Treatment of gastrointestinal angiodysplasia and unmet needs

Dray, Xavier; Camus, Marine; Coelho, Jessica; Ozenne, Violaine; Pocard, Marc; Marteau, Philippe

doi:10.1016/j.dld.2010.12.007

Cited by 53 publications

(41 citation statements)

References 72 publications

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“…In both groups, lesions were most commonly found in the jejunum. When findings were present, bleeds were most likely due to ulcer (23.3 %) when performed emergently and angiodysplasia/AVM (30.0 %) when performed non-emergently, similar to other published studies on both DBE and SBE 12 13 27 28 29. Only one mass, pathologically consistent with lipoma, was detected.…”

Section: Discussionsupporting

confidence: 84%

Timing of single balloon enteroscopy: significant or not?

et al. 2016

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Background: The development of balloon assisted enteroscopy (BAE) has revolutionized diagnostic and therapeutic modalities for small-bowel disorders. Although the role of emergent esophagogastroduodenoscopy and colonoscopy for upper and lower gastrointestinal bleeding is well defined, there is scarce data with regard to emergent BAE for gastrointestinal bleeding. Study: We performed a retrospective cohort study including 110 hospitalized patients with obscure gastrointestinal bleeding who underwent single balloon enteroscopy (SBE) between January 2010 and August 2013. Patients were divided into two groups based on procedures performed emergently (within 24 hours) versus non-emergently (greater than 24 hours). Data on patient demographics, hemodynamic characteristics, type of obscure bleed, lesions identified, location of lesions, endoscopic intervention performed, need for further surgical or radiological intervention, diagnostic and therapeutic yield, and adverse events were compared between groups. Independent samples t test and Fisher’s exact test were used to assess the association between dependent and independent variables. For continuous data, the results were summarized as mean difference and 95 % confidence intervals (CI), and for binary as odds ratio and 95 %CI. Results: Although patients in the group where enteroscopy was performed within 24 hours had a significantly higher incidence of radiological intervention (10.0 % vs. 0.0 %, P = 0.019), the diagnostic and therapeutic yields between the two groups were not significantly different. Additionally, there were no statistically significant differences between the groups for overt and occult bleeding, transfusion requirements, type and location of lesions, endoscopic intervention performed, or adverse events. Hospital stay was shorter in the patients who had SBE within 24 hours of admission (6.2 vs. 11.3 days, P < 0.001). Conclusions: Although the diagnostic and therapeutic yields of SBE were not significantly different between patients having the procedure within 24 hours and those having it later, the early SBE group required more interventional radiology procedures. While endoscopists may not necessarily have to perform emergent assessment within 24 hours in patients with obscure gastrointestinal bleeding (OGIB) for greater diagnostic or therapeutic yield, early intervention may allow for earlier stabilization and thus shorter hospital stays. Prospective studies further evaluating these findings are indicated.

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Section: Discussionsupporting

confidence: 84%

Timing of single balloon enteroscopy: significant or not?

et al. 2016

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“…15 Vascular lesions and preferably angiectasias are the most frequent finding in small bowel bleeding and an important indication for therapeutic BE. 16 Argon plasma coagulation (APC) is most often used to stop active bleeding and to prevent future bleeding episodes from angiectasias ( Fig. 1).…”

Section: Treatment Of Small Bowel Bleedingmentioning

confidence: 99%

Interventional balloon-enteroscopy

Albert¹

2012

jig

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“…It is recognized that as a diagnostic modality alone, SBCE plays a limited role in affecting outcome as it relies on the availability and success of therapeutic agents in the form of DBE and medical therapies [26]. Angiodysplasia, which accounted for 49% of positive findings in our study, is highly difficult to treat [27] and has high rates of rebleeding despite optimum treatment with medical and endoscopic therapies [28]. This explains the high rates of persistent anaemia in this group and should be looked upon as identifying a need for more effective treatment of angiodysplasia, rather than disregarding the benefit of its diagnosis by SBCE.…”

Section: Discussionmentioning

confidence: 92%