Hypoxic brain damage after massive small bowel bleeding

Korean J Med > Volume 71(3); 2006 > Article

Original Article

The Korean Journal of Medicine 2006;71(3):940-944.

Hypoxic brain damage after massive small bowel bleeding

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이화여자대학교 의과대학 내과학교실

증례 : 대량의 소장 출혈 후 발생한 저산소성 뇌손상

서검석&#;조은영&#;최창수&#;김지웅&#;김태현&#;최석채&#;나용호, , , , , ,

Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea

Abstract

Hypoxic brain damage is characterized by a decreased mental status, and neurological and psychological sequelae. The pathological sequelae of cerebral anoxia depends on the type and severity of the precipitating anoxia and on the vulnernability of the brain tissue. A 58-year-old man developed a decreased mental status and hematochezia for 2 days without any management such as blood transfusion and/or volume replacement. Brain MRI revealed a high signal in most of the subcortical white matter. We couldn't find a bleeding site with using colonoscopy and gastroscopy. However, capsule endoscopy revealed multiple, geographic ulcerations at the upper jejunum. After fluid therapy and blood transfusion, his decreased mental status was markedly improved, but neurological sequelae remained such as dysarthria, drooling, decreased motor activity and difficulties to write with his hand for over 8 months.(Korean J Med 71:S940-S944, 2006)

Key Words: Hypoxia, Brain damage, Hematochezia