Endoscopic Ligation Therapy for Gastric Angiodysplasia

Kim, Young Kwan; Kim, Young Ho; Lee, Young Rock; Kim, Kyu Sik; Cho, Seong Kwoo; Park, Sang Mo; Ku, So Young; Kim, Jae Kwon; Lee, Yeon Soo

Abstract

Gastric angiodysplasia may be responsible for up to 2% to 6% of upper gastrointestinal bleeding. Moreover, gastric angiodysplasia may be particularly difficult to treat and is usually associated with a high rebleeding rate. Bleeding due to gastric angiodypsplasia is usually treated by various endoscopic approaches, including argon and Nd:YAG laser photocoagulation, monopolar or biopolar electrocoagulation, heater probe, or injection. Associated complications of these methods, however, such as perforation, acute bleeding during the procedure, or delayed massive hemorrhage have been reported. Recently a few reports have been suggested that endoscopic ligation therapy is a safe, effective treatment for gastric angiodysplasia. A 70-year-old man, who had undergone subtotal gastrectomy for perforation of a duodenal ulcer for 20 years, was admitted due to melena and dizziness persisting for 1 week. A gastroscopy revealed a single angiodysplasia with active bleeding just above the anastomotic site of the remnant stomach. Endoscopic ligation therapy was performed successfully and the bleeding stopped immediately after endoscopic ligation. Since then, no recurrence of bleeding has been reported to date.