Acta Endoscopica

, Volume 44, Issue 6, pp 393–401 | Cite as

Angiodysplasies hémorragiques du tube digestif

  • G. Rahmi
Formation Médicale Continue / Continuing Medical Education

Bleeding from gastrointestinal angiodysplasia


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Gordon FH, Watkinson A, Hodgson H. Vascular malformations of the gastrointestinal tract. Best Pract Res Clin Gastroenterol 2001;15:41–58.PubMedCrossRefGoogle Scholar
  2. 2.
    Athanasoulis CA, Galdabini JJ, Waltman AC, Novelline RA, Greenfield AJ, Ezpeleta ML. Angiodysplasia of the colon: a cause of rectal bleeding. Cardiovasc Radiol 1977–1978;1:3–13.CrossRefGoogle Scholar
  3. 3.
    Boley SJ, Brandt LJ. Vascular ectasias of the colon — 1986. Dig Dis Sci 1986;31:26S–42S.PubMedCrossRefGoogle Scholar
  4. 4.
    Moretó M, Figa M, Ojembarrena E, Zaballa M. Vascular malformations of the stomach and duodenum: an endoscopic classification. Endoscopy 1986;18:227–9.PubMedCrossRefGoogle Scholar
  5. 5.
    Lecleire S, Iwanicki-Caron I, Di-Fiore A, Elie C, Alhameedi R, Ramirez S, et al. Yield and impact of emergency capsule enteroscopy in severe obscure-overt gastrointestinal bleeding. Endoscopy 2012;44:337–42.PubMedCrossRefGoogle Scholar
  6. 6.
    Foutch PG, Rex DK, Lieberman DA. Prevalence and natural history of colonic angiodysplasia among healthy asymptomatic people. Am J Gastroenterol 1995;90:564–7.PubMedGoogle Scholar
  7. 7.
    Richter JM, Christensen MR, Colditz GA, Nishioka NS. Angiodysplasia. Natural history and efficacy of therapeutic interventions. Dig Dis Sci 1989;34:1542–6.PubMedCrossRefGoogle Scholar
  8. 8.
    Junquera F, Feu F, Papo M, Videla S, Armengol JR, Bordas JM, et al. A multicenter, randomized, clinical trial of hormonal therapy in the prevention of rebleeding from gastrointestinal angiodysplasia. Gastroenterology 2001;121:1073–9.PubMedCrossRefGoogle Scholar
  9. 9.
    Gupta N, Longo WE, Vernava AM. Angiodysplasia of the lower gastrointestinal tract: an entity readily diagnosed by colonoscopy and primarily managed nonoperatively. Dis Colon Rectum 1995;38:979–82.PubMedCrossRefGoogle Scholar
  10. 10.
    Cappell MS, Gupta A. Changing epidemiology of gastrointestinal angiodysplasia with increasing recognition of clinically milder cases: angiodysplasia tend to produce mild chronic gastrointestinal bleeding in a study of 47 consecutive patients admitted from 1980–1989. Am J Gastroenterol 1992;87:201–6.PubMedGoogle Scholar
  11. 11.
    Rogers BH. Endoscopic diagnosis and therapy of mucosal vascular abnormalities of the gastrointestinal tract occurring in elderly patients and associated with cardiac, vascular, and pulmonary disease. Gastrointest Endosc 1980;26:134–8.PubMedCrossRefGoogle Scholar
  12. 12.
    Junquera F, Feu F, Papo M, Videla S, Armengol JR, Bordas JM, et al. Increased expression of angiogenic factors in human colonic angiodysplasia. Am J Gastroenterol 1999;94:1070–6.PubMedCrossRefGoogle Scholar
  13. 13.
    Starke RD, Ferraro F, Paschalaki KE, Dryden NH, McKinnon TA, Sutton RE, et al. Endothelial von Willebrand factor regulates angiogenesis. Blood 2011;117:1071–80.PubMedCentralPubMedCrossRefGoogle Scholar
  14. 14.
    Steger AC, Galland RB, Hemingway A, Wood CB, Spencer J. Gastrointestinal haemorrhage from a second source in patients with colonic angiodysplasia. Br J Surg 1987;74:726–7.PubMedCrossRefGoogle Scholar
  15. 15.
