[Endoscopic treatment of gastric and duodenal angiodysplasias by elastic rings ligation].
BACKGROUND
The most frequently applied methods of endoscopic treatment of angiodysplasias, such as argon plasma coagulation, multipolar coagulation and heater probe, proved to be effective with certain shortcomings and the possibility of complications. There are very scarce data in the literature about the treatment of angiodysplasias with endoscopic ligature.


OBJECTIVE
The aim of the study was to examine the efficacy and safety of endoscopic treatment of gastric and duodenal angiodysplasias by ligation with elastic rings.


METHODS
In 12 patients (10 male and 2 female, mean age 65.9 years) the endoscopic ligation of gastric and duodenal angiodysplasias was applied. Eight patients (66.6%) had solitary angiodysplasias in the stomach, two patients (16.6%) had solitary angiodysplasias in the descending part of the duodenum and two patients (16.6%) had multiple angiodysplasias in the stomach and duodenum.Two patients (16.6%) had active bleeding from angiodysplasias, while 10 patients (83.3%) had recent bleeding. We used the Cook Endoscopy system with 4 or 6 elastic rings for endoscopic ligation of angiodysplasias. Patients were under follow-up after 2-3 days, 30 days and then every 6 months following the endoscopic ligation of angiodysplasias.


RESULTS
Active bleeding from angiodysplasias was stopped in two patients (100%) by endoscopic ligation with elastic rings. The average number of applied ligation sessions in our 12 patients was 1.6, with an average of 1.8 ligatures per session. There were no complications after ligation of angiodysplasias. Recurrence of bleeding occurred in one patient (8.3%) with multiple gastric and duodenal angiodysplasias.The average period of follow-up of patients was 22.8 +/- 17.6 months.


CONCLUSIONS
Endoscopic ligation with elastic rings can be effective and safe for treatment especially of solitary gastric and duodenal angiodysplasias.
Saša
S
Grgov
Perica
P
Stamenković
Dejan
D
Janjić
D000328:Adult; D000368:Aged; D016888:Angiodysplasia / Q000150:complications / Q000628:therapy*; D004378:Duodenal Diseases / Q000150:complications / Q000628:therapy*; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008026:Ligation; D008297:Male; D008875:Middle Aged; D013272:Stomach Diseases / Q000150:complications / Q000628:therapy*