[Colic angiodysplasia and chronic haemodialysis. Argon plasma treatment. A case report].
BACKGROUND
Gastrointestinal angiodysplasia is a very common cause of digestive haemorrhage among patients with chronic renal insufficiency. It is well known that bleeding from angiodysplasias can be a difficult therapeutic problem since therapeutic possibilities are scarce and surgery is scolded with high mortality rate. Endoscopic argon plasma ablation therapy is a new, effective and safe treatment in the management of gastrointestinal angiodysplasia.


METHODS
We reported a case of a female haemodialysis patient aged 40 years. She was haemodialysed since 6 years in our center from unknown nephropathy. In March 2006, she complained of black stools and melena, and developed severe anaemia (Haemoglobin at 4 g/dL). Exploratory endoscope examination of the digestive tract showed the presence of bleeding from angiodysplastic lesions of the right colon. The patient had severe clinical picture extension of angiodysplastic lesions and frequent bleeding episodes. Bleeding arrest was observed after argon plasma coagulation, with a significant decrease of blood transfusions and improvement of anaemia.


CONCLUSIONS
Gastrointestinal angiodysplasia was reported to be an important complication in dialysis patients and was recognized as an important cause of erythropoietin-resistant anaemia. It can worsen vital prognosis. Argon plasma coagulation is an effective treatment in these patients.
Boubaker
Karima
K
Service de médecine interne A, hôpital Charles-Nicolle, Tunis, Tunisie. ranou04@yahoo.fr
Boubaker
Soumaya
S
Ounissi
Mondher
M
Harzallah
Amel
A
El Younsi
Fethi
F
Kaaroud
Hayet
H
Abderrahim
Ezzedine
E
Ben Abdallah
Taieb
T
Khédhiri
Fethi
F
Ben Maïz
Hédi
H
Kheder
Adel
A
D000328:Adult; D016888:Angiodysplasia / Q000150:complications / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D044682:Colon, Ascending / Q000473:pathology / Q000601:surgery*; D003108:Colonic Diseases / Q000150:complications / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D003113:Colonoscopy; D005260:Female; D006801:Humans; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008551:Melena / Q000209:etiology / Q000601:surgery*; D006435:Renal Dialysis / Q000009:adverse effects*; D051436:Renal Insufficiency, Chronic / Q000628:therapy; D016896:Treatment Outcome