结肠毛细血管扩张症伴出血1例并文献复习

Colonic telangiectasia combined with bleeding:A case report and literature review

目的探讨结肠毛细血管扩张症的临床特点及诊疗思路。方法回顾分析因反复消化道出血伴贫血就诊的结肠毛细血管扩张症1例患者的临床资料,并复习相关文献。结果患者,女,56岁,因“反复黑便、鲜血便交替”就诊,肠镜检查示盲肠至降结肠范围内环周黏膜多处见广泛大小不等的网状、树枝状、蜘蛛痣样毛细血管扩张,最大约5 mm×5 mm,诊断为结肠毛细血管扩张症。结论结肠毛细血管扩张症又称“结肠血管发育不良”,多见于老年患者,大多无症状,少数可表现为消化道出血,电子结肠镜检查是诊断本病的重要手段,病变多见于右半结肠,无症状者无需治疗,合并出血者可考虑药物治疗或内镜下局部止血。

Objective To explore the clinical characteristics and diagnostic and therapeutic strategies of colonic telangiectasia.Methods A retrospective analysis was conducted on the clinical data of a patient with colonic telangiectasia who presented with repeated gastrointestinal bleeding and anemia,and relevant literature was reviewed.Results A 56-year-old female patient presented with recurrent black stools and alternating fresh bloody stools.Colonoscopy showed extensive network-like,dendritic,and spider nevus-like capillary dilation in multiple locations around the mucosa from the cecum to the descending colon,with the maximum of approximately 5mm×5mm.She was finally diagnosed with colonic telangiectasia.Conclusion Colonic telangiectasia,also known as colonic vascular dysplasia,is more common in elderly patients.It is mostly asymptomatic,and gastrointestinal bleeding is an occasional symptom.Electronic colonoscopy is an important diagnostic method for colonic telangiectasia,and lesions are more common in the right colon.Asymptomatic patients do not require treatment,and those with concurrent bleeding may consider medications or local hemostasis under endoscopy.