Small-intestinal bleeding from angiodysplasia after aortic valve replacement.

An association between aortic stenosis and angiodysplasia of the gut has been reported, though this is unproven. In many instances, recurrent gastrointestinal bleeding originating from angiodysplasia has ceased following aortic valve replacement (AVR). A case is reported of massive bleeding from a small-intestinal angiodysplasia after AVR. The diagnosis was made using radioisotope-labeled red cell scintigraphy and selective angiography of the ileocolic artery soon after AVR. Selective embolization using sponge was performed, and bleeding ceased immediately. The time from onset of bleeding to completion of embolization was 6 h. However, signs of peritonitis appeared the next morning, and an emergency resection of the necrotic ileum was performed. Bleeding from angiodysplasia of the gut may occur after AVR, although the etiologic role of aortic stenosis in angiodysplasic hemorrhage is not clear.