Ogano Michio, Iwasaki Yu-ki, Takano Hitoshi, Takayama Morimasa, Takano Teruo, Fukuda Yu
First Department of Internal Medicine, Nippon Medical School, Tokyo.
Intern Med. 2006;45(6):355-8. doi: 10.2169/internalmedicine.45.1526. Epub 2006 Apr 17.
A 64-year-old man with repetitive gastrointestinal bleeding was admitted to our hospital. Colonic artery angiography revealed angiodysplasia as the bleeding site, and echocardiography showed aortic valve stenosis. A decrease in the high molecular weight von Willebrand factor multimers, which are known to play an important role in hemostasis, was observed, and Heyde syndrome was diagnosed. We selected colectomy instead of aortic valve replacement because the patient had undergone two open heart surgeries. Following colectomy, the patient showed a good clinical course without recurrent gastrointestinal bleeding. Colectomy might serve as a therapeutic option for Heyde syndrome after the precise site of angiodysplasia is detected by angiography.
一名64岁反复出现胃肠道出血的男性患者入住我院。结肠动脉血管造影显示血管发育异常为出血部位，超声心动图显示主动脉瓣狭窄。观察到在止血中起重要作用的高分子量血管性血友病因子多聚体减少，诊断为海德综合征。由于该患者已接受过两次心脏直视手术，我们选择了结肠切除术而非主动脉瓣置换术。结肠切除术后，患者临床过程良好，未再发生胃肠道出血。在通过血管造影检测到血管发育异常的确切部位后，结肠切除术可能是海德综合征的一种治疗选择。
