Cai Y, Chen XB, Mai DH, Wu P, Chen YH, Chen H. Multidetector computed tomography three-dimensional and multiplanar reconstruction diagnosis of a rare cause of gastrointestinal bleeding: A case report. World J Gastrointest Surg 2021; 13(1): 87-95 [PMID: 33552396 DOI: 10.4240/wjgs.v13.i1.87]
Corresponding Author of This Article
Hua Chen, MBBS, Doctor, Department of Oncology, Maoming People's Hospital, No. 101 Weimin Road, Maoming 525000, Guangdong Province, China. chen1hua@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Jan 27, 2021; 13(1): 87-95 Published online Jan 27, 2021. doi: 10.4240/wjgs.v13.i1.87
Multidetector computed tomography three-dimensional and multiplanar reconstruction diagnosis of a rare cause of gastrointestinal bleeding: A case report
Yong Cai, Xiao-Bo Chen, Yong-Hai Chen, Department of Diagnostic Imaging, Maoming People’s Hospital, Maoming 525000, Guangdong Province, China
Da-Hai Mai, Hua Chen, Department of Oncology, Maoming People's Hospital, Maoming 525000, Guangdong Province, China
Ping Wu, Department of Gastroenterology, Maoming People's Hospital, Maoming 525000, Guangdong Province, China
Author contributions: Chen H and Cai Y analyzed and designed the study; Chen XB, Mai DH, Wu P, and Chen YH worked together to analyze the data; Chen H wrote and edited the manuscript; and all authors read and approved the manuscript.
Supported bySpecial Fund for Scientific Research for the High-level Hospital Construction Research Project of Maoming People’s Hospital, No. zx2020003
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Received: September 17, 2020 Peer-review started: September 17, 2020 First decision: November 16, 2020 Revised: November 30, 2020 Accepted: December 10, 2020 Article in press: December 10, 2020 Published online: January 27, 2021 Processing time: 119 Days and 6.9 Hours
Abstract
BACKGROUND
Anastomosis of the testicular vein with the superior mesenteric vein rarely causes severe gastrointestinal bleeding. To date, there have been few studies describing its appearance on medical imaging. Here, we present multidetector computed tomography three-dimensional and multiplanar reconstruction (MPR) images of a typical digital subtraction angiography showing proven ectopic bleeding and provide the first review of the image performance.
CASE SUMMARY
A 68-year-old man who had been rushed to the hospital with a four-day history of melena and fainting underwent multiple esophagogastroduodenoscopy procedures that failed to identify the source of bleeding. We used MPR combined with three-dimensional reconstruction images, and found that the testicular vein had anastomosed with the superior mesenteric vein, and they clustered together in the jejunal vessel wall, which caused severe gastrointestinal bleeding. Digital subtraction angiography confirmed the location of bleeding. After transfusion and embolization therapy, the patient’s condition improved.
CONCLUSION
Computed tomography-MPR combined with three-dimensional images offers significant value in the localization and qualitative assessment of rare gastrointestinal hemorrhage. The features of multiphase spiral scanning can improve the accuracy of the diagnosis.
Core Tip: We report a case of anastomosis of the testicular vein with the superior mesenteric vein that caused severe gastrointestinal bleeding. We used multidetector computed tomography three-dimensional and multiplanar reconstruction, and found that the testicular vein had anastomosed with the superior mesenteric vein, and gathered together in the jejunal vessel wall. Digital subtraction angiography confirmed the location of bleeding. After vascular intervention, the patient’s symptoms significantly improved.
