Document Detail


Diagnosis and treatment control of bleeding colorectal angiodysplasias by endoscopic Doppler sonography: a preliminary study.
MedLine Citation:
PMID:  8163133     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The diagnostic accuracy and practical impact of trans-endoscopic Doppler ultrasonography were prospectively investigated in an open preliminary study of patients with hemorrhage from colonic vascular malformations. From January 1, 1991, to December 31, 1992, 437 consecutive patients were seen with lower gastrointestinal bleeding. In 15 cases the source of hemorrhage proved to be colorectal angiodysplasias (3.4%). In all cases bleeding had stopped spontaneously before the endoscopic examination. Upper gastrointestinal causes of bleeding were excluded endoscopically in each patient. To detect the superficial arterial vessels responsible for the hemorrhage a total of 32 lesions were scanned by trans-endoscopic Doppler ultrasonography. Twenty-nine vascular malformations in 12 patients were Doppler-positive (91%) and 3 lesions in 3 patients were Doppler-negative without an arterial signal. All Doppler-positive lesions had injection therapy with epinephrine and polidocanol. Twenty-six of the 29 sclerosed angiodysplasias (90%) in 9 patients could not be found endoscopically 2 weeks later, confirming the success of therapy. Doppler noise was still recorded in 3 visible malformations in the remaining 3 patients, indicating insufficient treatment. Further injections were made into these lesions, and the vascular anomalies were finally eliminated. During 6 months of follow-up, one of the 12 treated patients relapsed with an actively bleeding cecal angiodysplasia. After repeated endoscopic hemostasis, no further hemorrhage was observed in this patient. No bleeding recurred in the 3 patients with Doppler-negative lesions. Endoscopic Doppler sonography may help in the identification of intestinal angiodysplasias. The technically simple method allows objective evaluation of the endoscopic findings and enables monitoring of local endoscopic therapy.
Authors:
D Jaspersen; T Körner; W Schorr; C H Hammar
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Gastrointestinal endoscopy     Volume:  40     ISSN:  0016-5107     ISO Abbreviation:  Gastrointest. Endosc.     Publication Date:    1994 Jan-Feb
Date Detail:
Created Date:  1994-05-20     Completed Date:  1994-05-20     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0010505     Medline TA:  Gastrointest Endosc     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  40-4     Citation Subset:  IM    
Affiliation:
2nd Department of Internal Medicine, Academic Hospital, University of Marburg, Fulda, Germany.
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MeSH Terms
Descriptor/Qualifier:
Angiodysplasia / complications,  ultrasonography*
Colonic Diseases / complications,  ultrasonography*
Endoscopy, Gastrointestinal*
Epinephrine / administration & dosage
Gastrointestinal Hemorrhage / drug therapy*,  etiology,  ultrasonography*
Hemostasis, Endoscopic
Humans
Injections
Polyethylene Glycols / administration & dosage
Rectal Diseases / complications,  ultrasonography*
Ultrasonography, Interventional*
Chemical
Reg. No./Substance:
0/Polyethylene Glycols; 51-43-4/Epinephrine; 9002-92-0/polidocanol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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