Ethanolamine Injection for Sclerotherapy of Angiodysplasia of the Colon

Bemvenuti, Giovani A.; Jülich, M. M.

doi:10.1055/s-2007-1001345

Cited by 37 publications

(8 citation statements)

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“…Another study demonstrated the feasibility and safety of ethanolamine injection to treat eight patients with 15 lesions predominantly in the right colon. 162 None of the studies reported any serious com-plications. However, this technique can be challenging and time consuming depending of the site, number and ease of access to the lesions.…”

Section: Endoscopic Therapiesmentioning

confidence: 93%

“…used 0.5–1.0 mL of 1.5% sodium tetracedyl sulphate to treat 10 patients with upper GI AD directly injecting the sclerosant beneath the lesion. Another study demonstrated the feasibility and safety of ethanolamine injection to treat eight patients with 15 lesions predominantly in the right colon . None of the studies reported any serious complications.…”

Section: Managementmentioning

confidence: 99%

See 1 more Smart Citation

Review article: gastrointestinal angiodysplasia - pathogenesis, diagnosis and management

Sami

Al-Araji

Ragunath

2013

Aliment Pharmacol Ther

213

236

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Summary Background Angiodysplasia (AD) of the gastrointestinal (GI) tract is an important condition that can cause significant morbidity and –rarely – mortality. Aim To provide an up‐to‐date comprehensive summary of the literature evaluating this disease entity with a particular focus on pathogenesis as well as current and emerging diagnostic and therapeutic modalities. Recommendations for treatment will be made on the basis of the current available evidence and consensus opinion of the authors. Methods A systematic literature search was performed. The search strategy used the keywords ‘angiodysplasia’ or ‘arteriovenous malformation’ or ‘angioectasia’ or ‘vascular ectasia’ or ‘vascular lesions’ or ‘vascular abnormalities’ or ‘vascular malformations’ in the title or abstract. Results Most AD lesions (54–81.9%) are detected in the caecum and ascending colon. They may develop secondary to chronic low‐grade intermittent obstruction of submucosal veins coupled with increased vascular endothelial growth factor‐dependent proliferation. Endotherapy with argon plasma coagulation resolves bleeding in 85% of patients with colonic AD. In patients who fail (or are not suitable for) other interventions, treatment with thalidomide or octreotide can lead to a clinically meaningful response in 71.4% and 77% of patients respectively. Conclusions Angiodysplasia is a rare, but important, cause of both overt and occult GI bleeding especially in the older patients. Advances in endoscopic imaging and therapeutic techniques have led to improved outcomes in these patients. The choice of treatment should be decided on a patient‐by‐patient basis. Further research is required to better understand the pathogenesis and identify potential therapeutic targets.

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Section: Endoscopic Therapiesmentioning

confidence: 93%

Section: Managementmentioning

confidence: 99%

Review article: gastrointestinal angiodysplasia - pathogenesis, diagnosis and management

Sami

Al-Araji

Ragunath

2013

Aliment Pharmacol Ther

213

236

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“…To prevent brisk bleeding from angiodysplasia when contact electrocautery is performed, large angiodysplasia should be cauterized from the outer margin towards the centre to obliterate feeder vessels. Injection therapy with sclerosing agents, such as ethanolamine, has also been described for control of bleeding from colonic angiodysplasia but is not widely employed 89 . Argon plasma coagulation, a noncontact method, has been used increasingly for the treatment of bleeding colonic angiodysplasia (grade B evidence) 90–92 .…”

