Bramwell N H, Davies R A, Koshal A, Tse G N, Keon W J, Walley V M
Department of Pathology, University of Ottawa, Ontario, Canada.
J Heart Transplant. 1987 Sep-Oct;6(5):303-6.
The case of a 61-year-old man, in whom heart transplantation was complicated by fatal gastrointestinal hemorrhage from duodenal ulcers 50 days after surgery, is described. Autopsy examination revealed extensive mucosal ulceration and hemorrhage into the bowel and peritoneal hemorrhage. Microscopy showed classical cytomegalovirus inclusions in clusters of cells in necrotic foci in the duodenum, lungs, and colon. This unusual case is the first reported example of cytomegalovirus-associated fatal gastrointestinal hemorrhage after heart transplantation. It is discussed in the context of the known features of the morbidity and mortality associated with cytomegalovirus infection in transplant patients.
本文描述了一例61岁男性患者的病例，该患者在心脏移植术后50天因十二指肠溃疡导致致命性胃肠道出血。尸检发现肠道广泛黏膜溃疡、出血以及腹腔内出血。显微镜检查显示在十二指肠、肺和结肠的坏死灶中，细胞簇内有典型的巨细胞病毒包涵体。这一罕见病例是心脏移植后巨细胞病毒相关致命性胃肠道出血的首例报道。本文结合移植患者中巨细胞病毒感染相关发病和死亡的已知特征对此进行了讨论。
