Appiah John K, Asiedu Emmanuel K, Danso Edward A
Internal Medicine, Geisinger Health System, Wilkes-Barre, USA.
Internal Medicine, Mother and Child Hospital, Accra, GHA.
Cureus. 2025 Apr 28;17(4):e83119. doi: 10.7759/cureus.83119. eCollection 2025 Apr.
Lower gastrointestinal bleeding (LGIB) is a common clinical emergency; however, systemic complications such as bilateral non-arteritic anterior ischemic optic neuropathy (NAION) are exceedingly rare. We report the case of a 78-year-old male with a history of hypertension and hyperlipidemia who developed progressive bilateral vision loss following hospitalization for severe LGIB. His hemoglobin nadir dropped to 6.9 g/dL from a baseline of 11 g/dL, prompting transfusion with one unit of packed red blood cells. Arteritic causes were ruled out through appropriate workup. Imaging demonstrated significant carotid and vertebrobasilar atherosclerotic disease, and ophthalmologic evaluation confirmed bilateral NAION. This case highlights the potential for ischemic optic neuropathy in the setting of acute anemia and underlying vascular insufficiency. Clinicians should maintain a high index of suspicion for ischemic complications following severe gastrointestinal bleeding, particularly in high-risk patients.
下消化道出血（LGIB）是一种常见的临床急症；然而，诸如双侧非动脉炎性前部缺血性视神经病变（NAION）等全身性并发症极为罕见。我们报告一例78岁男性病例，该患者有高血压和高脂血症病史，因严重LGIB住院后出现进行性双侧视力丧失。他的血红蛋白最低点从基线的11 g/dL降至6.9 g/dL，因此输注了一个单位的浓缩红细胞。通过适当的检查排除了动脉性病因。影像学检查显示颈动脉和椎基底动脉存在明显的动脉粥样硬化病变，眼科评估确诊为双侧NAION。该病例突出了急性贫血和潜在血管功能不全情况下发生缺血性视神经病变的可能性。临床医生对严重胃肠道出血后发生的缺血性并发症应保持高度警惕，尤其是在高危患者中。