    Williams RC Jr. Aortic stenosis and unexplained gastrointestinal bleeding. Arch Intern Med 1961;108:859–63.PubMedCrossRefGoogle Scholar
  16. 16.
    Shoenfeld Y, Eldar M, Bedazovsky B, Levy MJ, Pinkhas J. Aortic stenosis associated with gastrointestinal bleeding. A survey of 612 patients. Am Heart J 1980;100:179–82.PubMedCrossRefGoogle Scholar
  17. 17.
    Veyradier A, Balian A, Wolf M, Giraud V, Montembault S, Obert B, et al. Abnormal von Willebrand factor in bleeding angiodysplasias of the digestive tract. Gastroenterology 2001;120:346–53.PubMedCrossRefGoogle Scholar
  18. 18.
    Hirri HM, Green PJ, Lindsay J. Von Willebrand’s disease and angiodysplasia treated with thalidomide. Haemoph Off J World Fed Hemoph 2006;12:285–6.CrossRefGoogle Scholar
  19. 19.
    Duray PH, Marcal JM Jr, LiVolsi VA, Fisher R, Scholhamer C, Brand MH. Gastrointestinal angiodysplasia: a possible component of von Willebrand’s disease. Hum Pathol 1984;15:539–44.PubMedCrossRefGoogle Scholar
  20. 20.
    Chalasani N, Cotsonis G, Wilcox CM. Upper gastrointestinal bleeding in patients with chronic renal failure: role of vascular ectasia. Am J Gastroenterol 1996;91:2329–32.PubMedGoogle Scholar
  21. 21.
    Boccardo P, Remuzzi G, Galbusera M. Platelet dysfunction in renal failure. Semin Thromb Hemost 2004;30:579–89.PubMedCrossRefGoogle Scholar
  22. 22.
    Kringen MK, Narum S, Lygren I, Seljeflot I, Sandset PM, Trøseid AM, et al. Reduced platelet function and role of drugs in acute gastrointestinal bleeding. Basic Clin Pharmacol Toxicol 2011;108:194–201.PubMedCrossRefGoogle Scholar
  23. 23.
    Triester SL, Leighton JA, Leontiadis GI, Fleischer DE, Hara AK, Heigh RI, et al. A meta-analysis of the yield of capsule endoscopy compared to other diagnostic modalities in patients with obscure gastrointestinal bleeding. Am J Gastroenterol 2005;100:2407–18.PubMedCrossRefGoogle Scholar
  24. 24.
    Nakamura M, Niwa Y, Ohmiya N, Miyahara R, Ohashi A, Itoh A, et al. Preliminary comparison of capsule endoscopy and doubleballoon enteroscopy in patients with suspected small-bowel bleeding. Endoscopy 2006;38:59–66.PubMedCrossRefGoogle Scholar
  25. 25.
    Rahmi G, Samaha E, Vahedi K, Ponchon T, Fumex F, Filoche B, et al. Multicenter comparison of double-balloon enteroscopy and spiral enteroscopy. J Gastroenterol Hepatol 2013;28:992–8.PubMedCrossRefGoogle Scholar
  26. 26.
    May A, Friesing-Sosnik T, Manner H, Pohl J, Ell C. Long-term outcome after argon plasma coagulation of small-bowel lesions using double-balloon enteroscopy in patients with mid-gastrointestinal bleeding. Endoscopy 2011;43:759–65.PubMedCrossRefGoogle Scholar
  27. 27.
    May A, Färber M, Aschmoneit I, Pohl J, Manner H, Lotterer E, et al. Prospective multicenter trial comparing push-and-pull enteroscopy with the single and double-balloon techniques in patients with small-bowel disorders. Am J Gastroenterol 2010;105:575–81.PubMedCrossRefGoogle Scholar
  28. 28.
    Takano N, Yamada A, Watabe H, Togo G, Yamaji Y, Yoshida H, et al. Single balloon versus double-balloon endoscopy for achieving total enteroscopy: a randomized, controlled trial. Gastrointest Endosc 2011;73:734–9.PubMedCrossRefGoogle Scholar
  29. 29.