Section: Management Approach To Patients With Acute Lower Gastrointesmentioning

confidence: 99%

Review article: the management of lower gastrointestinal bleeding

Farrell

2005

Aliment Pharmacol Ther

196

129

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SUMMARYSeveral recent advances have been made in the evaluation and management of acute lower gastrointestinal bleeding. This review focuses on the management of lower gastrointestinal bleeding, especially acute severe bleeding. The aim of the study was to critically review the published literature on important management issues in lower gastrointestinal bleeding, including haemodynamic resuscitation, diagnostic evaluation, and endoscopic, radiologic, and surgical therapy, and to develop an algorithm for the management of lower gastrointestinal bleeding, based on this literature review.Publications pertaining to lower gastrointestinal bleeding were identified by searches of the MEDLINE database for the years 1966 to December 2004. Clinical trials and review articles were specifically identified, and their reference citation lists were searched for additional publications not identified in the database searches. Clinical trials and current clinical recommendations were assessed by using commonly applied criteria. Specific recommendations are made based on the evidence reviewed.Approximately, 200 original and review articles were reviewed and graded. There is a paucity of high-quality evidence to guide the management of lower gastrointestinal bleeding, and current endoscopic, radiologic, and surgical practices appear to reflect local expertise and availability of services. Endoscopic literature supports the role of urgent colonoscopy and therapy where possible. Radiology literature supports the role of angiography, especially after a positive bleeding scan has been obtained. Limited surgical data support the role of segmental resection in the management of persistent lower gastrointestinal bleeding after localization by either colonoscopy or angiography.There is limited high-quality research in the area of lower gastrointestinal bleeding. Recent advances have improved the endoscopic, radiologic and surgical management of this problem. However, treatment decisions are still often based on local expertise and preference. With increased access to urgent therapeutic endoscopy for the management of acute upper gastrointestinal bleeding, diagnostic and therapeutic colonoscopy can be expected to play an increasing role in the management of acute lower gastrointestinal bleeding. INTRODUCTIONLower gastrointestinal bleeding is one-fifth to one-third as common as upper gastrointestinal bleeding and generally has a less severe course. The annual incidence rate of lower gastrointestinal bleeding in the US ranges from 20.5 to 27 cases per 100 000 adult population at risk (0.03%). In contrast, the annual incidence rate for upper gastrointestinal bleeding is reported to range from 100 to 200 cases per 100 000. As in upper gastrointestinal bleeding, lower gastrointestinal bleeding stops spontaneously in most cases (80-85%). 1The mean age of patients with lower gastrointestinal bleeding ranges from 63 to 77 years, with a reported mortality rate of 2-4% (Table 1). [2][3][4][5][6][7] The incidence rate of lower gastrointestinal bleed...

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“…In the past, most cases of vascular ectasia were treated endoscopically, although some cases were treated surgically 5 . Although sclerotherapy, ethanol injection, high‐frequency coagulation, thermocoagulation using a heat probe, and photocoagulation using a laser have been reported to be useful for treating vascular ectasia, a consensus of opinions has not yet been obtained 6–8 …”

Section: Discussionmentioning

confidence: 99%

Gastric vascular ectasia treated by endoscopic mucosal resection

Okamoto

Okayama

Hirai

et al. 2002

Digestive Endoscopy

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An 80‐year‐old woman consulted our hospital complaining of general weakness. She had iron deficiency anemia, and upper gastrointestinal endoscopy revealed a small lesion accompanying a small amount of fresh bleeding in the stomach. Close observation of the lesion revealed that it was composed of a local assembly of dilated microvessels. The diagnosis of this patient was gastric vascular ectasia causing anemia. Endoscopic ultrasonography demonstrated that the lesion involved the mucosal and submucosal layers of the stomach, and that there were no large vessels inflowing to or outflowing from the lesion. In the present case, we attempted endoscopic mucosal resection (EMR). The lesion was completely resected by only one procedure of EMR without complications such as bleeding. After the endoscopic treatment, iron deficiency anemia improved. Follow‐up endoscopy performed 1 year later revealed that there was no residual or recurrent lesion. Although there have not been any published reports describing the use of EMR for gastric vascular ectasia, EMR may be a useful endoscopic treatment for this condition.

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Ethanolamine Injection for Sclerotherapy of Angiodysplasia of the Colon

Cited by 37 publications

References 0 publications

Review article: gastrointestinal angiodysplasia - pathogenesis, diagnosis and management

Review article: gastrointestinal angiodysplasia - pathogenesis, diagnosis and management

Review article: the management of lower gastrointestinal bleeding

Gastric vascular ectasia treated by endoscopic mucosal resection

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