Summary
Angiodysplasia of the small intestine alone cannot be differentiated histologically from hereditary hemorrhagic telangiectasia (Morbus Rendu-Osler-Weber). Isolated localisation in the small intestine is rare and requires surgery in the event of massive bleeding. Four cases of bleeding from angiodysplasias of the small intestine in patients having undergone surgery at our institution over a ten-year period are presented. In three patients the particular intestine was resected. Two of these patients had an uneventful follow-up of even and ten years, one patient relapsed and was rehospitalized for surgical treatment. The fourth patient, who showed angiodysplasias scattered over the entire small intestine, had no further bleeding over a three-year period after transmural ligations of the lesions found by intraoperative endoscopical diaphany.
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Abbreviations
- AD:
-
Angiodysplasie
- HHT:
-
hereditäre hämorrhagische Teleangiektasie
Literatur
Baum S, Nusbaum WS, Blakemore WS, Finkelstein AK (1965) The preoperative radiographic demonstration of intra-abdominal bleeding from undetermined sites by percutaneous selective celiac and superior mesenteric angiography. Surgery 58:797–805
Boley S, Brandt LJ, Frank MS (1981) Severe lower intestinal bleeding: diagnosis and management. Clin Gastroenterol 10:65–91
Bruusgaard A, Juhl E (1974) Hereditary hemorrhagic Teleangiektasis (Rendu-Weber-Osler) with intestinal involvement successfully treated by surgery. Gastroenterology 67:1001–1005
Duray Ph, Marcal JM, LiVolsi VA, Fisher R, Schohamer G, Brand MH (1984) Small intestinal angiodysplasia in the elderly. J Clin Gastroenterol 6:311–319
Fataar S, Morton P, Schulman A (1981) Arteriovenous malformations of the gastrointestinal tract. Clin Radiol 32:623–628
Gelin J, Wilms G (1985) Angiodysplasien der Leber und des Gastrointestinaltraktes bei Mb. Rendu-Osler-Weber. Fortschr Röntgenstr 146, 6:722–724
Göthlin JH, Nordgard K, Jonsson K, Nyman U (1982) Hepatic teleangiektasia in Osler's disease treated with arterial embolisation. Europ J Radiol 2:27–30
Greenberg GR, Phillips MJ, Tovee EB, Jeeheebhoy KN (1976) Fiberoptic endoscopy during laparotomy in the diagnosis of small intestinal bleeding. Gastroenterology 7:133–135
Harford WV (1988) Gastrointestinal angiodysplasia: Clinical Features. Endoscopy 20:144–148
Heine O, Paschke R (1985) Hereditäre hämorrhagische Teleangiektasie (Morbus Osler): Intestinale Manifestation mit Mitralvitium. Chirurg 56:186–188
Hines JR, Stryben SJ, Neiman HL, Larsen RL, Gottlieb J, Craig RM, Poticha SM (1981) Intraoperative angiography in intestinal angiodysplasia. Surg Gynecol Obstet 52:453–460
Jensen DM, Machicado GA (1985) Bleeding colonic angioma: endoscopic coagulation and follow-up. Gastroenterology 88:1433 (Abstract)
Lancet (editorial) (1981) Angiodysplasia. Lancet 2:1086
Laugier P (1978) Les manifestations digestives de la maladie de Rendu-Osler. Ann Dermatol Venereol 105:1055–1058
Max MH, Richardson JD, Flint LM Jr, Knutson CO, Schwesinger W (1981) Colonoscopic diagnosis of angiodysplasia of the gastrointestinal tract. Surg Gynecol Obstet 152:195–199
Meyer CT, Troncale FJ, Galloway S, Sheahan DG (1981) Arteriovenous malformations of the bowel: An analysis of 22 cases and a review of the literature. Medicine 60:36–48
Moore JD, Thompson NW, Appelman HD, Foley D (1976) Arteriovenous malformations of the gastrointestinal tract. Arch Surg 111:381–387
Noppeney Th, Zirngibl H, Gebhardt Ch (1986) Gastrointestinale Blutung bei Angiodysplasie. Eine seltene, oft aber nicht erkannte Ursache. Akt Chir 21:187–190
Ottenjann R (1986) Gastrointestinale Angiodysplasien. Deutsch Med Wochenschr 111:1818–1819
Shah IA (1988) Angiodysplasia: Morphologic Diagnosis. Endoscopy 20:149–151
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Sandbichler, P., Pernthaler, H., Schmid, T. et al. Intestinale Angiodysplasie als Ursache schwerer Dünndarmblutungen — Bericht über vier Fälle. Klin Wochenschr 68, 290–293 (1990). https://doi.org/10.1007/BF02116061
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DOI: https://doi.org/10.1007/BF02116061