    Sidhu R, Sanders DS, Morris AJ, McAlindon ME. Guidelines on small bowel enteroscopy and capsule endoscopy in adults. Gut 2008;57:125–36.PubMedCrossRefGoogle Scholar
  30. 30.
    Dusold R, Burke K, Carpentier W, Dyck WP. The accuracy of technetium-99m-labeled red cell scintigraphy in localizing gastrointestinal bleeding. Am J Gastroenterol 1994;89:345–8.PubMedGoogle Scholar
  31. 31.
    Feingold DL, Caliendo FJ, Chinn BT, Notaro JR, Oliver GC, Salvati EP, et al. Does hemodynamic instability predict positive technetium-labeled red blood cell scintigraphy in patients with acute lower gastrointestinal bleeding? A review of 50 patients. Dis Colon Rectum 2005;48:1001–4.PubMedCrossRefGoogle Scholar
  32. 32.
    Junquera F, Quiroga S, Saperas E, Pérez-Lafuente M, Videla S, Alvarez-Castells A, et al. Accuracy of helical computed tomographic angiography for the diagnosis of colonic angiodysplasia. Gastroenterology 2000;119:293–9.PubMedCrossRefGoogle Scholar
  33. 33.
    Dray X, Camus M, Coelho J, Ozenne V, Pocard M, Marteau P. Treatment of gastrointestinal angiodysplasia and unmet needs. Dig Liver Dis Off J Ital Soc Gastroenterol Ital Assoc Study Liver 2011;43:515–22.Google Scholar
  34. 34.
    Sami SS, Al-Araji SA, Ragunath K. Review article: gastrointestinal angiodysplasia- pathogenesis, diagnosis and management. Aliment Pharmacol Ther 2014;39:15–34.PubMedCrossRefGoogle Scholar
  35. 35.
    Foutch PG. Angiodysplasia of the gastrointestinal tract. Am J Gastroenterol 1993;88:807–18.PubMedGoogle Scholar
  36. 36.
    Vargo JJ. Clinical applications of the argon plasma coagulator. Gastrointest Endosc 2004;59:81–8.PubMedCrossRefGoogle Scholar
  37. 37.
    Watson JP, Bennett MK, Griffin SM, Matthewson K. The tissue effect of argon plasma coagulation on esophageal and gastric mucosa. Gastrointest Endosc 2000;52:342–5.PubMedCrossRefGoogle Scholar
  38. 38.
    Gerson LB, Batenic MA, Newsom SL, Ross A, Semrad CE. Long-term outcomes after double-balloon enteroscopy for obscure gastrointestinal bleeding. Clin Gastroenterol Hepatol Off Clin Pr J Am Gastroenterol Assoc 2009;7:664–9.CrossRefGoogle Scholar
  39. 39.
    Samaha E, Rahmi G, Landi B, Lorenceau-Savale C, Malamut G, Canard JM, et al. Long-term outcome of patients treated with double balloon enteroscopy for small bowel vascular lesions. Am J Gastroenterol 2012;107:240–6.PubMedCrossRefGoogle Scholar
  40. 40.
    Olmos JA, Marcolongo M, Pogorelsky V, Herrera L, Tobal F, Dávolos JR. Long-term outcome of argon plasma ablation therapy for bleeding in 100 consecutive patients with colonic angiodysplasia. Dis Colon Rectum 2006;49:1507–16.PubMedCrossRefGoogle Scholar
  41. 41.
    Olmos JA, Marcolongo M, Pogorelsky V, Varela E, Dávolos JR. Argon plasma coagulation for prevention of recurrent bleeding from GI angiodysplasias. Gastrointest Endosc 2004;60:881–6.PubMedCrossRefGoogle Scholar
  42. 42.
    Rolachon A, Papillon E, Fournet J. Is argon plasma coagulation an efficient treatment for digestive system vascular malformation and radiation proctitis? Gastroentérologie Clin Biol 2000;24:1205–10.Google Scholar
  43. 43.
    Suzuki N, Arebi N, Saunders BP. A novel method of treating colonic angiodysplasia. Gastrointest Endosc 2006;64:424–7.PubMedCrossRefGoogle Scholar
  44. 44.
