A novel method of treating colonic angiodysplasia.
BACKGROUND
Colonic angiodysplasia is responsible for up to a third of lower-GI bleeding cases. Argon plasma coagulation (APC) is a recognized treatment modality, but active bleeding decreases the ablative efficacy of APC by dissipation of the energy. APC has been associated with colonic perforation.


OBJECTIVE
We propose a novel and safe method for the treatment of colonic angiodysplasia by a submucosal injection of a saline epinephrine solution followed by the application of APC.


METHODS
Three patients with a total of 10 colonic angiodysplasias were treated with this injection-APC method.


METHODS
Saline adrenaline solution (1:200,000) 2 to 3 mL was injected beneath the angiodysplasia before application of APC. APC 50 W and gas flow 2 L were applied onto the vascular lesion until the sufficient thermal effect was observed.


RESULTS
There were no procedure-related complications.


CONCLUSIONS
This new injection-APC method was safe for the treatment of colonic angiodysplasia. This may be useful in treating right-sided colonic lesions where the risks of perforation are greater than for the rest of the colon.
Suzuki
Noriko
N
Wolfson Unit for Endoscopy, St Mark's Hospital, Harrow, Middlesex, United Kingdom.
Arebi
Naila
N
Saunders
Brian P
BP
D000368:Aged; D016888:Angiodysplasia / Q000150:complications / Q000628:therapy*; D003106:Colon / Q000098:blood supply*; D003108:Colonic Diseases / Q000209:etiology / Q000628:therapy*; D003131:Combined Modality Therapy; D004837:Epinephrine / Q000008:administration & dosage; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000628:therapy*; D016558:Hemostasis, Endoscopic; D006801:Humans; D007267:Injections; D017075:Laser Coagulation; D008297:Male; D008875:Middle Aged; D014662:Vasoconstrictor Agents / Q000008:administration & dosage
D014662:Vasoconstrictor Agents; D004837:Epinephrine