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Hemorragia digestiva por divertículos jejunais : caso clínico
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Resumo(s)
A diverticulose jejunal é uma doença pouco comum e normalmente assintomática, o que dificulta e retarda o seu diagnóstico. Trata-se, muitas vezes, de um achado incidental em tomografia computorizada, séries radiográficas contrastadas do tubo digestivo, ou cirurgia. No entanto, pode também surgir sob a forma de complicação aguda com elevado risco de mortalidade tal como hemorragia gastrointestinal, diverticulite, perfuração ou volvo.
Apesar de ser uma condição pouco frequente, a diverticulose jejunal deve fazer parte dos diagnósticos diferenciais em casos de hemorragia gastrointestinal de causa desconhecida, uma vez que pode dar origem a uma hemorragia maciça.
Neste trabalho, descreve-se o caso clínico de um doente do sexo masculino de 67 anos de idade com um quadro de hemorragia digestiva obscura visível cuja etiologia revelou ser a presença de diverticulos jejunais.
Para um melhor reconhecimento e compreensão desta patologia, são revistos alguns aspectos da literatura pertinentes na interpretação do caso clínico.
Jejunal diverticulosis is a rare clinical entity, usually asymptomatic, which makes it difficult to diagnose and to have it done on time. This is frequently an incidental finding on a CT scan, radiologic follow-through study of the gastrointestinal tract or surgery. However, it can also present with life-threatening acute complications such as massive gastrointestinal bleeding, diverticulitis, perforation or volvulus. Despite being an uncommon condition, jejunal diverticulosis should remain on the differential diagnosis and investigations when a gastrointestinal bleeding with unknown etiology is considered, as it may cause massive hemorrhages. In this report, we describe a clinical case of a 67-year-old man, presenting with an overt obscure gastrointestinal bleeding that turned out to be secondary to a jejunal diverticular disease. In order to provide an adequate support for the understanding of this disease and clinical case, several aspects of the literature were reviewed in this paper.
Jejunal diverticulosis is a rare clinical entity, usually asymptomatic, which makes it difficult to diagnose and to have it done on time. This is frequently an incidental finding on a CT scan, radiologic follow-through study of the gastrointestinal tract or surgery. However, it can also present with life-threatening acute complications such as massive gastrointestinal bleeding, diverticulitis, perforation or volvulus. Despite being an uncommon condition, jejunal diverticulosis should remain on the differential diagnosis and investigations when a gastrointestinal bleeding with unknown etiology is considered, as it may cause massive hemorrhages. In this report, we describe a clinical case of a 67-year-old man, presenting with an overt obscure gastrointestinal bleeding that turned out to be secondary to a jejunal diverticular disease. In order to provide an adequate support for the understanding of this disease and clinical case, several aspects of the literature were reviewed in this paper.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2015
Palavras-chave
Divertículo Hemorragia gastrointestinal Jejuno Gastroenterologia