Adult intestinal heterotopic gastric mucosa resulting in alimentary tract hemorrhage: a report of 11 cases / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the clinical characteristics,diagnosis and treatment of intestinal heterotopic gastric mucosa resulting in alimentary tract hemorrhage.</p><p><b>METHODS</b>Eleven cases of intestinal heterotopic gastric mucosa with alimentary tract hemorrhage during the past 24 years in our hospital were reviewed and the clinical data were analyzed retrospectively.</p><p><b>RESULTS</b>The median age was 29 years old. Nine cases had abdominal pain, and radionuclide (99m)Tc-pertechnetate scan revealed bleeding lesion in 6 cases preoperatively. Segmental resection of the intestine with bleeding lesion were performed in all patients, postoperative pathology confirmed heterotopic gastric mucosa. The lesion was located in the jejunum in five cases and in the ileum in six cases. All lesions were complicated with diverticulum, or inflammatory mass on the intestinal wall, or abnormity of intestinal duplication.</p><p><b>CONCLUSIONS</b>Intestinal heterotopic gastric mucosa is difficult to be diagnosed preoperatively, and radionuclide (99m)Tc-pertechnetate scan plays a role in preoperative diagnosis.</p>

Early superselective angiography and transarterial embolization for massive bleeding after gastrectomy / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy of early superselective angiography and embolization in the diagnosis and treatment of massive bleeding after gastrectomy.</p><p><b>METHODS</b>The clinical data of 28 patients with massive bleeding after surgery from 1980 to 2001 were retrospectively analysed. All patients underwent emergency angiography and 27 of them were treated by transcatheter embolization.</p><p><b>RESULTS</b>Bleeding was controlled in 26 of the 28 patients (93%), recurrent bleeding occurred in 1, an recognized bleeding in 1, and abdominal pain in 1. There was no death.</p><p><b>CONCLUSIONS</b>Transarterial embolization for massive bleeding after gastrectomy is safe and effective. It is suggested that early emergency angiography should be considered in all patients with massive gastrointestinal bleeding after gastrectomy.</p>