胃肠道出血的罕见原因：Roux-en-Y胃旁路术患者的Taeniasis
A Rare Cause of Gastrointestinal Bleeding: Taeniasis in a Roux-en-Y Gastric Bypass Patient.
摘要(中文译文)
感染是一种全球分布的寄生虫病，在发达国家较为少见。绦虫病通常表现为轻微症状或无临床症状，贫血并非常见特征。我们报告一例50岁女性患者，有Roux-en-Y胃旁路术病史，因腹痛、乏力及黑便就诊。血液检查显示重度贫血，遂行内镜评估。食管胃十二指肠镜检查仅显示术后改变，下消化道内镜检查未发现出血来源。视频胶囊内镜显示Roux-en-Y吻合口附近及回肠内有血液。随后小肠镜检查发现十二指肠溃疡伴近期出血，并在输入袢内发现一条绦虫。采用止血粉实现止血，患者接受吡喹酮治疗。随访时患者无症状，血红蛋白水平已恢复正常。绦虫病是消化道出血的罕见病因，文献中仅有少数病例报道。本例患者中，寄生虫在胃旁路术的旷置肠袢内被检出。寄生虫附着或活动所致的黏膜损伤可能解释了出血原因。本病例强调，在黑便的鉴别诊断中应考虑寄生虫感染，即使患者来自非流行地区且无典型危险因素。提高对这一罕见表现的认识对于确保及时诊断和治疗至关重要。
Abstract
infection is a globally distributed parasitic disease that is uncommon in developed countries. Taeniasis typically presents with mild or no symptoms, and anemia is not a usual feature. We report the case of a 50-year-old woman with a history of Roux-en-Y gastric bypass who presented with a history of abdominal pain, asthenia, and melena. Blood tests revealed severe anemia, prompting endoscopic evaluation. EGD showed only postsurgical changes, and lower endoscopy revealed no bleeding source. Video capsule endoscopy demonstrated blood near the Roux-en-Y anastomosis and in the ileum. Enteroscopy subsequently identified a duodenal ulcer with recent bleeding and a tapeworm in the afferent limb. Hemostasis was achieved with hemostatic powder, and the patient was treated with praziquantel. At follow-up, she was asymptomatic, and her hemoglobin levels had normalized. Taeniasis is a rare cause of gastrointestinal bleeding, with only a few cases described in the literature. In this patient, the parasite was detected in the excluded limb of the gastric bypass. Mucosal injury caused by parasite attachment or movement may explain the bleeding. This case highlights the importance of considering parasitic infections in the differential diagnosis of melena, even in patients from non-endemic regions and without typical risk factors. Increased awareness of this rare presentation is essential to ensure timely diagnosis and treatment.
如何引用
AMA
Rita Ribeiro Dias, Paula Martins, André Pereira, Ana Fareleira, Silvestre Carneiro. A Rare Cause of Gastrointestinal Bleeding: Taeniasis in a Roux-en-Y Gastric Bypass Patient.. Cureus. 2026; doi:10.7759/cureus.108340.
APA
Rita Ribeiro Dias, Paula Martins, André Pereira, Ana Fareleira, Silvestre Carneiro (2026). A Rare Cause of Gastrointestinal Bleeding: Taeniasis in a Roux-en-Y Gastric Bypass Patient.. Cureus. https://doi.org/10.7759/cureus.108340
GB/T 7714
Rita Ribeiro Dias, Paula Martins, André Pereira, Ana Fareleira, Silvestre Carneiro. A Rare Cause of Gastrointestinal Bleeding: Taeniasis in a Roux-en-Y Gastric Bypass Patient.[J]. Cureus, 2026 doi:10.7759/cureus.108340.
在 PubMed增强版 阅读全文
翻译全文 · AI 文献问答 · PDF 原文下载 · 引用导出