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Vascular malformations of the small intestine

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Opinion statement

Vascular malformations of the small bowel are uncommon, yet remain a cause of gastrointestinal bleeding in up to 5% of patients with gastrointestinal hemorrhage. The diagnosis of these lesions is suspected in patients with a gastrointestinal source of blood loss with a negative upper endoscopy and colonoscopy. Enteroscopy remains the mainstay in diagnosing these lesions. Therapeutic options include endoscopic coagulation, pharmacologic agents (hormones, octreotide, iron replacement), and occasionally surgery. Pharmacologic and endoscopic treatments are discussed.

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References and Recommended Reading

  1. Morris AJ, Mokhashi M, Straiton M, et al.: Push enteroscopy and heater probe therapy for small bowel bleeding. Gastrointest Endosc 1996, 44:394–397.

    Article  PubMed  CAS  Google Scholar 

  2. Sorbi D, Conio M, Gostout CJ: Vascular disorders of the small bowel. Gastro Endosc Clin N Am 1999, 9:71–91. An excellent review with extensive references on this topic.

    CAS  Google Scholar 

  3. Gostout CJ: Angiodysplasia and aortic valve disease. Let’s close the book on this association. Gastrointest Endosc 1995, 42:491–493.

    Article  PubMed  CAS  Google Scholar 

  4. Richter J, Christensen M, Colditz G: Angiodysplasia—natural history and efficacy of therapeutic interventions. Dig Dis Sci 1989, 34:1542–1546.

    Article  PubMed  CAS  Google Scholar 

  5. Lewis B, Rivera-MacMurray S, Kornbluth A, et al.: Hormonal therapy for chronic GI bleeding from diffuse small bowel AVMs, the results of a controlled trial in 56 patients [abstract]. Am J Gastro 1990, 85:1266.

    Google Scholar 

  6. Haitjema T, Westermann CJJ, Overtoom TTC, et al.: Hereditary hemorrhagic telangiectasia: new insights in pathogenesis, complications, and treatment. Arch Intern Med 1996, 156:714–719.

    Article  PubMed  CAS  Google Scholar 

  7. Korzenil JR: Hereditary hemorrhagic telangiectasia and other intestinal vascular anomalies. Gastroenterologist 1996, 4:203–210.

    Google Scholar 

  8. Ramanujam PS, Venkatesh KS, Bettinger L, et al.: Hemangioma of the small intestine: case report and literature review. Am J Gastroenterol 1995, 90:2063–2064.

    PubMed  CAS  Google Scholar 

  9. Low DW: Hemangiomas and vascular malformations. Semin Pediat Surg 1994, 3:40–61.

    CAS  Google Scholar 

  10. Adrain AL, Krevsky B: Enteroscopy in patients with gastrointestinal bleeding of obscure origin. Dig Dis 1996, 14:345–355.

    PubMed  CAS  Google Scholar 

  11. Ress A, Benacci J, Sarr M: Efficacy of intraoperative enteroscopy in diagnosis and prevention of recurrent occult gastrointestinal bleeding. Am J Surg 1992, 163:94–98.

    Article  PubMed  CAS  Google Scholar 

  12. Baum S, Athanasoulis CA, Walteros AC, et al.: Gastrointestinal hemorrhage. II. Angiographic diagnosis and control. Adv Surg 1973, 7:149–198.

    PubMed  CAS  Google Scholar 

  13. Fiorito J, Brandt L, Kozicky O, et al.: The diagnostic yield of superior mesenteric angiography. Correlation with the pattern of gastrointestinal bleeding. Am J Gastroenterol 1989, 84:878–881.

    PubMed  CAS  Google Scholar 

  14. Schmidt S, Boskind J, Smith D, et al.: Angiographic localization of small bowel angiodysplasia with the use of platinum coils. J Vasc Interv Radiol 1993, 4:737–739.

    Article  PubMed  CAS  Google Scholar 

  15. Alavi A, Dann RW, Baum S, et al.: Scintigraphy detection of acute gastrointestinal bleeding. Radiology 1977, 124:753–756.

    PubMed  CAS  Google Scholar 

  16. Voeller GR, Bunch G, Britt L: Use of technetium labeled red blood cell scintigraphy in the detection and management of gastrointestinal hemorrhage. Surgery 1991, 110:799–804.

    PubMed  CAS  Google Scholar 

  17. Bronner MH, Pate MB, Cunningham TJ, et al.: Estrogen-progesterone therapy for bleeding gastrointestinal telangiectasias in chronic renal failure. Ann Int med 1986, 105:371–374.

    PubMed  CAS  Google Scholar 

  18. Van Cutsem E, Rutgeerts P, Vantrappen G: Treatment of bleeding gastrointestinal vascular malformations with estrogen-progesterone. Lancet 1990, 335:953–955.

    Article  PubMed  Google Scholar 

  19. Barkin JS, Ross BS: Medical therapy for chronic gastrointestinal bleeding of obscure origin. Am J Gastroenterol 1998, 93:1250–1254. Study showing the efficacy of hormonal therapy in chronic gastrointestinal bleeding of obscure origin.

    Article  PubMed  CAS  Google Scholar 

  20. Lewis BS, Solomon P, Rivera-MacMurray, et al.: Does hormonal therapy have any benefit for bleeding angiodysplasia? J Clin Gastroenterol 1992, 15:99–103.

    Article  PubMed  CAS  Google Scholar 

  21. Rossini FP, Arrigoni A, Pennazio O: Octreotide in the treatment of bleeding due to angiodysplasia of the small intestine. Am J Gastroenterol 1993, 88:1424–1427.

    PubMed  CAS  Google Scholar 

  22. Saba H, Morrelli G, Logrono L: Treatment of bleeding in HHT with aminocaproic acid. N Engl J Med 1994, 330:1789–1790.

    Article  PubMed  CAS  Google Scholar 

  23. Korzenik J, Topazian M, Burdge C, et al.: Danazol in the treatment of GI hemorrhage secondary to HHT [abstract]. Gastroenterology 1995, 108:297.

    Article  Google Scholar 

  24. Cutsem EV, Piessevaux H: Pharmacologic therapy of arteriovenous malformations. Gastr Endos Clinic N Am 1996, 6:819–832.

    Google Scholar 

  25. Askin M, Lewis B: Long term success of endoscopic cauterization of small intestinal angiodysplasia [abstract]. Gastrointest Endosc 1994, 40:15.

    Google Scholar 

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Karnam, U.S., Barkin, J.S. Vascular malformations of the small intestine. Curr Treat Options Gastro 4, 173–178 (2001).

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