Endoscopic treatment of bleeding gastric ulcer causing gastric wall necrosis:A case report

BACKGROUND Gastric wall necrosis is a rare complication of endoscopic treatment for bleeding gastric ulcer,which may exacerbate the patient’s condition once it occurs and may even require surgical intervention for treatment.CASE SUMMARY A 59-year-old man was admitted to our department with melena.Endoscopy revealed a giant ulcer in the gastric antrum with a visible vessel in its center,which was treated with sclerosants and tissue glue injection and resulted in necrosis of the gastric wall.CONCLUSION Injection of sclerosants and tissue glue may lead to gastric wall necrosis,which is a serious complication.Therefore,before administering this treatment to patients,we should consider other more effective methods of hemostasis to avoid gastric wall necrosis.

双气囊小肠镜检查联合小肠CT造影在小肠疾病中的诊断价值

目的探讨双气囊小肠镜(DBE)联合小肠CT造影(CTE)检查在小肠疾病中的诊断价值。方法纳入不明病因的小肠疾病患者65例,均进行CTE和DBE检查,分析DBE、CTE及两者联合检查对病因的检出率。结果在不明原因消化道出血、消瘦和腹痛患者中,DBE检出率均优于CTE(P<0.01),联合检查检出率均优于CTE或DBE单项检查(P<0.01);对不明原因腹胀的患者,联合检查检出率与DBE单项检查相当,均优于CTE(P<0.01)。ROC曲线提示联合检查检出率更高。结论对于不明原因消化道出血的患者,可优先选择DBE或两者联合;对于怀疑肠腔占位或者狭窄的患者,应优先行CTE检查。根据患者情况联合应用DBE和CTE有优势互补作用,能极大地提高小肠疾病的诊断率。