Eighteen patients with gastrointestinal angiodysplasia were seen in a single surgical unit over a period of 8 years. The mean age at onset of symptoms was 33 years. The average duration of symptoms was 54 months (range 2 days-16 years). Three patients had gastric angiodysplasia, two had colonic angiodysplasia, both diagnosed endoscopically preoperatively. The remaining patients required further investigation, which included small bowel enema (SBE), erythrocyte tagged scan (ETC), selective visceral angiography and intraoperative enteroscopy (IOE). SBE was useful but not diagnostic in 3, ETC in 3 and angiography in 5. Four patients required IOE for a diagnosis. Follow up of 17 months is available on all patients. Four had recurrence of symptoms. One required re-exploration and resection of 3 feet of small bowel and right hemicolectomy, another is on hormonal therapy and maintaining normal haemoglobin. Two others are asymptomatic on oral iron therapy.
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Medicine (Baltimore)
January 2025
Department of Gastroenterology, The Affiliated People's Hospital of Ningbo University, Ningbo, China.
Rationale: Gastric antral vascular ectasia (GAVE) is a rare acquired lesion characterized by vascular dilation in the gastric antrum, frequently results in occult or overt gastrointestinal bleeding. Endoscopic intervention remains the cornerstone of therapy. Argon plasma coagulation was previously considered a first treatment option.
View Article and Find Full Text PDFCureus
December 2024
General Surgery, King Saud Medical City, Riyadh, SAU.
Angiodysplasia is one of the causes of recurrent episodes of lower gastrointestinal (GI) bleeding. Angiodysplasia could be associated with few lesions or multiple diffuse lesions, causing diversity in the clinical presentation of such patients. We report a case of a 19-year-old male presenting with life-threatening gastrointestinal bleeding due to diffuse angiodysplasia of the bowel extending from the jejunum to the sigmoid colon and requiring multiple investigations and management.
View Article and Find Full Text PDFCureus
December 2024
Internal Medicine, Hospital Universitario Dr. José Eleuterio González, Monterrey, MEX.
Heyde's syndrome is a clinical entity that combines aortic stenosis, gastrointestinal angiodysplasia, and an acquired von Willebrand factor disorder. This syndrome is characterized by the association between aortic stenosis and recurrent gastrointestinal bleeding episodes, typically linked to angiodysplasias. Effective treatment requires addressing the underlying condition, specifically aortic stenosis, which leads to the structural destruction of coagulation proteins, resulting in the acquired von Willebrand factor disorder and perpetuating the bleeding.
View Article and Find Full Text PDFJ Med Cases
January 2025
Gastroenterology and Hepatology, St. Joseph's University Medical Center, Paterson, NJ, USA.
Heyde syndrome is a triad of aortic stenosis (AS), gastrointestinal (GI) bleeding from angiodysplasia, and acquired von Willebrand disease (vWD). It is hypothesized that stenotic aortic valves cleave von Willebrand factor (vWF) multimers, predisposing patients to bleeding from GI angiodysplasias. This hypothesis is supported by the observation that aortic valve replacement often leads to the resolution of GI bleeding.
View Article and Find Full Text PDFInt J Gen Med
December 2024
Surgery Department, University of Medicine and Pharmacy of Craiova, Craiova, Romania.
Introduction: Most studies have shown a declining incidence of upper gastrointestinal bleeding (UGIB) in recent years. Data regarding mortality were controversial; in non-variceal bleeding, the increasing age of the population, increased use of anti-thrombotic and anticoagulant therapy in patients with cardiovascular diseases, and the use of non-steroidal anti-inflammatory drugs are counterbalanced by the progress in endoscopic therapy with stable mortality.
Material And Method: We performed a retrospective, cross-sectional study that included patients admitted with UGIB in Clinical Emergency Hospital Craiova during 2013-2020.
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