[Angiodysplasia of the right colon and aortic stenosis. A case report]

We report the case of a female patient who came to our observation for a severe enterorrhage. Following colonoscopic examination and color-Doppler M-B Mode echocardiography we made the following diagnosis: "angiodysplasia of the right colon in females with aortic stenosis". It was possible to ascertain whether there were similar lesions in other parts of the gastro-intestinal tract because the patient opposed firmly. In agreement with other authors, we believe that colonoscopic examination is the appropriate method to diagnose gastro-intestinal angiodysplasia. The advanced age and the clinical conditions of the patient did not allow surgical treatment, so we treated her with antihaemorrhagic drugs and elevated doses of ascorbic acid (4 g/die). The disappearance of enterorrhagies, the rapid clinical recovery and the normalization of red blood cell (RBC) count allowed us to discontinue antihaemorrhagic treatment and to continue the administration of elevated doses of ascorbic acid. Eight days later, the patient was discharged in good clinical condition and ascorbic acid was prescribed to be continued at home. A good clinical and haemodynamic balance was observed at the six-month follow-up. In conclusion we think that the clinical case we observed, characterized by the association angiodysplasia of the right colon-aortic stenosis, may be included in the diction Heyde's syndrome. In aging patients with severe concomitant diseases, ineligible for surgical interventions, the enterorrhage caused by a non complicated angiodysplastic lesion of the gastro-intestinal tract may benefit from the acute administration of ascorbic acid as the therapeutic agent of first choice capable to loose and/or stop the haemorragic complication and, in chronic administration, to reduce the number of relapses.