Emanuel R B, Weiser M M, Shenoy S S, Satchidanand S K, Asirwatham J
J Clin Gastroenterol. 1985 Jun;7(3):237-46. doi: 10.1097/00004836-198506000-00010.
Arteriovenous malformations of the gastrointestinal tract are a source of upper and lower gastrointestinal bleeding. We studied 40 patients with arteriovenous malformations. Eighteen percent had single lesions in either the distal transverse colon or the left colon (the angiographic distribution of the inferior mesenteric artery). Seventeen percent had concomitant colonic and extracolonic arteriovenous malformations. Only 6% of those who underwent surgery for removal of arteriovenous malformations rebled. We also studied the incidence of angiodysplastic lesions of the colon of 159 patients over the age of 55 with lower gastrointestinal bleeding; associated arteriovenous malformations were present in 21%. These data suggest: that to evaluate arteriovenous malformations as a cause of gastrointestinal bleeding, one must perform inferior and superior mesenteric and celiac angiography; the incidence of rebleeding is reduced when triple-vessel selective visceral angiography precedes surgical removal of arteriovenous malformations; and the incidence of associated arteriovenous malformations approaches that of diverticulosis in elderly patients with lower gastrointestinal bleeding.
胃肠道动静脉畸形是上、下消化道出血的一个来源。我们研究了40例患有动静脉畸形的患者。18%的患者在横结肠远端或左结肠有单个病变（肠系膜下动脉的血管造影分布）。17%的患者同时存在结肠和结肠外动静脉畸形。接受动静脉畸形切除术的患者中只有6%再次出血。我们还研究了159例55岁以上下消化道出血患者结肠血管发育异常病变的发生率；其中21%存在相关的动静脉畸形。这些数据表明：要评估动静脉畸形作为胃肠道出血的原因，必须进行肠系膜上、下动脉和腹腔动脉造影；在手术切除动静脉畸形之前进行三血管选择性内脏血管造影可降低再出血的发生率；在老年下消化道出血患者中，相关动静脉畸形的发生率接近憩室病的发生率。
