Progress of Digestive Endoscopy
Online ISSN : 2187-4999
Print ISSN : 1348-9844
ISSN-L : 1348-9844
症例
DAPT内服中に血便を呈し孤立性PJSと診断された透析患者の一例
石井 亮佑池宮城 秀和申 貴広普天間 朝久原 英展杉山 勇太町田 智世米本 有輝伊東 詩織深見 裕一吉野 耕平先田 信哉熊谷 二郎石原 早織
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2020 年 97 巻 1 号 p. 108-109

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A 65-year-old man taking dual antiplatelet therapy (DAPT) on maintenance dialysis for chronic renal insufficiency was rescued to our hospital by chief complaint of bloody stool in 2019. Contrast-enhanced CT showed extravasation of the contrast agent into the ileum, and he was hospitalized with a diagnosis of small intestinal bleeding. Blood stool disappeared after discontinuation of DAPT. Small intestinal endoscopy revealed a 25 mm-sized polyp with erosion in the ileum, which was considered a bleeding source. Based on the risk of rebleeding due to DAPT resumption, EMR was performed, and Peutz-Jeghers type polyp was diagnosed. With the aging, the number of patients taking DAPT is expected to increase. Small intestinal polyps, which had previously been asymptomatic, may cause gastrointestinal bleeding due to oral administration of DAPT, which may increase the frequency of detection. In gastrointestinal bleeding from the small intestine of patients receiving DAPT, it was considered important to remind bleeding from polyps such as in this case.

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© 2020 一般社団法人 日本消化器内視鏡学会 関東支部
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