    Norton ID, Wang L, Levine SA, Burgart LJ, Hofmeister EK, Rumalla A, et al. Efficacy of colonic submucosal saline solution injection for the reduction of iatrogenic thermal injury. Gastrointest Endosc 2002;56:95–9.PubMedCrossRefGoogle Scholar
  45. 45.
    Ladas SD, Karamanolis G, Ben-Soussan E. Colonic gas explosion during therapeutic colonoscopy with electrocautery. World J Gastroenterol 2007;13:5295–8.PubMedCentralPubMedCrossRefGoogle Scholar
  46. 46.
    ASGE Standards of Practice Committee, Ben-Menachem T, Decker GA, Early DS, Evans J, Fanelli RD, et al. Adverse events of upper GI endoscopy. Gastrointest Endosc 2012;76:707–18.CrossRefGoogle Scholar
  47. 47.
    Cello JP, Grendell JH. Endoscopic laser treatment for gastrointestinal vascular ectasias. Ann Intern Med 1986;104:352–4.PubMedCrossRefGoogle Scholar
  48. 48.
    Naveau S, Aubert A, Poynard T, Chaput JC. Longterm results of treatment of vascular malformations of the gastrointestinal tract by neodymium YAG laser photocoagulation. Dig Dis Sci 1990;35:821–6.PubMedCrossRefGoogle Scholar
  49. 49.
    Moparty B, Raju GS. Role of hemoclips in a patient with cecal angiodysplasia at high risk of recurrent bleeding from antithrombotic therapy to maintain coronary stent patency: a case report. Gastrointest Endosc 2005;62:468–9.PubMedCrossRefGoogle Scholar
  50. 50.
    Pishvaian AC, Lewis JH. Use of endoclips to obliterate a colonic arteriovenous malformation before cauterization. Gastrointest Endosc 2006;63:865–6.PubMedCrossRefGoogle Scholar
  51. 51.
    Kantsevoy SV, Cruz-Correa MR, Vaughn CA, Jagannath SB, Pasricha PJ, Kalloo AN. Endoscopic cryotherapy for the treatment of bleeding mucosal vascular lesions of the GI tract: a pilot study. Gastrointest Endosc 2003;57:403–6.PubMedCrossRefGoogle Scholar
  52. 52.
    Wong RM, Ota S, Katoh A, Yamauchi A, Arai K, Kaneko K, et al. Endoscopic ligation for non-esophageal variceal upper gastrointestinal hemorrhage. Endoscopy 1998;30:774–7.PubMedCrossRefGoogle Scholar
  53. 53.
    Matsui S, Kamisako T, Kudo M, Inoue R. Endoscopic band ligation for control of nonvariceal upper GI hemorrhage: comparison with bipolar electrocoagulation. Gastrointest Endosc 2002;55:214–8.PubMedCrossRefGoogle Scholar
  54. 54.
    Junquera F, Brullet E, Campo R, Calvet X, Puig-Diví V, Vergara M. Usefulness of endoscopic band ligation for bleeding small bowel vascular lesions. Gastrointest Endosc 2003;58:274–9.PubMedCrossRefGoogle Scholar
  55. 55.
    Marwick T, Kerlin P. Angiodysplasia of the upper gastrointestinal tract. Clinical spectrum in 41 cases. J Clin Gastroenterol 1986;8:404–7.PubMedCrossRefGoogle Scholar
  56. 56.
    Bemvenuti GA, Jülich MM. Ethanolamine injection for sclerotherapy of angiodysplasie of the colon. Endoscopy 1998;30:564–9.PubMedCrossRefGoogle Scholar
  57. 57.
    Barkin JS, Ross BS. Medical therapy for chronic gastrointestinal bleeding of obscure origin. Am J Gastroenterol 1998;93:1250–4.PubMedCrossRefGoogle Scholar
  58. 58.
    Junquera F, Feu F, Papo M, Videla S, Armengol JR, Bordas JM, et al. A multicenter, randomized, clinical trial of hormonal therapy in the prevention of rebleeding from gastrointestinal angiodysplasia. Gastroenterology 2001;121:1073–9.PubMedCrossRefGoogle Scholar
  59. 59.
