Cargando…
Definitive therapy of colonic angioectasia by submucosal coagulation
Background and study aims Colonic angioectasia are the most common vascular lesions in the gastrointestinal tract and are among the most common causes for chronic or recurrent lower gastrointestinal bleeding. Endoscopic treatment involves a variety of techniques, all of which focus on destruction o...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
© Georg Thieme Verlag KG
2019
|
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6904233/ https://www.ncbi.nlm.nih.gov/pubmed/31828216 http://dx.doi.org/10.1055/a-0965-6688 |
_version_ | 1783477968116383744 |
---|---|
author | Sriram, Nagaraj Bar-Yishay, Iddo Kumarasinghe, Priyanthi Yusoff, Ian Segarajasingam, Dev Bourke, Michael J. Raftopoulos, Spiro |
author_facet | Sriram, Nagaraj Bar-Yishay, Iddo Kumarasinghe, Priyanthi Yusoff, Ian Segarajasingam, Dev Bourke, Michael J. Raftopoulos, Spiro |
author_sort | Sriram, Nagaraj |
collection | PubMed |
description | Background and study aims Colonic angioectasia are the most common vascular lesions in the gastrointestinal tract and are among the most common causes for chronic or recurrent lower gastrointestinal bleeding. Endoscopic treatment involves a variety of techniques, all of which focus on destruction of the mucosal abnormality. However, recurrent bleeding after endoscopic treatment is common, with more than one treatment frequently necessary. We report a technique for definitive treatment of colonic angioectasia by targeting the feeding submucosal vessel. Patients and methods Analogous to endoscopic mucosal resection, a submucosal injection is made beneath the target lesion which is then removed by electrocautery snare resection of the mucosal lesion. The exposed feeding vessel is then destroyed by application of coagulation current. The resection defect is closed by clips. Results Six patients with a total of 14 colonic angioectasia were treated over the study period. All lesions were destroyed without adverse events. Conclusion Elevation, hot snare resection and coagulation (ESC) of the visible vessel for treating colonic angioectasia appears safe and effective. Larger prospective comparative studies are required to assess its specific role. |
format | Online Article Text |
id | pubmed-6904233 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | © Georg Thieme Verlag KG |
record_format | MEDLINE/PubMed |
spelling | pubmed-69042332019-12-11 Definitive therapy of colonic angioectasia by submucosal coagulation Sriram, Nagaraj Bar-Yishay, Iddo Kumarasinghe, Priyanthi Yusoff, Ian Segarajasingam, Dev Bourke, Michael J. Raftopoulos, Spiro Endosc Int Open Background and study aims Colonic angioectasia are the most common vascular lesions in the gastrointestinal tract and are among the most common causes for chronic or recurrent lower gastrointestinal bleeding. Endoscopic treatment involves a variety of techniques, all of which focus on destruction of the mucosal abnormality. However, recurrent bleeding after endoscopic treatment is common, with more than one treatment frequently necessary. We report a technique for definitive treatment of colonic angioectasia by targeting the feeding submucosal vessel. Patients and methods Analogous to endoscopic mucosal resection, a submucosal injection is made beneath the target lesion which is then removed by electrocautery snare resection of the mucosal lesion. The exposed feeding vessel is then destroyed by application of coagulation current. The resection defect is closed by clips. Results Six patients with a total of 14 colonic angioectasia were treated over the study period. All lesions were destroyed without adverse events. Conclusion Elevation, hot snare resection and coagulation (ESC) of the visible vessel for treating colonic angioectasia appears safe and effective. Larger prospective comparative studies are required to assess its specific role. © Georg Thieme Verlag KG 2019-12 2019-12-10 /pmc/articles/PMC6904233/ /pubmed/31828216 http://dx.doi.org/10.1055/a-0965-6688 Text en https://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited. |
spellingShingle | Sriram, Nagaraj Bar-Yishay, Iddo Kumarasinghe, Priyanthi Yusoff, Ian Segarajasingam, Dev Bourke, Michael J. Raftopoulos, Spiro Definitive therapy of colonic angioectasia by submucosal coagulation |
title | Definitive therapy of colonic angioectasia by submucosal coagulation |
title_full | Definitive therapy of colonic angioectasia by submucosal coagulation |
title_fullStr | Definitive therapy of colonic angioectasia by submucosal coagulation |
title_full_unstemmed | Definitive therapy of colonic angioectasia by submucosal coagulation |
title_short | Definitive therapy of colonic angioectasia by submucosal coagulation |
title_sort | definitive therapy of colonic angioectasia by submucosal coagulation |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6904233/ https://www.ncbi.nlm.nih.gov/pubmed/31828216 http://dx.doi.org/10.1055/a-0965-6688 |
work_keys_str_mv | AT sriramnagaraj definitivetherapyofcolonicangioectasiabysubmucosalcoagulation AT baryishayiddo definitivetherapyofcolonicangioectasiabysubmucosalcoagulation AT kumarasinghepriyanthi definitivetherapyofcolonicangioectasiabysubmucosalcoagulation AT yusoffian definitivetherapyofcolonicangioectasiabysubmucosalcoagulation AT segarajasingamdev definitivetherapyofcolonicangioectasiabysubmucosalcoagulation AT bourkemichaelj definitivetherapyofcolonicangioectasiabysubmucosalcoagulation AT raftopoulosspiro definitivetherapyofcolonicangioectasiabysubmucosalcoagulation |