Small-bowel angiodysplasia and intestinal bleeding: a diagnostic challenge - 16/08/11
Doi : 10.1016/j.gie.2006.05.023
| Commentary Angiodysplasias and other small vascular lesions, including angioectasias and telangiectasias, can be very difficult to find in the patient in whom they are the cause of bleeding, and I believe they are particularly difficult to find in the presence of anemia or hypotension, or when meperidine is used during the endoscopic examination. I have found that transfusion to a Hb of 10.0 g/dL, hydration, maintenance of normal blood pressure, and avoidance of meperidine are helpful to maximize the chances of finding these lesions during endoscopy. As for intraoperative endoscopy, one must be careful to look at the segment of bowel being evaluated before pleating the bowel over the endoscope. In other words, look on the way in, not on the way out to avoid diagnostic confusion because of mucosal trauma and bleeding that occurs during the pleating process. Lawrence J. Brandt Associate Editor for Focal Points |
© 2006
American Society for Gastrointestinal Endoscopy. Publié par Elsevier Masson SAS. Tous droits réservés.
Vol 64 - N° 6
P. 1008-1009 - décembre 2006 Retour au numéro
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