Endoscopic classification of vascular lesions of the small intestine (with videos)

Yano, Tomonori; Yamamoto, Hironori; Sunada, Keijiro; Miyata, Tomohiko; Iwamoto, Michiko; Hayashi, Yoshikazu; Arashiro, Masayuki; Sugano, Kentaro

doi:10.1016/j.gie.2007.08.005

Cited by 166 publications

(120 citation statements)

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“…Enteroscopic techniques such as argon plasma coagulation (APC) and endoscopic clipping have been well studied [1][2][3][4][5] . Endoscopic band ligation (EBL) had been used for the treatment of esophageal varices [6][7][8][9][10] .…”

Section: Introductionmentioning

confidence: 99%

Endoscopic band ligation for bleeding lesions in the small bowel

Ikeya¹

2014

WJGE

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AIM:To investigate the safety and efficacy of endoscopic band ligation (EBL) for bleeding lesions in the small bowel.METHODS: This is a retrospective study evaluating EBL in six consecutive patients (three males, three females, 46-86 years of age) treated between May 2009 and February 2014: duodenal vascular ectasia; 1, jejunal bleeding diverticulum; 1, ileal Dieulafoy's lesion; 1 and ileal bleeding diverticula; 3. The success of the initial hemostasis was evaluated, and patients were observed for early rebleeding (within 30 d after EBL), and complications such as perforation and abscess formation. Follow-up endoscopies were performed in four patients. RESULTS:Initial hemostasis was successfully achieved with EBL in all six patients. Eversion was not sufficient in four diverticular lesions. Early rebleeding occurred three days after EBL in one ileal diverticulum, and a repeat endoscopy revealed dislodgement of the O-band and ulcer formation at the banded site. This rebleeding was managed conservatively. Late rebleeding occurred in this case (13 and 21 mo after initial EBL), and re-EBL was performed. Follow-up endoscopies revealed scar formation and the disappearance of vascular lesions at the banded site in the case with a duodenal bleeding lesion, and unresolved ileal diverticula in three cases. Surgery or transarterial embolization was not required without any complications during the median follow-up period of 45 (range, 2-83) mo. CONCLUSION:EBL is a safe and effective endoscopic treatment for hemostasis of bleeding lesions in the small bowel.© 2014 Baishideng Publishing Group Inc. All rights reserved.Key words: Endoscopic band ligation; Small bowel; Diverticular hemorrhage; Jejunal bleeding; Ileal bleeding; Therapeutic endoscopy; Hemostasis Core tip: There have been few reports regarding the use of endoscopic band ligation (EBL) for the treatment of bleeding lesions in the small intestine. The present study demonstrates safe and effective use of EBL to treat six patients with small bowel lesions including, duodenal vascular ectasia, ileal Dieulafoy's lesion, and jejunal and ileal bleeding diverticula. Although the bleeding was successfully managed in all patients, those with diverticular bleeding in the small bowel should be closely monitored after an initial EBL.

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Section: Introductionmentioning

confidence: 99%

Endoscopic band ligation for bleeding lesions in the small bowel

Ikeya¹

2014

WJGE

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“…According to Yano-Yamamoto's endoscopic classification of small intestinal vascular lesions, AVMs usually appear as pulsatile red protrusion with surrounding venous dilatation [6]. Intestinal AVM that appears as mass or polypoid lesion is extremely rare as like our case.…”

Section: Discussionmentioning

confidence: 57%

Unusual Giant Arteriovenous Malformation in Jejunum: A Case Report

Kim¹,

Goo²

2017

J Korean Assoc Pediatr Surg

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Polypoid or tumorous arteriovenous malformation (AVM) of small intestine is rare and can be misdiagnosed as other tumorous conditions. We experienced a rare case of giant jejunal AVM in a 15-year-old boy, who complained of intense abdominal pain. Ultrasonography and contrast-enhanced CT revealed a 13.5-cm-sized multiseptated cystic mass arising in small intestine, which was mimicking submucosal tumor. It was successfully treated by surgical resection. The specimen showed a multilobulated outbulging submucosal mass in jejunum. Histopathologic evalulation confirmed AVM located in the submucosa, muscularis propria and subserosa. This case is the largest AVM of small intestine among which has ever been reported.

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“…Medical terminology of GI is unfortunately not homogenous [5,9]. Yano et al proposed 4 groups of small bowel lesions what was shown in Table 1 [5,10]. The most common reason of bleeding is angiodysplasia, in 40% to 60% cases there are more than one bowel lesion and in 20% cases lesions are disseminated in gastrointestinal tract [8,9].…”

Section: Case Reportmentioning

confidence: 99%

“…Small bowel angiodysplasia 32% to 61% [1,2,4,5,10,12,14] Arteriovenous malformation (AVM) 9,1% [5] Ulceration 85 to 14,7% [1,4,5] Small bowel tumors 45 to 20% [1,4,5,14] Cameron erosion 5% to 15% [14] Upper GI tract angiodysplasia 45 to 10% [11,14] Crohn's disease 2% to 10% [14] Small bowel diverticula 3,3% to 5% [1,5,14] Colon dysplasia 2% to 4% [5] Varices haemorrhoidalis 0,4% to 5% [4,5,14] Dieulafoy lesions 0,4% to 3,5% [5,12,14] Unknown 16% to 20,7% [1,5] of cases transfusion of PRBC and FFP units is required [1,3,7]. It is discussed whether repeated endoscopy after failed first investigation is indicated because it was proven that it is not efficient enough and it enables visualization of only 3.5% to 5% of lesions responsible for bleeding.…”

Section: Reason Count (%)mentioning

confidence: 99%