title: Evaluation of the efficacy of therapeutic endoscopy in gastrointestinal bleeding secondary to angiodysplasias.
abstract: BACKGROUND
  Gastrointestinal angiodysplasias are defined as vascular dilations that communicate capillaries and veins in the walls of the digestive tract. The clinical presentation of these lesions varies from chronic occult bleeding to severe gastrointestinal hemorrhage.
  
  
  OBJECTIVE
  The primary aim of our study was to analyze lesion location, the efficacy of therapeutic endoscopy with argon plasma coagulation, and the factors associated with rebleeding in patients with gastrointestinal angiodysplasias.
  
  
  METHODS
  A retrospective study of 32,042 endoscopies was carried out within the time frame of January 2012 and December 2013 at our hospital center. Gastrointestinal angiodysplasia was the diagnosis in 331 of the endoscopies. The procedures included upper gastrointestinal endoscopy, colonoscopy, sigmoidoscopy, and enteroscopy.
  
  
  RESULTS
  The most frequent location of the angiodysplasias was the cecum (49%), followed by the ascending colon (17%) and the sigmoid colon (16%). They were most frequently found in the duodenum (60%) and gastric body (49%) at upper gastrointestinal endoscopy. Therapeutic endoscopy was performed in 163 cases (49.8%) and the most predominant methods were fulguration with argon (90%) and combination treatment (argon plasma coagulation and injection sclerotherapy) (6.7%). The macroscopic rebleeding rate after therapeutic endoscopy was 7.4%. Patients that had rebleeding presented with a lower hemoglobin concentration, higher mean age, and the presence of multiple angiodysplasias at endoscopy (P<.05).
  
  
  CONCLUSIONS
  Therapeutic endoscopy was performed in 49.8% of the patients with angiodysplasias. The macroscopic rebleeding rate after treatment was 7.4%. There were statistically significant differences in the patients with rebleeding in relation to mean age, hemoglobin values, and the presence of multiple angiodysplasias.
authors.affiliation: Servicio de Gastroenterología y Hepatología, Hospital Ramón y Cajal, Madrid, España. Electronic address: jariant@hotmail.com.
authors.forename: J
authors.initials: J
authors.lastname: Arribas Anta
authors.affiliation: Servicio de Gastroenterología y Hepatología, Hospital Ramón y Cajal, Madrid, España.
authors.forename: C
authors.initials: C
authors.lastname: Zaera de la Fuente
authors.affiliation: Servicio de Gastroenterología y Hepatología, Hospital Ramón y Cajal, Madrid, España.
authors.forename: R
authors.initials: R
authors.lastname: Martín Mateos
authors.affiliation: Servicio de Gastroenterología y Hepatología, Hospital Ramón y Cajal, Madrid, España.
authors.forename: J A
authors.initials: JA
authors.lastname: González Martín
authors.affiliation: Servicio de Gastroenterología y Hepatología, Hospital Ramón y Cajal, Madrid, España.
authors.forename: A
authors.initials: A
authors.lastname: Cañete Ruiz
authors.affiliation: Servicio de Gastroenterología y Hepatología, Hospital Ramón y Cajal, Madrid, España.
authors.forename: D
authors.initials: D
authors.lastname: Boixeda de Miquel
authors.affiliation: Servicio de Gastroenterología y Hepatología, Hospital Ramón y Cajal, Madrid, España.
authors.forename: A
authors.initials: A
authors.lastname: Albillos Martínez
mesh_terms: D000328:Adult; D000368:Aged; D016888:Angiodysplasia / Q000150:complications* / Q000000981:diagnostic imaging; D057908:Argon Plasma Coagulation; D003131:Combined Modality Therapy; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D016558:Hemostasis, Endoscopic / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D015911:Sclerotherapy; D016896:Treatment Outcome
keywords: Angiodisplasias; Angiodysplasias; Argon; Argón; Bleeding; Sangrado