Romano T J, Graham S M, Chuong J, Ballantyne G H, Modlin I M, Sussman J, West A B
Department of Gastroenterology, Yale University School of Medicine, New Haven, CT 06510.
J Clin Gastroenterol. 1988 Dec;10(6):693-8. doi: 10.1097/00004836-198812000-00025.
Atheromicroembolism after aortic or cardiac catheterization is frequently found at autopsy but rarely recognized in life, perhaps because many cases are asymptomatic. We report two patients who, after left heart catheterization, developed gastrointestinal hemorrhage from a solitary colonic ulcer caused by occlusive atheromicroemboli in submucosal vessels. We briefly review the spectrum and pathogenesis of atheromicroembolic injury to the gastrointestinal tract. Atheromicroemboli, which occlude vessels too small to be visualized by angiography, should be considered in the differential diagnosis of gastrointestinal bleeding in patients who have undergone aortic instrumentation.
主动脉或心脏导管插入术后的动脉粥样硬化微栓塞在尸检时经常被发现，但在生前很少被识别，这可能是因为许多病例没有症状。我们报告了两名患者，他们在左心导管插入术后，因黏膜下血管闭塞性动脉粥样硬化微栓子导致的孤立性结肠溃疡而发生胃肠道出血。我们简要回顾了胃肠道动脉粥样硬化微栓塞损伤的范围和发病机制。对于接受主动脉器械操作的患者，在胃肠道出血的鉴别诊断中应考虑动脉粥样硬化微栓子，这些微栓子会阻塞太小而无法通过血管造影显示的血管。
