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[Intestinal angiodysplasia].

F Spinelli1, A Carditello, M Barone

  • 1Istituto di Chirurgica Toracica e Cardiovascolare U.O. Chirurgia Toracica, Università degli Studi di Messina.

Il Giornale Di Chirurgia
|August 23, 2001
PubMed
Summary
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This case study details a rare cause of gastrointestinal bleeding from intestinal angiodysplasia. Surgical intervention was complicated by an anomalous left gastric artery, requiring extensive resection and management of post-operative complications.

Area of Science:

  • Gastroenterology
  • Vascular Surgery
  • Interventional Radiology

Background:

  • Intestinal angiodysplastic lesions are a common cause of significant gastrointestinal bleeding.
  • Effective management of these lesions can be challenging, often requiring complex interventions.

Observation:

  • A patient presented with severe gastrointestinal hemorrhage due to a suspected angiodysplastic lesion.
  • Initial selective arteriography of the superior mesenteric artery indicated surgical intervention.
  • Recurrent massive hemorrhage occurred post-surgery, revealing an unrecognized anomalous origin of the left gastric artery.

Findings:

  • The anomalous left gastric artery originating from the superior mesenteric artery necessitated a partial, then a total gastrectomy.
  • Post-operative complications included an esophageal-jejunal anastomosis leak and acute renal failure.

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  • Nasogastric parenteral nutrition (NPT) and hemodialysis were crucial in managing these complications.

    • Implications:

    • This case highlights the importance of thorough pre-operative vascular imaging to identify anomalous arteries.
    • Aggressive surgical management, including extensive resection, may be required for complex angiodysplastic lesions.
    • Multidisciplinary management is essential for resolving severe post-operative complications in gastrointestinal surgery.