A novel method of treating colonic angiodysplasia

Wolfson Unit for Endoscopy, St Mark's Hospital, Harrow, Middlesex, United Kingdom.
Gastrointestinal Endoscopy (Impact Factor: 5.37). 10/2006; 64(3):424-7. DOI: 10.1016/j.gie.2006.04.032
Source: PubMed


Colonic angiodysplasia is responsible for up to a third of lower-GI bleeding cases. Argon plasma coagulation (APC) is a recognized treatment modality, but active bleeding decreases the ablative efficacy of APC by dissipation of the energy. APC has been associated with colonic perforation.
We propose a novel and safe method for the treatment of colonic angiodysplasia by a submucosal injection of a saline epinephrine solution followed by the application of APC.
Three patients with a total of 10 colonic angiodysplasias were treated with this injection-APC method.
Saline adrenaline solution (1:200,000) 2 to 3 mL was injected beneath the angiodysplasia before application of APC. APC 50 W and gas flow 2 L were applied onto the vascular lesion until the sufficient thermal effect was observed.
There were no procedure-related complications.
This new injection-APC method was safe for the treatment of colonic angiodysplasia. This may be useful in treating right-sided colonic lesions where the risks of perforation are greater than for the rest of the colon.

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    • "Angiodysplasias are treated locally with Argon plasma coagulation (APC) [18] or bipolar/heater probe [19]. Angiography may permit localization of a large bleeding lesion with therapeutic embolization or injection of vasopressin [20]. "
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