The term "vascular ectasia" is defined to include angiodysplasia, gastric antral vascular ectasia (GAVE) and telangiectasis, and these are the leading causes of acute or chronic gastrointestinal bleeding. We describe here the first 2 Korean cases of GAVE with rectal vascular ectasia in patients with liver cirrhosis. A 70-year-old woman was admitted to the hospital with hematochezia. The finding on endoscopy showed diffuse nonconfluent spots with oozing bleeding on the antrum and several vascular spots with oozing bleeding on the rectum. The lesions were successfully treated by argon plasma coagulation (APC). We report on another case of rectal vascular ectasia in a patient with liver cirrhosis. A 77-year-old man was admitted to the hospital with hematochezia. The findings on colonoscopy showed diffuse vascular spots with oozing bleeding on the rectum. The lesions were successfully treated by APC. These two patients have had no bleeding since their treatment, and they are currently being evaluated by follow-up studies at the outpatient department.
Aged ; Angiodysplasia ; Argon ; Argon Plasma Coagulation ; Carbamates ; Colonoscopy ; Dilatation, Pathologic ; Endoscopy ; Female ; Follow-Up Studies ; Gastric Antral Vascular Ectasia ; Gastrointestinal Hemorrhage ; Hemorrhage ; Humans ; Liver ; Liver Cirrhosis ; Organometallic Compounds ; Outpatients ; Rectum ; Telangiectasis

No abstract available.
Angiodysplasia ; Stomach

No abstract available.
Angiodysplasia* ; Child* ; Colon, Sigmoid* ; Humans

Angiodysplasia of small bowel is uncommon and frequently undiagnosed and presents a taxing surgical problem. It is usually diagnosed for unexplained gastrointestinal bleeding. For the surgeon, the main technical problem is that the lesion is impalpable, and invisible to the naked eye, so it usually cannot be identified unless bleeds actively at the time of surgery. Arteriography gives a little information about wax and wane pattern of bleeding in the lesion. Endoscopy is often unfruitful because the majority of lesions are submucosal and rarely exceed a few millimeters in diameter. Transillumination of the intestinal wall from inside of the lumen to the outside in a dark room can define the precise vascular anatomy of the wall. The delicate lesion of the angiodysplasia can be identified by this transillumination method. We described a simple intraoperstive endoscopic translllumination technique used successfully to identify an angiodysplasia in the small bovwel prior to the bowel resecion. This report summarized our experience and review of literature.
Angiodysplasia* ; Angiography ; Endoscopy ; Hemorrhage ; Taxes ; Transillumination*

Angiodysplsia of the small bowel is uncommon, but provably remains frequently undiagnosed. In the small intestine, angiodysplasia presents a taxing surgical problem and is uauslly diagnosed for unexplained gastrointestinal bleeding. For the surgeon, the main technical problem is that even when identified by frequently impalpable, and invisible to the naked eye unless they are actively bleeding at the time of surgery. Ensocopy is often unfruitful because the majority of lesions are submucosal and rarely exceed a few milimeters in diameter. We described a simple intraoperative endoscopic transillumination technique used successfully to identify an angiodysplasia in the jejunum prior to the small bowel resection. This report summarized our experience and review of literature.
Angiodysplasia* ; Hemorrhage ; Intestine, Small ; Jejunum* ; Taxes ; Transillumination*

Angiodysplasia has been recognized as an important cause of lower gastrointestinal bleeding, but it is difficult to confirm the lesions. Angiodysplasia in the small bowel could be the most probable cause of bleeding particularly in the elderly patients when usual methods fail to document the focus. Small bowel angiodysplasias have been diagnosed by angiography and/or surgery at the sites where usual endoscope could not reach, and treated by medical therapy, angiographic embolization or surgery. We experienced a case of a bleeding angiodysplasia in the terminal ileum in a 51-year-old man who was taking anti-platelet agents. The lesion was diagnosed by colonoscopy, and bleeding was easily controlled with hemoclipping.
Aged ; Angiodysplasia* ; Angiography ; Colonoscopy ; Endoscopes ; Hemorrhage* ; Humans ; Ileum* ; Middle Aged

