Ito T, Ando H
Department of Internal Medicine, Takatsuki Red Cross Hospital, Osaka, Japan.
Jpn Circ J. 1994 Jun;58(6):439-42. doi: 10.1253/jcj.58.439.
Gastrointestinal bleeding is not rare in patients with calcific aortic stenosis (AS) in Western countries, which has suggested an association between the two conditions. However, there has been no previous report of this association in Japan. In this report we describe a patient with AS who had recurrent gastrointestinal bleeding. An 84-year-old female who had been followed for severe AS presented with recurrent rectal bleeding, but the site of bleeding could not be detected despite various examinations, including endoscopy. She died of progressive heart failure during hospitalization. Postmortem examination disclosed severe left ventricular hypertrophy with calcific aortic stenosis. Microscopically, angiodysplastic lesions were observed in the submucosa throughout the gastrointestinal tract.
在西方国家,钙化性主动脉瓣狭窄(AS)患者中胃肠道出血并不罕见,这表明这两种情况之间存在关联。然而,日本此前尚无关于这种关联的报告。在本报告中,我们描述了一名患有AS且反复出现胃肠道出血的患者。一名因严重AS接受随访的84岁女性出现反复直肠出血,但尽管进行了包括内镜检查在内的各种检查,仍未检测到出血部位。她在住院期间死于进行性心力衰竭。尸检发现严重左心室肥厚伴钙化性主动脉瓣狭窄。显微镜下,在整个胃肠道黏膜下层观察到血管发育异常病变。