Bleeding from the jejunum diagnosed by double-balloon endoscopy in a maintenance hemodialysis patient

Kishi Seiji, Nishioka Keisuke, Araki Makoto, Araoka Toshikazu, Matsumura Takeshi, Kawanami Michiharu, Saita Hiroshi, Takeoka Hiroya

doi:10.4009/jsdt.40.669

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Other Title

ダブルバルーン式内視鏡にて慢性消化管出血の診断に成功した維持血液透析患者の１例
症例報告ダブルバルーン式内視鏡にて慢性消化管出血の診断に成功した維持血液透析患者の1例
ショウレイホウコクダブルバルーンシキナイシキョウニテマンセイショウカカンシュッケツノシンダンニセイコウシタイジケツエキトウセキカンジャノ 1レイ

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Abstract

The patient was a 71-year-old woman who started hemodialysis on July 5, 2002.<br>Around the same time, she developed black stool and severe anemia was detected (Hb 4.2 g/dL). She had no etiology for bleeding identified on routine endoscopy of the upper and lower gastrointestinal tracts. Between initiation of hemodialysis and February 2005, she had four episodes of gastrointestinal bleeding that required blood transfusion support. The source of bleeding could not be identified by conventional radiological or endoscopic evaluation. Since we suspected small bowel bleeding, Wireless capsule endoscopy was performed. Unfortunately the source of bleeding was not identified. During hospital stay (Department of Ophthalmology) on July 22, 2005, she developed hypotension during hemodialysis. Severe anemia and black stool were detected. After blood transfusion support, she underwent double-balloon endoscopy which showed red spots at the middle portion of the jejunum. We considered these lesions to be angiodysplasia or solitary varix. The lesions disappeared without treatment. After prescription of carbazochrome sodium sulfonate, there were no further episodes of gastrointestinal bleeding.

Journal

Nihon Toseki Igakkai Zasshi

Nihon Toseki Igakkai Zasshi 40 (8), 669-674, 2007

The Japanese Society for Dialysis Therapy

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