Acta Scientific Gastrointestinal Disorders (ISSN: 2582-1091)

Case Report Volume 3 Issue 4

Unique Case of Isolated Jejunal Angiodysplasia Refractory to Coil Embolization Managed by Laparoscopic Resection

Jyotsna Misra1*, Subham Bera1, Shubhayu Banerjee2 and Shuvro H Roy Chowdhury3

1DNB Resident, Department of General Surgery, Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata, West Bengal, India
2Consultant Laparoscopic and Gastrointestinal Surgeon, Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata, West Bengal, India
3Consultant Intervention Radiology, Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata, West Bengal, India

*Corresponding Author: Jyotsna Misra, DNB Resident, Department of General Surgery, Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata, West Bengal, India.

Received: March 16, 2020; Published: March 30, 2020

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Abstract

  Angiodysplasia is one of the commonest vascular lesion leading to gastrointestinal bleed accounting for approximately 6.0% of lower gastrointestinal (GI) bleeding and 1.2 - 8.0% upper GI bleed. In elderly patients small bowel angiodysplasia is responsible for 40% of obscure bleed while in 10 % of young adults small bowel angiodysplasia is the single most common cause of obscure GI bleed [1]. Jejunum is the most common site of intestinal vascular ectasia followed by ileum and duodenum [2]. By far degenerative changes are considered as the most common cause of upper intestinal angiodysplasia. Angiodysplasia has a varied clinical presentation, from a spectrum of occult bleeding to acute massive hemorrhage. It can also be diagnosed incidentally. CT angiography and endoscopy are the useful diagnostic tools. Therapeutic strategies include or angiographic embolization, endoscopic obliteration of bleeding angiodysplastic lesion and Surgery [3].

Keywords: Angiodysplasia; CT Angiography; Laparoscopic Resection

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References

  1. Crabtree K. “Angiodysplasia of the Gastrointestinal Tract”. Radiology 194.1 (1995): 96.
  2. Sharma V., et al. “Gastrointestinal bleeding in the tropics: look for the hookworm”. Tropical Doctor 47.1 (2017): 48-51.
  3. Chen H., et al. “Bleeding recurrence in patients with gastrointestinal vascular malformation after thalidomide”. Medicine 95.33 (2016): e4606.
  4. Pires D., et al. “Gastrointestinal angiodysplasia. Estrogen-progesterone therapy”. Acta Medica Portuguesa 7.11 (1994): 631-633.
  5. Höchter W., et al. “Angiodysplasia in the colon and rectum”. Endoscopy 17.5 (1985): 182-185.
  6. Xu M., et al. “Embolization of arterial gastrointestinal hemorrhage with Fuaile medical adhesive”. Journal of the Chinese Medical Association 81.7 (2018): 636-642.
  7. Triadafilopoulos G. “Management of lower gastrointestinal bleeding in older adults”. Drugs and Aging 29.9 (2012): 707-715.
  8. Brown C., et al. “Somatostatin analogues in the treatment of recurrent bleeding from gastrointestinal vascular malformations: an overview and systematic review of prospective observational studies”. Digestive Diseases and Sciences 55.8 (2010): 2129-2134.
  9. Ali M., et al. “Treatment of nonvariceal gastrointestinal hemorrhage by transcatheter embolization”. Radiology Research and Practice (2013): 604328.
  10. Suh SW., et al. “Small bowel ischemia after angiographic embolization for angiodysplasia of lower gastrointestinal tract: the case for conservative management”. Clinics and Research in Hepatology and Gastroenterology 35.12 (2011): 819-822.
  11. Bookstein JJ., et al. “Transcatheter hemostasis of gastrointestinal bleeding using modified autogenous clot”. Radiology 113.2 (1974): 277-285.
  12. Hasanefendioglu Bayrak A., et al. “Occult bleeding of small bowel: endovascular embolization and literature review”. Journal of Digestive Diseases 10.2 (2009): 152-156.
  13. Richardson JD., et al. “Bleeding vascular malformations of the intestine”. Surgery 84.3 (1978): 430-436.
  14. Nguyen N., et al. “Embolotherapy for small bowel angiodysplasia”. Gastrointestinal Endoscopy 58.5 (2003): 797-800.
  15. Funaki B., et al. “Superselective microcoil embolization of colonic hemorrhage”. American Journal of Roentgenology 177.4 (2001): 829-836.
  16. Raphaeli T and Menon R. “Current treatment of lower gastrointestinal hemorrhage”. Clinics in Colon and Rectal Surgery 25.4 (2012): 219-227.
  17. Maleux G., et al. “Long-term outcome of transcatheter embolotherapy for acute lower gastrointestinal hemorrhage”. American Journal of Gastroenterology 104.8 (2009): 2042-2046.
  18. Ono H., et al. “Intraoperative localization of arteriovenous malformation of a jejunum with combined use of angiographic methods and indocyanine green injection: Report of a new technique”. International Journal of Surgery Case Reports 29 (2016): 137-140.
  19. So M., et al. “Laparoscopic resection of idiopathic jejunal arteriovenous malformation after metallic coil embolization”. Surgical Case Reports 4.1 (2018): 78.
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Citation

Citation: Jyotsna Misra., et al. “Unique Case of Isolated Jejunal Angiodysplasia Refractory to Coil Embolization Managed by Laparoscopic Resection”. Acta Scientific Gastrointestinal Disorders 3.4 (2020): 11-14.



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