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患者,男性,51岁。1988年5月开始不明原因出现柏油样便,每日3～4次,每次量多少不定。以后5年时间内反复多次出血,多家医院均按胃炎伴出血、胃窦炎伴出血给予相应治疗。1992年2月24日第7次复发,肛检发现直肠空虚,指套有暗红色血迹,进一步行纤维结肠镜检查,发现位于距回盲部5 cm～6 cm处的升结肠血管瘤出血,其大小为1.5 cm×1.5 cm,给予升结肠血管瘤切除,肠壁修补术而痊愈。术后笔者随访5年多,无胃部不适,也未服用治疗胃炎的任何药物,未再出现柏油样便。 讨论:血管瘤是由血管组织构成,一般认为是血管发育畸形或血管增生,分毛细血管瘤、蔓状血管瘤、海绵状血管瘤,绝大多数位于体表的皮下组织内或肌肉内,位于内脏者甚少。本例误诊误治达5年之久,笔者认为有如下原因:①被柏油样便乃是上消化道出血的惯性思维方式所束缚,在5年多时间里,先后被6家医
Patient, male, 51 years old. In May 1988, tarry stools began to appear for unknown reasons, 3 to 4 times a day, each time the amount of uncertainty. Repeated bleeding over the next 5 years, a number of hospitals were treated with gastritis associated with bleeding, antral gastritis associated with bleeding. On the 24th of February 1992, the 7th relapse occurred. The rectal empty was found on the rectal examination. The fingertips were covered with dark red bloodstains. Further colonoscopy was performed. It was found that hemorrhagic ascending hemangioma located 5 cm to 6 cm away from the ileocecal region. Its size was 1.5 cm × 1.5 cm, and it was given ascending colonic hemangioma, which was cured by intestinal wall repair. After more than 5 years of follow-up, the author had no stomach discomfort, nor did he take any medication for gastritis and no tarry stools occurred. Discussion: Hemangiomas consist of vascular tissue and are generally considered to be vascular malformations or vascular hyperplasia. They are divided into capillary hemangiomas, involute hemangiomas, and cavernous hemangiomas, most of which are located in the subcutaneous tissue or muscle of the body surface. There are few viscera. This case was misdiagnosed and mistreated for a period of 5 years. The author believes that there are the following reasons: 1 It is bound by the inertial thinking mode of upper gastrointestinal bleeding and it has been treated by 6 doctors in more than 5 years.