Endoscopic Treatment of Bleeding Angioectasia of the Upper Gastrointestinal Tract

Song, Young Doo; Choi, Sun Taek; Eun, Jong Ryul; Lee, Hak Jun; Kim, Young Sung; Han, Jae Ho; Jang, Byeong Ik; Kim, Tae Nyun; Chung, Moon Kwan

Abstract

BACKGROUND/AIMS
Angioectasia of the gastrointestinal tract have been recognized with increasing frequency as an important cause of acute and chronic gastrointestinal bleeding. The purpose of this study is to define the response of endoscopic treatment for bleeding angioectasia of upper gastrointestinal tract and to evaluate long term efficacy of endoscopic treatment.
METHODS
A clinical study was done on 18 patients (20 cases) of angioectasia bleeding of upper gastrointestinal tract who admitted to Yeungnam University hospital from January 1989 to October 1998. Endoscopic therapy was done by electrocauterizaton, laser therapy, O-band ligation. In cases of failure to achieve hemostasis after endoscopic retreatment, we have done operation or used antifibrinolytic agent.
RESULTS
The mean age was 60.6+/-11.2 years (range 31-77 years). Bleeding control was succeeded in 19 cases and one case was failed by endoscopic therapy. This patient was operated. Recurred bleeding was observed in 4 patients during long term follow-up period. Bleeding was controlled after endoscopic re-treatment in two of four patients. The other patients (Osler-Weber-Lendu syndrome 2 patients) were periodically required of transfusion after endoscopic therapy. Tranexamic acid was given to these patients.
CONCLUSIONS
Endoscopic therapy for bleeding angioectasia could reduce bleeding or make it stop, but repeated treatment was often necessary for multiple angioectasia. Tranexamic acid may be a useful treatment for refractory bleeding due to multiple angioectasia, such as Osler-Weber-Lendu syndrome.