    Junquera F, Santos J, Saperas E, Armengol JR, Malagelada JR. Estrogen and progestagen treatment in digestive hemorrhage caused by vascular malformations. Gastroenterol Hepatol 1995;18:61–5.PubMedGoogle Scholar
  60. 60.
    Van Cutsem E, Rutgeerts P, Vantrappen G. Treatment of bleeding gastrointestinal vascular malformations with oestrogenprogesterone. Lancet 1990;335:953–5.PubMedCrossRefGoogle Scholar
  61. 61.
    Lewis BS, Salomon P, Rivera-MacMurray S, Kornbluth AA, Wenger J, Waye JD. Does hormonal therapy have any benefit for bleeding angiodysplasia? J Clin Gastroenterol 1992;15:99–103.PubMedCrossRefGoogle Scholar
  62. 62.
    Szilagyi A, Ghali MP. Pharmacological therapy of vascular malformations of the gastrointestinal tract. Can J Gastroenterol 2006;20:171–8.PubMedCentralPubMedGoogle Scholar
  63. 63.
    Scaglione G, Pietrini L, Russo F, Franco MR, Sorrentini I. Longacting octreotide as rescue therapy in chronic bleeding from gastrointestinal angiodysplasia. Aliment Pharmacol Ther 2007;26:935–42.PubMedCrossRefGoogle Scholar
  64. 64.
    Nardone G, Rocco A, Balzano T, Budillon G. The efficacy of octreotide therapy in chronic bleeding due to vascular abnormalities of the gastrointestinal tract. Aliment Pharmacol Ther 1999;13:1429–36.PubMedCrossRefGoogle Scholar
  65. 65.
    Junquera F, Saperas E, Videla S, Feu F, Vilaseca J, Armengol JR, et al. Longterm efficacy of octreotide in the prevention of recurrent bleeding from gastrointestinal angiodysplasia. Am J Gastroenterol 2007;102:254–60.PubMedCrossRefGoogle Scholar
  66. 66.
    Bon C, Aparicio T, Vincent M, Mavros M, Bejou B, Raynaud JJ, et al. Longacting somatostatin analogues decrease blood transfusion requirements in patients with refractory gastrointestinal bleeding associated with angiodysplasia. Aliment Pharmacol Ther 2012;36:587–93.PubMedCrossRefGoogle Scholar
  67. 67.
    Molina Infante J, Pérez Gallardo B, Hernández Alonso M, Mateos Rodríguez JM, Dueñas Sadornil C, Fernández Bermejo M. Octreotide long acting release for severe obscure gastrointestinal haemorrhage in elderly patients with serious comorbidities. Med Clinica 2009;133:667–70.CrossRefGoogle Scholar
  68. 68.
    Ge ZZ, Chen HM, Gao YJ, Liu WZ, Xu CH, Tan HH, et al. Efficacy of thalidomide for refractory gastrointestinal bleeding from vascular malformation. Gastroenterology 2011;141:1629–37.e1–4.PubMedCrossRefGoogle Scholar
  69. 69.
    Bandi R, Shetty PC, Sharma RP, Burke TH, Burke MW, Kastan D. Superselective arterial embolization for the treatment of lower gastrointestinal hemorrhage. J Vasc Interv Radiol 2001;12:1399–1405.PubMedCrossRefGoogle Scholar
  70. 70.
    Mirsadraee S, Tirukonda P, Nicholson A, Everett SM, McPherson SJ. Embolization for non-variceal upper gastrointestinal tract haemorrhage: a systematic review. Clin Radiol 2011;66:500–9.PubMedCrossRefGoogle Scholar
  71. 71.
    Douard R, Wind P, Berger A, Maniere T, Landi B, Cellier C, et al. Role of intraoperative enteroscopy in the management of obscure gastointestinal bleeding at the time of video-capsule endoscopy. Am J Surg 2009;198:6–11.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag France 2014

Authors and Affiliations

  1. 1.Service d’hépatogastroentérologie du Professeur-Christophe-Cellierhôpital européen Georges-PompidouParisFrance

Personalised recommendations