Transfusionspflichtige gastrointestinale Blutung als Erstmanifestation eines Dünndarmkarzinoids
| Autor: | Peter Knoflach, S Meindl, Johann Auer, W Höbling, P. Oppitz, G Hinterholzer, J Kalchmair, Andreas Kirchgatterer, G Neuwirth, Allinger S, R Berent |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
endocrine system
medicine.medical_specialty Gastrointestinal bleeding business.industry Carcinoid tumors Gastroenterology medicine.disease digestive system diseases Hematochezia Appendix Small intestine medicine.anatomical_structure Internal medicine medicine Duodenum Upper gastrointestinal bleeding medicine.symptom business Carcinoid syndrome |
| Zdroj: | Zeitschrift für Gastroenterologie. 38:631-636 |
| ISSN: | 1439-7803 0044-2771 |
| DOI: | 10.1055/s-2000-7507 |
| Popis: | Carcinoid tumors arise from enterochromaffin or enterochromaffin-like cells that are present in the gastrointestinal tract, ovaries, and lungs. Over 90% of carcinoids originate in the gastrointestinal tract with the most common sites in order of frequency being the appendix, terminal ileum, rectum, and the remainder of the colon. Gastroduodenal and pancreatic carcinoids are infrequent. Carcinoid syndrome is associated with small intestine carcinoids in about 40%. Common symptoms include intermittent intestinal obstruction with crampy abdominal pain and vomiting, and weight loss. Upper gastrointestinal bleeding with melaena or hematochezia is a relatively rare early symptom of patients with small intestine carcinoid tumors. We report on a 69-year-old man, treated with acenocoumarol for previous thromboembolic complications of hereditary protein S deficiency. He was admitted to hospital because of an acute episode of hematochezia followed by melaena. Endoscopic evaluation of esophagus, stomach, duodenum and colonoscopy revealed no apparent source of bleeding. Selective angiographic evaluation of mesenterial arteries showed pathologic vasculature approximately in mid jejunum. Laparotomy revealed bleeding from a small submucosal malignant carcinoid tumor in small intestine and multiple large metastases within mesenteric tissue. Segmental resection of small intestine and exstirpation of the metastatic masses was performed. Postoperative period was uneventful. Cytotoxic chemotherapy in this adjuvant setting has not been recommended. Small intestinal carcinoid tumor has to be considered as a rare cause of gastrointestinal bleeding with melaena or hematochezia. Nevertheless, bleeding is a relatively rare early symptom of patients with small intestine carcinoid tumor. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|