[Occult gastrointestinal bleeding due to a Dieulafoy lesion in the terminal ileum]. / Occult gastro-intestinaal bloedverlies door een laesie van Dieulafoy in het terminale ileum.
Ned Tijdschr Geneeskd
; 150(32): 1776-9, 2006 Aug 12.
Article
en Nl
| MEDLINE
| ID: mdl-16948240
ABSTRACT
A 50-year-old man awaiting liver transplantation for primary sclerosing cholangitis developed iron-deficiency anaemia. Repeated occult gastrointestinal bleeding led to an increasing need for blood transfusions. After multiple oesophagogastroduodenoscopies and colonoscopies, videocapsule endoscopy finally demonstrated a polyp-like lesion in the terminal ileum. The lesion had not been detected despite two attempts (oral and anal) at double-balloon enteroscopy and even a peroperative enteroscopy. Only during a second laparotomy, again involving peroperative enteroscopy, a small red lesion was detected and resected 80 cm proximal to the ileocecal valve (Bauhin's valve). Histology revealed a Dieulafoy lesion. Four months later, after normalisation and stabilisation of his haemoglobin level, the patient received a successful liver transplant. If the cause of occult gastrointestinal bleeding in a patient remains unclear despite regular endoscopic procedures, new techniques like videocapsule endoscopy and double-balloon enteroscopy may contribute to identifying the cause. This may lead to an exceptional finding such as a Dieulafoy lesion in the distal ileum.
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Colección:
01-internacional
Asunto principal:
Endoscopía Gastrointestinal
/
Endoscopios Gastrointestinales
/
Hemorragia Gastrointestinal
/
Íleon
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Prognostic_studies
Límite:
Humans
/
Male
/
Middle aged
Idioma:
Nl
Revista:
Ned Tijdschr Geneeskd
Año:
2006
Tipo del documento:
Article