Endoscopic detachable mini-loop ligation for treatment of gastroduodenal angiodysplasia: case study of 11 patients with long-term follow-up.
BACKGROUND
Detachable mini-loop ligation is useful for endoscopic management of esophageal varices. This study evaluated the treatment of gastroduodenal angiodysplasia by detachable mini-loop ligation.


METHODS
Eleven patients (9 women, 2 men; mean age 61 [18] years) with bleeding gastroduodenal angiodysplasia were treated endoscopically by detachable mini-loop ligation. At endoscopy, two patients had actively bleeding lesions. By using a ligating device, a detachable nylon ring was inserted through the accessory channel of an endoscope and opened at the rim of a transparent ligation chamber attached to the tip of the instrument. The angiodysplasia was aspirated into the chamber, and the mini-loop was closed and detached.


METHODS
Initial ligation therapy was successful in all patients without inducing uncontrollable bleeding. In one patient, two mini-loops were applied to the same angiodysplastic lesion. The only significant complication was severe GI bleeding from a duodenal ulcer that developed at the ligation site in one patient. This was successfully treated by endoscopic placement of hemoclips.


CONCLUSIONS
Detachable mini-loop ligation is an effective and safe modality for endoscopic treatment of bleeding gastroduodenal angiodysplasia.
Ljubicić
Neven
N
Division of Digestive Diseases Endoscopy Unit, Department of Internal Medicine, Sestre milosrdnice Clinical Hospital, Zagreb, Croatia.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016888:Angiodysplasia / Q000175:diagnosis* / Q000628:therapy*; D004384:Duodenoscopy / Q000379:methods; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000628:therapy*; D005773:Gastroscopy / Q000379:methods; D016558:Hemostasis, Endoscopic / Q000379:methods; D006801:Humans; D008026:Ligation / Q000379:methods; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018570:Risk Assessment; D012494:Sampling Studies; D012680:Sensitivity and Specificity; D013997:Time Factors; D016896:Treatment Outcome