Intractable gastrointestinal bleeding from angiodysplasia in a patient of Bernard-Soulier syndrome--report of a case--.
We herein report a case of gastrointestinal bleeding induced by angiodysplasia of the cecum in a case of Bernard-Soulier syndrome with recurrent breast cancer. In spite of endoscopic hemostatic therapy and interventional embolization, she had repeated massive bleeding from the cecal lesion. In addition, she had chronic hepatitis C and progressive liver tumors metastasized from breast cancer, and she finally died of hepatic failure. There are four case reports in the literature describing Bernard-Soulier syndrome with gastrointestinal bleeding angiodysplasia. The reported cases benefited from hormonal, endoscopical hemostasis and surgical therapy. In our case, because of her terminal metastatic breast cancer, only conservative treatments were administered after the third bleed. Both the endoscopic hemostatic method and interventional embolization showed only a temporary effect. Surgical treatment should be considered if the general condition can tolerate a surgical procedure.
Okita
Riki
R
Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Kasumi 1-2-3, Minami-ku, Hiroshima 734-8551, Japan. rokita@hiroshima-u.ac.jp
Hihara
Jun
J
Konishi
Kazuo
K
Osaki
Akihiko
A
Yoshida
Kazuhiro
K
Yamaguchi
Yoshiyuki
Y
Toge
Tetsuya
T
Fujimura
Kingo
K
Iwata
Takashi
T
Sawamura
Akihiro
A
D016888:Angiodysplasia / Q000150:complications* / Q000473:pathology*; D000792:Angiography; D001606:Bernard-Soulier Syndrome / Q000150:complications* / Q000473:pathology*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000150:complications* / Q000473:pathology*; D006801:Humans; D008875:Middle Aged