scholarly journals Contribution of Capsule Endoscopy Early in a Bleeding Episode to Treatment of Small Bowel Angioectasia: A Case Report

Medicina ◽  
2021 ◽  
Vol 57 (4) ◽  
pp. 321
Author(s):  
Yoshinori Arai ◽  
Maiko Ogawa ◽  
Rikako Arimoto ◽  
Yoshitaka Ando ◽  
Daisuke Endo ◽  
...  
Keyword(s):  
Small Bowel ◽  
Capsule Endoscopy ◽  
Bleeding Episode ◽  
Argon Plasma Coagulation ◽  
Argon Plasma ◽  
Small Intestinal Mucosa ◽  
Plasma Coagulation ◽  
Proximal Small Intestine ◽  
Small Intestinal ◽  
Small Bowel Bleeding

Background: Recent advances in endoscopic devices such as small bowel capsule endoscopy and balloon-assisted endoscopy have improved the level of medical care for small bowel bleeding. However, treating small bowel angioectasia remains challenging because repeated intermittent bleeding can occur from the multiple minute lesions (about 1 mm in size) that develop in a synchronous and metachronous manner. Here, we report a case of small bowel angioectasia in which capsule endoscopy performed early in a bleeding episode contributed to treatment. Case Summary: A 66-year-old man with suspected small bowel bleeding underwent small bowel capsule endoscopy and balloon-assisted endoscopy with argon plasma coagulation hemostasis for a small intestinal angioectasia. Because small bowel bleeding recurred intermittently after the treatment, small bowel capsule endoscopy and balloon-assisted endoscopy were repeated when there was no bleeding, but no abnormalities were found. Subsequent small bowel capsule endoscopy during a bleeding episode revealed bloody intestinal fluid in the proximal small intestine. Peroral balloon-assisted endoscopy was performed 2 days after SBCE for detailed observation of the small intestinal mucosa at the suspected bleeding site, and there a 1-mm Dieulafoy’s lesion with no active bleeding was identified. We performed argon plasma coagulation, and no bleeding was observed thereafter. Conclusions: Small bowel capsule endoscopy immediately after bleeding onset can identify the bleeding source of multiple minute lesions in small bowel angioectasia.

Push Enteroscopy and Argon Plasma Coagulation in the Prevention of Recurrent Bleeding From Small Bowel Angiodysplasia

2005 ◽  
Vol 61 (5) ◽  
pp. AB177 ◽  
Author(s):  
Jorge Olmos ◽  
Mariano Marcolongo ◽  
Valeria Pogorelsky ◽  
Leandro Herrera ◽  
Federico Tobal ◽  
...  
Keyword(s):  
Small Bowel ◽  
Argon Plasma Coagulation ◽  
Argon Plasma ◽  
Recurrent Bleeding ◽  
Push Enteroscopy ◽  
Plasma Coagulation

scholarly journals Video capsule endoscopy: Initial experience from a tertiary care center in Sri Lanka

2021 ◽  
Vol 12 (11) ◽  
pp. 40-44
Author(s):  
Dinesh Rangika Perera ◽  
Piyal Rangana ◽  
Sanjeewa Aryasingha
Keyword(s):  
Small Bowel ◽  
Sri Lanka ◽  
Capsule Endoscopy ◽  
Bowel Disease ◽  
Diagnostic Yield ◽  
Tertiary Care ◽  
Small Bowel Disease ◽  
Small Intestinal ◽  
Intestinal Ulcers ◽  
Small Bowel Bleeding

Background: Since its global introduction in 2000, capsule endoscopy (CE) has revolutionized the evaluation of small bowel disease. Aims and Objective: The aim of this study was to share our experience with CE including the findings and its diagnostic yield. Materials and Methods: A retrospective study was carried out at Colombo South Teaching Hospital of Sri Lanka. Data of patients who underwent CE from its initiation in 2017 until June 2020 were obtained from the hospital computer database. These included the patient demographics, indications for the study, quality of bowel preparation, and its findings. Results: The study included 54 patients with a mean age of 55 years. Mean gastric time and small bowel transit time were 52 and 272 min, respectively. Forty-five CE studies were done for the evaluation of small bowel bleeding and an abnormal study was found in 26 (57.78%) patients. Small intestinal ulcers and erosions were the most frequently found abnormality (n=16, 35.56%) followed by tumors (n=5, 11.11%). Active bleeding was evident in 14 (31.11%) patients. Overall diagnostic yield was higher in those with a history of overt bleeding (n=15, 71.43%) compared to occult bleeding (n=11, 45.83%). Most patients who were evaluated for abdominal pain and diarrhea had normal CE except for two who had small intestinal ulcers and subepithelial lesions. Only one case was complicated with capsule retention. Conclusion: CE is a useful investigation for the evaluation of small bowel disease, particularly in suspected small bowel bleeding. In contrast to western population, ulcers and erosions were the more frequently found abnormalities seen in local setting.

Refractory Anaemia Secondary to Small Bowel Angioectasias - Comparison between Endotherapy Alone versus Combination with Somatostatin Analogues

2017 ◽  
Vol 26 (4) ◽  
pp. 369-374 ◽  
Author(s):  
Stefania Chetcuti Zammit ◽  
Reena Sidhu ◽  
David Sanders
Keyword(s):  
Small Bowel ◽  
Argon Plasma Coagulation ◽  
Argon Plasma ◽  
Additional Treatment ◽  
Double Balloon Enteroscopy ◽  
Balloon Enteroscopy ◽  
Plasma Coagulation ◽  
Double Balloon ◽  
Group 2 ◽  
Group 1

Background & Aims: Patients with small bowel angioectasias (SBAs) can be difficult to manage as they are generally elderly with multiple co-morbidities. Angioectasias are multiple and tend to recur. Argon plasma coagulation (APC), despite being a commonly used method to treat these patients has an associated persistent rate of re-bleeding necessitating additional treatment to manage these patients.Methods: All patients with refractory iron deficiency anaemia secondary to SBAs were retrospectively subdivided into two groups. Patients in group 1 were managed with double balloon enteroscopy (DBE) and APC alone and those in group 2 received Lanreotide in addition to DBE and APC.Results: A total of 49 patients were included in this study: group 1: 37 patients (75.5%), group 2: 12 patients (24.5%). All had significant comorbidities and the mean duration of anaemia was 114.3, SD 307.0 months. Significant improvements in haemoglobin (Hb) (11g/L vs 3.2g/L p=0.043), transfusion requirements per month (0.8 vs 4.7 p=0.052) and mean bleeding episodes (1.08 vs 2.6 p=0.032) were demonstrated in group 2 when compared to group 1. One patient developed symptomatic gallstone disease and one patient stopped Lanreotide due to a lack of response.Conclusions: This is the first study comparing endotherapy to a combination of endotherapy and pharmacotherapy. It shows a significantly better outcome in patients receiving a combination of endotherapy and Lanreotide. Lanreotide can be a safe additional treatment in patients not responding to APC alone.Abbreviations: APC: argon plasma coagulation; CE: capsule endoscopy; DBE double balloon enteroscopy; Hb: hemoglobin; OGIB: over gastrointestinal bleeding; SBAs: small bowel angioectasias.

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