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主动脉瓣狭窄——结肠血管发育异常反复出血的一个促发因素:文献综述

Aortic Valve Stenosis, a Precipitating Factor of Recurrent Bleed in Colonic Angiodysplasia: A Literature Review.

作者信息

Johnson Adejoke M, Chovwen Praise E, Akpan Ezekiel J, Patel Anna

机构信息

Medicine, All Saints University School of Medicine, Roseau, DMA.

Medicine, All Saints University College of Medicine, Kingstown, VCT.

出版信息

Cureus. 2021 Jun 24;13(6):e15903. doi: 10.7759/cureus.15903. eCollection 2021 Jun.

Abstract

Angiodysplasia (also known as angioectasia) is a lesion characterized by abnormal, dilated small blood vessels in the mucosa and submucosal layers of the GI tract. With the estimated low incidence of active GI bleeding from these lesions, angiodysplasia can be challenging to diagnose. The presence of aortic stenosis has increased the recognition rate of angiodysplasia, especially in the elderly. Despite the associations between aortic stenosis and angiodysplasia (Heyde's syndrome) revealed in several studies, the etiology of Heyde syndrome is still debatable, which has led to the proposition of several hypotheses that are reviewed in this article. This activity will help review the meaning of Heyde's syndrome, epidemiology, proposed pathophysiology, diagnosis, and management by surveying articles published between 1955 and 2021 on PubMed. We used search terms such as "colonic angiodysplasia," "arteriovenous malformation," "Heyde syndrome," "refractory gastrointestinal bleed," "aortic valve stenosis," and "acquired von Willebrand disease." Findings revealed an association between aortic stenosis and lower gastrointestinal (GI) bleed.

摘要

血管发育异常(也称为血管扩张)是一种病变,其特征是胃肠道黏膜层和黏膜下层出现异常扩张的小血管。由于这些病变导致的活动性胃肠道出血估计发病率较低,血管发育异常的诊断可能具有挑战性。主动脉瓣狭窄的存在提高了血管发育异常的识别率,尤其是在老年人中。尽管多项研究揭示了主动脉瓣狭窄与血管发育异常(海德综合征)之间的关联,但海德综合征的病因仍存在争议,这导致了本文所综述的几种假说的提出。本活动将通过查阅1955年至2021年在PubMed上发表的文章,帮助回顾海德综合征的含义、流行病学、提出的病理生理学、诊断和管理。我们使用了“结肠血管发育异常”、“动静脉畸形”、“海德综合征”、“难治性胃肠道出血”、“主动脉瓣狭窄”和“获得性血管性血友病”等搜索词。研究结果显示主动脉瓣狭窄与下消化道出血之间存在关联。

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