BACKGROUND/AIMS: Substantial time and attention are required to read and interpret the recordings of capsule endoscopic images. A suspected blood identification system (SBIS) has been developed to assist in the reading of capsule images. This software automatically marks "red tags" that correlate with suspected blood or red areas. However, the sensitivity and accuracy of the system have not been well characterized. We investigated the usefulness of the SBIS in capsule endoscopy according to various small bowel bleeding lesions. METHODS: Two expert endoscopists reviewed the capsule images. Angiodysplasias, ulcers and erosion were considered as significant lesions, and active bleeding lesions were considered when bleeding or blood clots were seen in the capsule images. The red tags that were automatically marked by the use of the rapid software were compared to the significant lesions reviewed by the endoscopists. RESULTS: A total of 95 patients were enrolled in the study. The endoscopists identified 159 significant lesions and 71 lesions marked by red tags were identified by the SBIS. Among the 71 lesions, 31 lesions correctly coincided with the significant lesions. The overall sensitivity and positive predictive value of the use of the SBIS were 20% and 44%, respectively. The sensitivities of active ulcers and active bleeding lesions were 83% and 93%, respectively. CONCLUSIONS: The SBIS should be considered as a rapid screening tool to identify active bleeding lesions, and a complete review of capsule images by a physician is still needed.
Angiodysplasia ; Capsule Endoscopy ; Hemorrhage ; Humans ; Mass Screening ; Ulcer

Gastric antral vascular ectasia ("watermelon stomach") is characterized by a prominent longitudinalerythematous fold of gastric antrum. Because it has usually been diagnosed by gastroscopy and biopsy, itsradiologic findings have not been well described. We report a case of gastric antral vascular ectasia, anddescribe its findings, as seen on UGIS, ultrasonography, and computed tomography.
Biopsy ; Gastric Antral Vascular Ectasia* ; Gastroscopy ; Pyloric Antrum ; Stomach ; Ultrasonography

A 79-year-old woman with a known history of hypertrophic cardiomyopathy presented with severe anemia of unknown origin. She had also suffered from repeated episodes of upper gastrointestinal bleeding for the previous 2-3 years. Despite small bowel series and panendoscopic and angiographic studies, the origin of anemia remained undefined until a small multiple bleeding site was found during capsule endoscopy. The lesion proved to be angiodysplasia in jejunum. We report a case of jejunal angiodysplasia is diagnosed by capsule endoscopy in a patient with hypertrophic cardiomyopathy.
Aged ; Anemia ; Angiodysplasia* ; Capsule Endoscopy* ; Cardiomyopathy, Hypertrophic* ; Endoscopy ; Female ; Hemorrhage ; Humans ; Jejunum

BACKGROUND/AIMS: There is no consensus as to the best treatment for non-variceal, non-ulcer gastrointestinal hemorrhage. Endoscopic band ligation is an inexpensive, readily available, and easily learned technique in contrast to conventional thermal methods of endoscopic hemostasis. The purpose of this study is to define the effectiveness of endoscopic band ligation for non-variceal, non-ulcer gastrointestinal hemorrhage and post-polypectomy hemorrhage. METHODS: Twenty eight patients were treated by band ligation between July 1996 and October 2000. The lesions treated were: Dieulafoy's lesion in 13, Mallory-Weiss tear in 7, angiodysplasia in 1, post-polypectomy bleeding in 4, post-endoscopic mucosal resection bleeding in 2, post-endoscopic biopsy bleeding in 1. RESULTS: Endoscopic band ligation was successful in 25 of 28 cases. Additional sclerotherapy was necessary in two cases of Dieulafoy's lesion. The remaining case was early band detachment. CONCLUSIONS: Endoscopic band ligation is effective for non-variceal, non-ulcer bleeding. It has the advantage of ease of use and is relatively inexpensive.
Angiodysplasia ; Biopsy ; Consensus ; Gastrointestinal Hemorrhage* ; Hemorrhage* ; Hemostasis, Endoscopic ; Humans ; Ligation* ; Mallory-Weiss Syndrome ; Sclerotherapy