Ikuta Takeshi, Shibata Toshihiko, Hirai Hidekazu, Fukui Toshihiro, Suehiro Shigefumi
Department of Cardiovascular Surgery, Osaka City University Medical School, Osaka, Japan.
J Heart Valve Dis. 2003 Jul;12(4):458-60.
An association between aortic stenosis and angiodysplasia of the gut has been reported, though this is unproven. In many instances, recurrent gastrointestinal bleeding originating from angiodysplasia has ceased following aortic valve replacement (AVR). A case is reported of massive bleeding from a small-intestinal angiodysplasia after AVR. The diagnosis was made using radioisotope-labeled red cell scintigraphy and selective angiography of the ileocolic artery soon after AVR. Selective embolization using sponge was performed, and bleeding ceased immediately. The time from onset of bleeding to completion of embolization was 6 h. However, signs of peritonitis appeared the next morning, and an emergency resection of the necrotic ileum was performed. Bleeding from angiodysplasia of the gut may occur after AVR, although the etiologic role of aortic stenosis in angiodysplasic hemorrhage is not clear.
虽然尚未得到证实，但已有报告称主动脉瓣狭窄与肠道血管发育异常之间存在关联。在许多情况下，源自血管发育异常的反复胃肠道出血在主动脉瓣置换术（AVR）后已经停止。本文报告了1例AVR后小肠血管发育异常导致大量出血的病例。AVR后不久，通过放射性核素标记红细胞闪烁扫描术和回结肠动脉选择性血管造影术做出诊断。采用明胶海绵进行选择性栓塞，出血立即停止。从出血开始到栓塞完成的时间为6小时。然而，第二天早晨出现了腹膜炎体征，遂对坏死的回肠进行了急诊切除。肠道血管发育异常导致的出血可能发生在AVR后，尽管主动脉瓣狭窄在血管发育异常出血中的病因作用尚不清楚。
