Aralik 2020
Akut gastrointestinal sistem kanmasi: Endoskopi sonrasi sirada ne var? Olgu sunumu
Acute gastrointestinal bleeding: What is the next step after endoscopy? A case report
- Ana Sayfa
- Sayılar
- Aralik 2020
- Akut gastrointestinal sistem kanmasi: Endoskopi sonrasi sirada ne var? Olgu sunumu...
Özet
Gastrointestinal sistem kanamalarinin nadir sebepleri arasinda gastrointestinal stromal tümörler vardir. Bu tümörler, gastrointestinal sisteminen sik görülen mezenkimal neoplazmlaridir. Ince barsak yerlesimli olduklarinda üst gastrointestinal sistem endoskopide ve kolonoskopidesaptanmasi güç olabilir. Ince barsak yerlesimli bu tümörleri saptamakiçin çesitli non-invaziv ve invaziv görüntüleme yöntemleri kullanilir. Buyöntemlerden biri de manyetik rezonans enterografidir. Bu yazimizdaacil servise melena sikayetiyle gelen 62 yasinda erkek hastamizi sunuyoruz. Endoskopik görüntülemelerde ve eritrosit isaretli sintigrafide kanama odagi ve kanamaya sebep olan patolojinin saptanamamasi üzerineyapilan manyetik rezonans enterografide jejunum-ileum bileskesindeyumusak doku intensitesinde kitleye rastlandi. Operasyonla çikarilan kitlenin patolojisi gastrointestinal stromal tümör olarak geldi. Operasyonsonrasi hasta sifa ile taburcu edildi. Gastrointestinal sistem kanamalarinda tani ve tedavide endoskopik yöntemler ilk basvurulan araçlardir.Endoskopik islemlerin yetersiz kaldigi durumlarda invasiv araçlara basvurulabilir. Bu araçlara basvurmadan, endoskopik yöntemlerle nedeni saptanamayan gastrointestinal sistem kanamalarda non-invasiv bir yöntemolan manyetik rezonans enterografi akla gelmelidir.
Abstract
Gastrointestinal stromal tumors are among the rare causes of gastrointestinal system bleeding. These tumors are the most common mesenchymal neoplasms of the gastrointestinal tract. When located in thesmall intestine, they may be difficult to detect by upper gastrointestinalendoscopy and colonoscopy. Various non-invasive and invasive imagingtechniques have been employed to detect these small bowel tumors.One of these methods includes magnetic resonance enterography. Inthis study, we have presented a 62-year-old male patient who was admitted to the emergency department with the complaint of melena.Because no causative factor for bleeding was detected by endoscopicimaging and erythrocyte-labeled scintigraphy, magnetic resonance enterography was performed. A mass of soft tissue density was detectedat the jejunum-ileum junction. The pathology of the surgically removedmass was gastrointestinal stromal tumor. After the operation, the patient was discharged with full recovery. Endoscopic methods are thefirst-line methods in diagnosis and treatment of gastrointestinal systembleeding. In cases where endoscopic procedures are insufficient, non-invasive tools can be used. Magnetic resonance enterography, which is anon-invasive method, should therefore be considered in gastrointestinalsystem bleedings when the source of bleeding cannot be detected byendoscopic methods.
