Massive arterial haemorrhage from the lower gastrointestinal tract.

Abstract:

:We have studied the clinical, radiological and pathological features of three patients with recurrent massive lower gastrointestinal arterial haemorrhage. Case 1 was an example of Dieulafoy's vascular malformation within the proximal ascending colon in a 46-year-old woman. Cases 2 and 3 were men aged 81 and 83 years with arterial erosions contained within small mucosal diverticula in the hepatic flexure and descending colon, respectively. All three patients presented with recurrent acute episodes of massive lower gastrointestinal haemorrhage. Selective mesenteric angiography was performed in cases 1 and 3 to localize the bleeding point in both patients. The features were very different to those of angiodysplasia, lacking the tuft of abnormal vessels and the early venous filling phase commonly seen in the latter condition. The patients were all successfully treated by partial colectomy. The aetiology of Dieulafoy's vascular malformation remains unclear. The ruptured arteries in cases 2 and 3 shared many histological features with the Dieulafoy lesion in case 1. The lesions in cases 1 and 2 were associated with recent oral non-steroidal anti-inflammatory therapy, suggesting coincidental mucosal ulceration as a contributory factor.

journal_name

Histopathology

journal_title

Histopathology

authors

Bateman AC,Beer TW,Bass PS,Odurny A,Gallagher PJ

doi

10.1111/j.1365-2559.1996.tb01395.x

subject

Has Abstract

pub_date

1996-09-01 00:00:00

pages

225-31

issue

3

eissn

0309-0167

issn

1365-2559

journal_volume

29

pub_type

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