Fatal post-operative gastro intestinal hemorrhage because of angio-dysplasia of small intestine in aortic regurgitation.
Gastrointestinal bleeding due to angiodysplasia of the large intestine associated with calcific aortic stenosis is a well-known entity. Angiodysplasias are artero-venous malformations and they form one of the common causes of occult gastro-intestinal bleeding in the elderly. A 59-year-old man underwent aortic valve replacement for severe aortic regurgitation, developed severe gastro intestinal bleeding. Selective angiography was inconclusive. Exploratory laparotomy revealed angiodysplasia of the terminal ileum, which was resected. We report this case to draw attention to this rare cause of gastro intestinal bleeding and the difficulty in arriving at a diagnosis by the usual investigations.
Varma
Praveen
P
Division of Cardiovascular and Thoracic surgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India 695011. pkvarma@sctimst.ker.nic.in
Misra
Manoranjan
M
Radhakrishnan
Vishnupuri Venkatraman
VV
Neelakandhan
Kurur Sankaran
KS