Maeshima E, Yamada Y, Yukawa S
The Third Department of Internal Medicine, Wakayama Medical College, Wakayama City, Japan.
Scand J Rheumatol. 1999;28(4):262-4. doi: 10.1080/03009749950155670.
A case of a 60-year-old woman with secondary gastrointestinal amyloidosis to rheumatoid arthritis is reported. Biopsy findings in the mucosa of the stomach and lower gastrointestinal tract revealed amyloidosis. Endoscopic examination of the lower gastrointestinal tract revealed multiple nodular elevations. The patient showed massive melena. Emergency angiography was performed and an extravasation was found at branches of the jejunal artery. Embolization was performed and this lead to a good prognosis. Patients with massive hemorrhages following gastrointestinal amyloidosis generally have a poorer prognosis. Embolotherapy performed for the present case might represent an effective therapeutic method for gastrointestinal hemorrhage in gastrointestinal amyloidosis.
报告了一例60岁患有类风湿关节炎继发胃肠道淀粉样变性的女性病例。胃和下消化道黏膜的活检结果显示为淀粉样变性。下消化道内镜检查发现多个结节状隆起。患者出现大量黑便。进行了急诊血管造影,发现空肠动脉分支处有造影剂外渗。进行了栓塞治疗,预后良好。胃肠道淀粉样变性后出现大量出血的患者通常预后较差。对本病例实施的栓塞治疗可能是胃肠道淀粉样变性所致胃肠道出血的一种有效治疗方法。