以急性消化道大出血为表现的青年小肠多发间质瘤1例并文献复习  

Multiple intestinal stromal tumors in a young patient with acute gastrointestinal hemorrhage:A case report and literature review

作　　者：马兴彬 刘丽娟 牛琼[1] 尚炳英[1] 李扬扬[2] 刘成霞[1] Xing-Bin Ma;Li-Juan Liu;Qiong Niu;Bing-Ying Shang;Yang-Yang Li;Cheng-Xia Liu(Department of Gastroenterology,Binzhou Medical College Affiliated Hospital,Binzhou 256603,Shandong Province,China;Department of Pathology,Binzhou Medical College Affiliated Hospital,Binzhou 256603,Shandong Province,China)

机构地区：[1]滨州医学院附属医院消化内科,山东省滨州市256603 [2]滨州医学院附属医院病理科,山东省滨州市256603

出　　处：《世界华人消化杂志》2019年第15期972-976,共5页World Chinese Journal of Digestology

摘　　要：背景临床诊疗中急性小肠出血无特异性,且因小肠活动度大,迂回曲折,内镜检查不易操作,故对小肠出血的诊断仍是临床上的一大挑战.病例概述本案例为一例青年患者发生小肠多发间质瘤合并急性消化道大出血,在积极纠正休克后,以腹部电子计算机断层扫描(computed tomography,CT)为导向,完善急诊小肠镜检查,而后经过多学科综合会诊讨论迅速制定合理规范治疗方案及后续治疗计划,挽救患者生命,使患者获得最大受益.结论小肠间质瘤起病隐匿,缺乏特异性临床表现,可结合特点联合应用B超,CT、磁共振成像及相关血管造影,胃肠镜,胶囊内镜等检查明确术前诊断、精确临床分期,经多学科讨论制定规范的治疗方案,改善患者预后.BACKGROUND Acute small intestinal bleeding in clinical diagnosis and treatment is not specific,and the diagnosis of small intestinal bleeding is still a major clinical challenge because of its high mobility,tortuosity,and difficulty in endoscopic examination.CASE SUMMARY This case is a young patient with multiple stromal tumors of the small intestine complicated with acute massive hemorrhage of the digestive tract.After correction of shock,abdominal computed tomography(CT)and emergency enteroscopy were performed,followed by multi-disciplinary team discussion to develop a reasonable and standardized treatment plan and subsequent therapy to save the patient’s life and maximize the benefits of the patient.CONCLUSION Small intestinal stromal tumor has an insidious onset and lacks specific clinical manifestations.According to the characteristics of this disease,B-mode ultrasound,CT,magnetic resonance imaging,digital subtraction angiography,gastrointestinal endoscopy,capsule endoscopy,and other examinations should be used to make a preoperative diagnosis and conduct accurate clinical staging.Multidisciplinary discussion is helpful to develop standardized treatment options to improve the prognosis of patients.

关 键 词：小肠 胃肠道多发间质瘤 消化道出血 

分 类 号：R735.32[医药卫生—肿瘤]