上部消化管出血および急性失血性貧血の原因となる過形成性胃ポリープ

Hyperplastic Gastric Polyp Causing Upper Gastrointestinal Hemorrhage and Acute Blood Loss Anemia.

• Aimen Farooq
• Bayarmaa Mandzhieva
• James Wert
• Mamoon Ur Rashid

抄録

過形成性胃ポリープは、米国で2番目に多い胃ポリープで、男女ともに同程度の発生率であり、通常は内視鏡検査中に偶発的に発見されます。慢性的な出血による鉄欠乏性貧血を合併していることはよく知られている。症例は69歳男性で，急性上部消化管出血を伴う比較的小さな過形成性胃ポリープを有し，メレナと急性出血性貧血を呈し，集中治療室への入院を必要とした．病理検査では、限局性の腸内転形成と低悪性度の異形成を認めたが、悪性腫瘍は認められなかった。退院後は消化器内科での外来経過観察となった。

Hyperplastic polyps are the second most common type of gastric polyp in the United States with equal incidence in both genders, usually found incidentally during endoscopic examinations. It is a well-known fact that they are associated with iron-deficiency anemia due to chronic blood loss. We present a case of a 69-year-old man with a relatively small hyperplastic gastric polyp with acute upper gastrointestinal bleeding, presenting with melena and acute blood loss anemia requiring admission to intensive care unit and urgent endoscopic intervention with hot snare removal of the polyp and cautery of surrounding area with excellent hemostasis. The pathology revealed focal intestinal metaplasia and low-grade dysplasia with no evidence of malignancy. He was subsequently discharged with outpatient follow-up with gastroenterology.

Copyright © 2020, Farooq et al.