十二指肠球部溃疡浸润致假性动脉瘤破裂引发致命性上消化道大出血1例

One case of upper gastrointestinal tract hemorrhage due to rupture of pseudoaneurysm caused by duodenal bulb ulcer

非静脉曲张上消化道出血是临床常见急诊.病因以消化性溃疡占首位.按照溃疡的胃镜下出血表现,即Forrest分级制定诊治策略已成为国内外共识.本文报道1例十二指肠球部溃疡浸润致假性动脉瘤破裂,导致上消化道大出血的患者,在行介入栓塞、及多种药物、包括多种胃黏膜保护剂的综合治疗下救治成功经验,为临床推广Forrest分级及提高上消化道大出血救治水平积累资料.

Nonvariceal upper tract hemorrhage is a common emergency clinically, and the peptic ulcer prevails over other pathogeneses. According to the endoscopic manifestations of ulcer bleeding, the endoscopic Forrest grading is used to guide the clinical therapeutic strategy. Here we report one patient suffering from massive hemorrhage of the upper gastrointestinal tract, whose bleeding was due to pseudoaneurysm rupture caused by duodenal bulb ulcer. The patient was successfully rescued by comprehensive treatment including interventional embolization and medications such as multiple gastric mucosa protective agents. This case will promote the awareness of the Forrest grading and provide more data for improving the treatment of massive gastrointestinal bleeding.