Volume 3, Issue 1 (Spring 2000)                   J Arak Uni Med Sci 2000, 3(1): 25-29 | Back to browse issues page

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Fani A. Presentation of a Case with Diffuse Telangectasia, Hematemesis and Nasal Bleeding. J Arak Uni Med Sci 2000; 3 (1) :25-29
URL: http://jams.arakmu.ac.ir/article-1-6609-en.html
School of Medicine, Arak University of Medical Sciences, Arak, Iran.
Abstract:   (1328 Views)
A 56 years old female was admitted to our hospital, because of, dyspnea, tachycardia hematemesis and melena. In physical exams she was severely ill, pale, and tachycardia, with decreased breath sounds on the base of right lung, with BP, 100.60, and pulse rate of 120/min. Abdomen was soft In rectal exam streaky fresh blood and melena was observed. Diffuse red populace on face, trunk and oral mucosa were present with recurrent nasal bleeding since last year. In upper GI endoscopy and colonoscopy, diffuse telangectasic lesions in esophagus, stomach, duodenum and entire length of colon and streaky fresh blood in colon were observed, Under conservative treatment her bleeding stopped on the 10th day after treatment. Collagen vascular diseases, coagulopathy and malignancies were ruled out by paraclinical examinations. Senile angiodisplastic diseases which are usually limited to colon and vascular ectasia can not be suggested because the skin and upper gastrointestinal tract is involved. Cancers, polyps and hemorrhoid , were ruled out by endoscopy and colonoscopy. Heriditary Hemorrhagic Telangictasia (HHT) is an Auto-Dom disorder with involvement of oral and gastrointestinal mucosa, skin and viscera. HHT involves capillaries, makes tortuous, fragile bloody spaces which can be manifested through infancy to old age. The most common manifestation of the diseases(in addition to nose bleeding and skin lesions), is the severe gastrointestinal bleeding, often leading to massive blood transfusion. Recommended treatment:
1-Coagulotherapy of hemorrhagic lesions. 2- Estrogen and progesterone therapy. 3- Amino caproic acid therapy for prevention of fibrinolysis. 4- In severe cases , surgical therapy is needed.
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Type of Study: Original Atricle | Subject: Internal
Accepted: 2000/03/20

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