1/6. Chronic bleeding caused by small bowel angiodysplasia: a problem of recognition and diagnosis.angiodysplasia of the gastrointestinal tract is a disorder consisting of ectasia of submucosal and mucosal vessels, which causes acute and chronic bleeding. We describe the case of a 58-year-old man with a history of recurrent lower intestinal bleeding and severe anemia. endoscopy and X-ray examination of the gastrointestinal tract failed to show the source of bleeding. Selective angiography of the superior and inferior mesenteric arteries revealed a vascular ectasia. The patient underwent ileo-cecal resection with remarkable improvement after surgery.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/6. Abnormal blood vessels of the prepyloric antrum in cirrhosis of the liver as a cause of chronic gastrointestinal bleeding.Three elderly females presenting with iron deficiency anaemia and faecal loss of blood were found to have a macronodular cirrhosis of the liver and an unusual red spotty appearence of the prepyloric antral mucosa. One patient underwent antral resection and the surgical specimen revealed abnormalities of the (sub)mucosal blood vessels. Anaemia and occult faecal blood loss disappeared after operation. It is suggested that this type of antral vascular abnormality is aetiologically related to hepatic cirrhosis and may represent a gastric equivalent of cutaneous spider angiomata.- - - - - - - - - - ranking = 189.51809670632keywords = blood vessel, vessel (Clic here for more details about this article) |
3/6. Abnormal blood vessels in the gastric antrum: a cause of upper-gastrointestinal bleeding.Three patients who bled from curious vascular lesions of the gastric antrum are described. Each presented with an iron-deficiency anemia. Histological examination in two of the patients demonstrated numerous ectatic submucosal vessels in the antrum, the appearances being somewhat similar to angiodysplasia of the colon. The gastric lesions were not shown by barium meal examination or angiography but gave characteristic appearances on endoscopy. We believe that Billroth I partial gastrectomy is the treatment of choice for this condition.- - - - - - - - - - ranking = 152.61447736505keywords = blood vessel, vessel (Clic here for more details about this article) |
4/6. Diffuse vascular ectasia of the gastric antrum.Diffuse vascular ectasia of the gastric antrum may present as occult gastrointestinal blood loss and iron-deficiency anemia. Four patients are described with iron-deficiency anemia in whom characteristic lesions were found at endoscopy. As in previous reports, lesions are either angioid linear streaking of the antrum with convergence at the pylorus ("watermelon stomach") or diffuse, well-demarcated erythematous areas. biopsy with the electrocautery forceps may show dilated ectatic mucosal vessels often containing fibrin thrombi which will establish a diagnosis. Standard biopsy techniques failed to make a diagnosis in two of the three patients in which it was attempted. Medical therapy consisted of iron replacement and transfusion as needed. In three of the four cases, symptomatic anemia recurred and required antrectomy for management of the anemia. The antrectomy specimens revealed ectatic mucosal and submucosal vessels with a fibrotic pattern involving the lamina propria. This pattern has been previously reported. One patient was treated with corticosteroids transiently with resolution of her anemia. The endoscopic appearance of this entity may mimic antral gastritis and needs to be considered in the differential diagnosis of iron-deficiency anemia from chronic gastrointestinal blood loss.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
5/6. gastric antral vascular ectasia: the watermelon stomach.We report 3 patients with severe and persistent iron deficiency anemia who were found to have gastric antral vascular ectasia. Endoscopically, the patients presented with a characteristic antral appearance so distinctive as to be diagnostic: longitudinal rugal folds traversing the antrum and converging on the pylorus, each containing a visible convoluted column of vessels, the aggregate resembling the stripes on a watermelon; and, less prominently, evidence of mucosal prolapse. In 2 of these patients, with uncontrollable anemia, antrectomy and Billroth I anastomosis were performed; their hemoglobin levels have subsequently remained normal over the following 2 yr. In the third patient, who was achlorhydric, prednisone therapy substantially reduced the rate of bleeding. In all patients, endoscopic biopsy specimens showed dilatation of mucosal capillaries, with focal thrombosis and fibromuscular hyperplasia of the lamina propria; the resected specimens, additionally, show thickened mucosa with tortuous submucosal venous channels. The importance of the condition lies in its recognition.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
6/6. Blue rubber-bleb nevus syndrome with Masson's vegetant intravascular hemangioendothelioma.A 14-year-old Japanese male showed numerous small cutaneous hemangiomas and severe anemia produced by internal hemorrhages from intestinal hemangiomas. Histological studies revealed ectatic vessels lined by a single layer of endothelial cells. Six hemangiomas, with fibrous walls of variable thickness, showed characteristics of vegetant intravascular hemangioendothelioma (Masson) in an organizing thrombus. Electron microscopy confirmed that the dilated cavities, were lined by a layer of flattened endothelial cells, surrounded by a few pericytes and/or smooth muscle cells. No appreciable abnormalities were found in the blood vessels located in the clinically normal skin. A few amyloid deposits in the subepidermal connective tissue were also observed.- - - - - - - - - - ranking = 38.903619341264keywords = blood vessel, vessel (Clic here for more details about this article) |