Anjiyodisplaziye bağlı akut alt GİS kanama ve argon plazma koagülasyon uygulanması

Öz

Anjiyodisplazi, gastrointestinal kanal mukoza ve submukozasında belirgin olarak dilate izlenen damarsal lezyonlardır. Yaşla birlikte görülme sıklığı artmakta ve sistemik hastalıklara eşlik edebilmektedir. Endoskopik olarak genellikle sağ kolonda, multiple, kırmızı, düz, 2-10 mm boyutlarında, oval yada yıldızvari-örümcek şeklinde izlenir. Tedavide skleroterapi, heater probe, argon lazer fotokoagülasyon, anjiyografik embolizasyon kullanılmakta olup yanıt vermeyen olgularda cerrahi tedavi uygulanabilir. Burada akut alt gastrointestinal sistem kanaması ile başvuran ve kolonoskopide anyjiyodisplazi saptanıp argon plazma koagülasyon uygulanan iki olgu sunulmaktadır.

Anahtar Kelimeler

• Argon plazma koagülasyon, anjiyodisplazi, GİS kanama, kolon

Angiodysplasia presenting with acute gastrointestinal bleeding and argon plasma coagulation

Abstract

Angiodysplasia is known as vascular dilatation of submucosal veins. These lesions increase with age and may accompany systemic diseases. Colonoscopy shows angiodysplasia as red, usually multiple, less than 10 mm in size, spider- like lesions especially in the right colon. Endoscopic therapies such as sclerotherapy, heater probe and argon plasma coagulation can control acute bleeding from colonic angiodysplasias in most patients. Furthermore, selective embolization with angiography during bleeding episodes from angiodysplasia may control the bleeding. Herein, we report two patients with colonic angiodysplasia that presented with acute bleeding; argon plasma coagulation was applied in both patients.

Keywords

• Argon plasma coagulation, bleeding, angiodysplasia, colon

Kaynakça

1. Richter JM, Hedberg SE, Athanasoulis CA, Schapiro RH. Angiodysplasi- a. Clinical presentation and colonoscopic diagnosis. Dig Dis Sci 1984;29:481-5.
2. Hochter W, Weingart J, Kuhner W, et al. Angiodysplasia in the colon and rectum. Endoscopic morphology, localisation and frequency. En- doscopy 1985;17:182-5.
3. Kwan V, Bourke MJ, Williams SJ, et al. Argon plasma coagulation in the management of symptomatic gastrointestinal vascular lesions: experien- ce in 100 consecutive patients with long-term follow-up. Am J Gastro- enterol 2006;101:58-63.
4. Bronner MH, Pate MB, Cunningham JT, Marsh WH. Estrogen-progeste- rone therapy for bleeding gastrointestinal telangiectasias in chronic renal failure. An uncontrolled trial. Ann Intern Med 1986;105:371-4.
5. Barkin JS, Ross BS. Medical therapy for chronic gastrointestinal bleeding of obscure origin. Am J Gastroenterol 1998;93:1250-4.