以Histoacryl治療十二指腸靜脈瘤出血－－病例報告

Sclerotherapy of Duodenal Varices with Histoacryl--A Case Report

臨床上，十二指腸靜脈瘤出血遠較食道及胃靜脈瘤少見，但可能造成大量出血，並且危及生命。我們報告一個病例：43歲男性病人，曾因酒精性肝硬化及食道靜脈瘤出血住院治療：此次因為吐血及黑便而至急診求診，經內視鏡檢查診斷為十二指腸球部靜脈瘤出血。經由內視鏡注射Histoacryl之後止血成功，而出院。兩週後，再度出血而住院；再一次實施內視鏡注射Histoacryl止血。之後追蹤至今，未再復發。我們於此討論十二指腸靜脈瘤的成因，臨床上、放射學上，以及內視鏡上的表現，與其治療方式。

Bleeding from duodenal varices, although clinically not so common as esophageal and gastric varicas, could be severe and fatal. We now report such a case: A 43 y/o male patient, used to be a victim of liver cirrhosis and esophageal varices bleeding, was admitted for hematemesis and tarry stool while panendoscopy revealed a blood-coated varices in the duodenal bull. Undergoing sclerotherapy with Histoacryl injection and observing for 2 more days without evidences of bleeding any longer, he was permitted to leave and keep in resting state for weeks at home. But, he came back for re-bleeding of the duodenal varices, that was stopped with another endoscopic sclerotherapy of same procedure mentioned above. We hereupon discuss the etiology, clinical presentation, radiological finding, endoscopic picture, and therapeutic methods of this disorder.