| Autor: |
J A, Wegdam, H S, Hofker, G, Dijkstra, M F J, Stolk, M A J M, Jacobs, A J H, Suurmeijer |
| Jazyk: |
Dutch; Flemish |
| Rok vydání: |
2006 |
| Předmět: |
|
| Zdroj: |
Nederlands tijdschrift voor geneeskunde. 150(32) |
| ISSN: |
0028-2162 |
| Popis: |
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. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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