Gastrointestinal bleeding due to angiodysplasia in patients on hemodialysis: A single-center study

Abstract

Gastrointestinal (GI) bleeding due to angiodysplastic lesions is a common problem among patients receiving hemodialysis (HD). We studied 22 HD patients (5 females and 17 males) who had GI bleeding due to angiodysplasia; the mean age of whom was 54 ± 10 years. All patients had upper and lower GI endoscopy. The most common site for the lesion was the right colon in seven cases (31.8%), followed by stomach in 4 cases (18.1%). In eight (36.3%) patients, there were multiple lesions located in the stomach, duodenum, and the right colon. All patients were treated with coagulation; with argon plasma in 14 (63.6%) patients, bipolar coagulation in five (22.7%) patients, and hot clip in three (13.6%) patients. One patient who presented with persistent bleeding despite endoscopic therapy was well-benefited of a complementary treatment, thalidomide. Hemostasis was obtained in all patients after an average of 6.8 sessions of endoscopic coagulation procedure. We conclude that angiodysplasia is a frequent cause of hemorrhage in chronic renal failure that can be managed in most patients by argon plasma and bipolar coagulation.

Esophageal arteriovenous malformation, a rare cause of significant upper gastrointestinal bleeding: Case report and review of literature

“…Other theories suggest increased pressure in the venous system could lead to the formation of the AVMs (10). Clinical presentations of AVM include hematemesis, melena, bleeding per rectum, unexplained iron deficiency and anemia (4,11). Diagnosis is usually made by endoscopy, however, in some cases, angiography or surgery may be required to make the diagnosis.…”

Angiodysplasia in Renal Disease Patients: Analysis of Risk Factors and Approach to Manage Such Patients

“…Gastrointestinal (GI) angiodysplasia is a frequently encountered problem in patients with renal disease. It is also the most frequent cause of recurrent bleeding in patients with renal failure [1]. The prevalence of angiodysplasia in renal failure patients ranges from 19% to 32% compared to only 5% in individuals with normal renal function [1,2].…”

“…It is also the most frequent cause of recurrent bleeding in patients with renal failure [1]. The prevalence of angiodysplasia in renal failure patients ranges from 19% to 32% compared to only 5% in individuals with normal renal function [1,2]. Angiodysplasia presents at a younger age in patients than in the general population.…”

“…Angiodysplasia presents at a younger age in patients than in the general population. Angiodysplasia is a vascular malformation with a diameter of less than 1 cm within the mucosal and submucosal layer of the bowel [1]. Multiple hemorrhagic episodes are frequent and mostly occult and intermittent [1,2].…”

“…Clinical features of angiodysplasia consist of iron-deficiency anemia, hemoccult-positive stool, and melena, and in some cases, hematemesis. Hemorrhage is usually painless, and the bleeding ceases spontaneously in at least 90% of the cases [1,3]. Angiodysplastic lesions can be present in any part of the GI tract and are usually more than 1 in number [3,4].…”