内镜下胃息肉切除术并发胃血肿1例

A case of gastric hematoma precipitated by endoscopic gastric mucosal resection

内镜下微创手术治疗并发胃血肿很罕见,可发生在凝血功能正常的患者。宜昌市中心人民医院消化科于2022年7月30日收治1例内镜下胃息肉切除术并发胃血肿患者。该患者在内镜下胃息肉切除术后出现腹痛,内镜检查发现胃血肿破裂出血,经内镜止血后病情好转出院。内镜下微创手术治疗前须警惕患者是否具有凝血功能障碍及胃壁血管畸形等潜在风险因素;术中须警惕胃血肿的形成,早发现、早治疗;术后须警惕患者是否有难以解释的腹痛、腹胀,以及有无呕血、黑便。若并发消化道出血,应及时内镜下止血,难以控制的出血应行数字减影血管造影介入或外科手术治疗。

Gastric hematoma as a complication following endoscopic minimally invasive treatment is rare and can occur in patients with normal coagulation.On July 30,2022,a patient with gastric hematoma precipitated by endoscopic gastric mucosal resection was admitted to the Department of Gastroenterology,Yichang Central People’s Hospital.The patient experienced abdominal pain after the endoscopic mucosal resection.Rupture and bleeding of gastric hematoma were found under endoscopy,and the condition was improved after endoscopic hemostasis.Potential risk factors should be alerted,such as coagulation disorders and gastric vascular malformation,before undergoing endoscopic invasive treatment.In order to early detection and treatment,it is essential to realize the formation of hematoma during the endoscopic treatment.After endoscopic treatment,we should be cautions if patients experiences unexplained abdominal pain or distension,hematemesis or dark stool.Timely endoscopic hemostasis should be performed to control gastrointestinal bleeding.Digital subtraction angiography or surgery should be applied if the bleeding is difficult to control.