodenal Ulcer in a Patient with Liver Cirrhosis
スポンサーリンク
概要
- 論文の詳細を見る
We report a case of intestinal obstruction due to intramural hematoma of the duodenum following therapeutic endoscopy for a bleeding duodenal ulcer in a patient with liver cirrhosis. A 44-year-old man was admitted to our hospital with severe epigastralgia, nausea and tarry stool. Two years previously he had undergone endoscopic sclerotherapy for esophageal varices caused by alcoholic liver cirrhosis. Endoscopy revealed an open ulcer with a bleeding vessel in the duodenal bulb, and sclerotherapy was performed by clipping the vessel and injecting 20 ml of 0.2% epinephrine. His platelet count was 3.5×104/μl. Twelve hours later, he again developed epigastralgia and hypotension. Emergency computed tomography and ultrasonography revealed an intramural hematoma, 15×18 cm in diameter, at the dorsal and lateral duodenum. Endoscopy and upper gastrointestinal series revealed severe stenosis of the duodenal lumen caused by intramural hematoma. He received parenteral feeding for 22 days and within 8 weeks the hematoma was gradually absorbed using conservative management. Intramural duodenal hematoma may be diagnosed as a complication of the endoscopic procedure in a patient with a bleeding tendency, such as liver cirrhosis.
- 社団法人 日本内科学会の論文
著者
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Uchimura Koutaro
Department Of Medicine And Bioregulatory Science Graduate School Of Medical Sciences Kyushu Universi
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Kajiwara Eiji
Department Of Gastroenterology Internal Medicine And Pathology Nippon Steel Yawata Memorial Hospital
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SADOSHIMA Seizou
Department of Internal Medicine, Nippon Steel Yawata Memorial Hospital
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SUGAI Kyoko
Department of Internal Medicine, Nippon Steel Yawata Memorial Hospital, Kitakyushu
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MOCHIZUKI Yuichi
Department of Internal Medicine, Nippon Steel Yawata Memorial Hospital, Kitakyushu
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NOMA Eijiro
Department of Internal Medicine, Nippon Steel Yawata Memorial Hospital, Kitakyushu
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NAKASHIMA Jo
Department of Internal Medicine, Nippon Steel Yawata Memorial Hospital, Kitakyushu
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Nakashima Jo
Department Of Gastroenterology Shimonoseki City Central Hospital
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SADOSHIMA Seizou
Department of Internal Medicine, Nippon Steel Yawata Memorial Hospital, Kitakyushu
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UCHIMURA Koutaro
Department of Internal Medicine, Nippon Steel Yawata Memorial Hospital, Kitakyushu
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KAJIWARA Eiji
Department of Internal Medicine, Nippon Steel Yawata Memorial Hospital, Kitakyushu
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