Department of Internal Medicine, Carle Foundation Hospital, Urbana, Illinois, USA
Department of Internal Medicine, Shalamar Medical and Dental College, Lahore, Pakistan.
BMJ Case Rep. 2021 Jan 28;14(1):e237876. doi: 10.1136/bcr-2020-237876.
Granulomatosis with polyangiitis (GPA) is characterised by systemic necrotising vasculitis of small arteries and veins with multitude of organ involvement, with the most common being the upper and lower respiratory tract and renal system. Gastrointestinal involvement is a rare late manifestation with a high mortality rate and usually results in intestinal perforation. Our patient presented with gastrointestinal bleeding secondary to jejunal artery vasculitis. Gastrointestinal bleeding as initial presentation of GPA is very rarely documented. CT mesenteric angiogram is helpful for the localisation of bleed in these cases. In case of refractory bleeding, surgical excision is required.
肉芽肿性多血管炎(GPA)的特征是小动脉和静脉的系统性坏死性血管炎,伴有多种器官受累,最常见的是上呼吸道和下呼吸道以及肾脏系统。胃肠道受累是一种罕见的晚期表现,死亡率很高,通常导致肠穿孔。我们的患者因空肠动脉血管炎而出现胃肠道出血。以胃肠道出血为 GPA 首发表现的情况非常罕见。肠系膜 CT 血管造影有助于确定这些情况下的出血部位。对于难治性出血,需要手术切除。