伴十二指肠球部溃疡出血的小肠间质瘤1例及临床分析

Clinical Analysis of One Case of Small Intestinal Stromal Tumor with Duodenal Ulcer Bleeding

本文报道了1例临床工作中遇到的空肠间质瘤合并大出血的病例,起病危急,主要表现为黑便伴头晕、心悸,患者入院后出现失血性休克,初始确诊疾病为常规的消化性溃疡出血。但治疗过程中随着疾病的演变,患者仍有活动性出血,后通过腹腔动脉CTA检查,最终确诊为空肠间质瘤同时合并十二指肠球部溃疡并出血。该病例患者经内科、介入科及普外科多科协作治疗,最终痊愈出院。本病例虽然入院时患者的临床症状误导了临床医生对疾病的判断,但本研究着重从消化道出血的鉴别诊断思路入手,对胃肠间质瘤加以分析与讨论,以期为消化科临床医师在日后工作中遇到类似患者提供相关参考。

In this paper,a case of jejunal stromal tumor with massive hemorrhage encountered in clinical work is reported.The disease is very critically dangerous which mainly manifested as black stools with dizziness,palpitations.The patient has hemorrhagic shock after admission.The initial diagnosis of the disease is gastrointestinal hemorrhage.However,as the disease progresses during the treatment,the patient still has active bleeding.It is emphasized that the patient has duodenal ulcer with hemorrhage at the same time,which begins to mislead the doctor's judgment of the disease after CTA examination.The patient was treated by internal medicine department,interventional department and general surgery department,and finally recovered.Although the patient's clinical symptoms at the time of admission misled the clinician's judgment on the disease,this study focused on the differential diagnosis of gastrointestinal bleeding,and analyzed and discussed gastrointestinal stromal tumors,in order to provide with relevant reference about similar patients for clinician of the digestive department in the future work.