Document Detail


Bleeding gastric vascular ectasia treated by argon plasma coagulation: a comparison between patients with and without cirrhosis.
MedLine Citation:
PMID:  18226684     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Gastric vascular ectasia (GVE) is an uncommon etiology of GI bleeding. GVE can affect not only patients with cirrhosis but also patients with a variety of chronic diseases. OBJECTIVE: The aim of the study was to compare clinical and endoscopic patient characteristics and responses to treatment by argon plasma coagulation (APC) of bleeding GVE between patients with cirrhosis and noncirrhotic patients. DESIGN: Retrospective study of consecutive patients. PATIENTS: Between January 2001 and December 2005, 30 patients were treated by APC for bleeding GVE. INTERVENTIONS: Clinical and endoscopic features and APC treatment success were compared between patients with cirrhosis (group 1) and noncirrhotic patients (group 2). MAIN OUTCOME MEASUREMENTS: Endoscopic treatment efficacy was assessed on the recurrence of symptoms after APC. RESULTS: Seventeen patients were cirrhotic and 13 had no cirrhosis. Cirrhotic patients presented more frequently with overt bleeding (65% vs 15%) and noncirrhotic patients with occult bleeding with iron deficiency anemia (35% vs 85%, P= .01). Endoscopy in noncirrhotic patients revealed more frequently a "watermelon" appearance (23.5% vs 76.9%, P= .008). Endoscopic treatment by APC was successful in 83.3% of patients (88.2% vs 76.9%, not significant). Patients from group 2 required significantly more APC sessions to achieve a complete treatment (2.18 vs 3.77, P= .04). CONCLUSIONS: APC treatment of bleeding GVE was efficient and safe in cirrhotic and noncirrhotic patients in more than 80% of cases. Noncirrhotic patients required significantly more APC sessions to achieve a complete treatment. An endoscopic watermelon appearance and the use of antiplatelet drugs were associated with failure of APC.
Authors:
Stéphane Lecleire; Emmanuel Ben-Soussan; Michel Antonietti; Odile Goria; Ghassan Riachi; Eric Lerebours; Philippe Ducrotté
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Gastrointestinal endoscopy     Volume:  67     ISSN:  0016-5107     ISO Abbreviation:  Gastrointest. Endosc.     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-01-29     Completed Date:  2008-04-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0010505     Medline TA:  Gastrointest Endosc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  219-25     Citation Subset:  IM    
Affiliation:
Department of Hepato-Gastroenterology and Nutrition, Endoscopy Unit, ADEN-EA3234/IFRMP23 Research Group, Rouen University Hospital Charles-Nicolle, Rouen, France.
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MeSH Terms
Descriptor/Qualifier:
Aged
Argon / therapeutic use
Comorbidity
Electrocoagulation*
Female
Gastric Antral Vascular Ectasia / complications,  epidemiology,  therapy*
Gastrointestinal Hemorrhage / epidemiology,  etiology,  therapy*
Gastroscopy
Humans
Liver Cirrhosis / epidemiology
Male
Middle Aged
Retrospective Studies
Chemical
Reg. No./Substance:
7440-37-1/Argon

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