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Von Willebrand Disease and Angiodysplasia: a wider view of pathogenesis in pursuit of therapy.
Haematologica
November 2024
Centre for Haematology, Department of Immunology and Inflammation, Imperial College London, UK; Department of Haematology, Imperial College Healthcare NHS Trust, London.
Bleeding in the GI tract continues to pose a therapeutic challenge for clinicians in patients with Von Willebrand Disease (VWD). It is associated with significant morbidity and mortality and represents the major unmet need in VWD. Defective angiogenesis in the gut is primarily responsible, resulting in angiodysplastic malformations making bleeding notoriously refractory to standard replacement therapy.
View Article and Find Full Text PDFCapsule endoscopy for small bowel bleed: Current update.
Indian J Gastroenterol
October 2024
Institute of Gastrosciences and Liver Transplantation, Apollo Multispeciality Hospitals, Kolkata, 700 054, India.
Small intestine, hitherto an obscure area for endoscopists before 2000, is now easily evaluated non-invasively using capsule endoscopy and invasively by device-assisted enteroscopies. Major advances in understanding the causes and management of small bowel diseases have been in obscure gastrointestinal (GI) bleed, currently re-named as small bowel bleed, after the discovery of capsule endoscopy. The current article is a narrative review of the technology of capsule endoscopy, its advantages and limitations, future perspective and Indian studies on its utility in patients with small bowel bleed.
View Article and Find Full Text PDFDiagnosis and Endoscopic Treatment of Hemobilia Due to Biliary Angiodysplasia: A Case Report and Literature Review.
Cureus
December 2023
Gastrointestial Endoscopy, Hospital 9 de Julho, São Paulo, BRA.
Hemobilia is described as bleeding from the intra- or extrahepatic biliary tree expressed through the major duodenal papilla into the duodenum, with angiodysplasia of the major biliary duct as a rare etiological factor with few cases reported in the literature. Cholangioscopy plays a pivotal role in diagnosing and making therapeutic decisions regarding biliary tract lesions. We report a case of the diagnosis and treatment of hemobilia secondary to bleeding from angiodysplasia of the major biliary duct, which was resolved after the placement of a fully covered metallic stent, with a review of the literature.
View Article and Find Full Text PDFClinical features, treatments and prognosis of appendiceal bleeding: a case series study.
BMC Gastroenterol
November 2023
Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, 37 Guoxue Lane, Chengdu, 610041, Sichuan, China.
Background: Appendiceal bleeding is a rare cause of lower gastrointestinal bleeding, could be overlooked and diagnosed as obscure gastrointestinal bleeding. Due to limited real-world cases, the optimized management of appendiceal bleeding is unclear. We here shared our experiences in the past 20 years.
View Article and Find Full Text PDFTrends in Upper Gastrointestinal Bleeding in Patients on Primary Prevention Aspirin: A Nationwide Emergency Department Sample Analysis, 2016-2020.
Am J Med
December 2023
Section of Digestive Diseases, Department of Medicine, Yale School of Medicine, New Haven, Conn. Electronic address:
Background: Recent guidelines do not recommend routine use of aspirin for primary cardiovascular prevention (ppASA) and suggest avoidance of ppASA in older individuals due to bleeding risk. However, ppASA is frequently taken without an appropriate indication. Estimates of the incidence of upper gastrointestinal bleeding due to ppASA in the United States are lacking.
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