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Diffuse hemorrhagic gastroenteropathy: report of a new entity
V A Fishbein1, A M Rosen, E E Lack
1Department of Gastroenterology, Georgetown University Hospital, Washington, D.C.
Gastroenterology
|February 1, 1994
Summary
A novel condition, diffuse hemorrhagic gastroenteropathy (DHG), caused chronic gastrointestinal bleeding in a patient. DHG involves small vessel vasculopathy leading to mucosal ischemia and bleeding.
Area of Science:
- Gastroenterology
- Pathology
- Vascular Biology
Background:
- Chronic gastrointestinal bleeding poses significant diagnostic and therapeutic challenges.
- Unexplained blood loss necessitates investigation into rare gastrointestinal pathologies.
Observation:
- A 70-year-old female presented with 3 years of unremitting gastrointestinal blood loss.
- Extensive blood transfusions (over 200 units) were required.
- Endoscopy revealed diffusely hemorrhagic mucosa throughout the stomach, duodenum, and small intestine.
Findings:
- Biopsies showed capillary and venule narrowing in the lamina propria.
- Endothelial cell swelling and proliferation, neutrophil margination/emigration, and fibrin thrombi were observed.
- These changes suggest a small vessel vasculopathy affecting the gastrointestinal mucosa.
Implications:
- Diffuse hemorrhagic gastroenteropathy (DHG) may represent a distinct clinical entity.
- DHG is characterized by mucosal ischemia secondary to localized small vessel disease.
- This finding expands the differential diagnosis for chronic gastrointestinal hemorrhage.