Gastrointestinal telangiectasia: a study by EGD, colonoscopy, and capsule endoscopy in 75 patients.

Abstract

BACKGROUND:

The distribution of lesions in the gastrointestinal tract in patients with sporadic telangiectasia is at present unknown.

PATIENTS AND METHODS:

75 patients with sporadic telangiectasia underwent esophagogastroduodenoscopy (EGD), capsule endoscopy, and colonoscopy. Endoscopic diagnosis of telangiectasia and gastrointestinal bleeding were required for enrollment in the study. Hemorrhagic diathesis, co-morbidity, number of blood transfusions, and subsequent management were also noted.

RESULTS:

35 of the patients presented with gastroduodenal vascular lesions, 51 with small-bowel lesions, and 28 with colonic lesions. 67 % of patients in whom EGD found telangiectasia also presented small-bowel vascular lesions at capsule endoscopy and 43 % colonic lesions at colonoscopy. 54 % percent of patients with positive colonoscopy also presented gastroduodenal lesions and 48 % small-bowel lesions. Patients with known duodenal lesions were more likely to have small-bowel lesions at capsule endoscopy (odds ratio [OR] 10.19, 95 % CI 2.1 - 49.33, P = 0.003). Patients with associated diseases, such as liver cirrhosis, chronic renal failure, or heart valvulopathy, presented more severe disease requiring blood transfusions (OR 6.37, 95 % CI 1.39 - 29.2, P = 0.015). The number of blood transfusions correlated with the number of sites affected ( R = 0.35, P = 0.002). The detection of new lesions at capsule endoscopy allowed new treatment in 46 % of patients. Mean follow-up was 18 months.

CONCLUSIONS:

Sporadic telangiectasia is a multifocal disease potentially involving the whole digestive tract. Patients with duodenal telangiectasia show a higher risk of jejunal or ileal lesions. Capsule endoscopy is a useful diagnostic tool for the detection of such small-bowel vascular lesions, indicating a more specific prognosis and treatment strategy.

• Authors: L Polese, R D'Incà, I Angriman, M Scarpa, D Pagano, C Ruffolo, F Lamboglia, G C Sturniolo, D F D'Amico, L Norberto
• Journal: Endoscopy (Endoscopy) Vol. 40 Issue 1 Pg. 23-9 (Jan 2008) ISSN: 1438-8812 [Electronic] Germany
• PMID: 18058652 (Publication Type: Comparative Study, Journal Article)

Topics

• Adult
• Age Distribution
• Aged
• Aged, 80 and over
• Capsule Endoscopy (methods)
• Cohort Studies
• Colonoscopy (methods)
• Endoscopy, Gastrointestinal (methods)
• Female
• Follow-Up Studies
• Gastric Mucosa (pathology)
• Gastrointestinal Diseases (diagnosis, epidemiology, therapy)
• Gastroscopy (methods)
• Humans
• Intestinal Mucosa (pathology)
• Logistic Models
• Male
• Middle Aged
• Multivariate Analysis
• Prevalence
• Probability
• Risk Assessment
• Sensitivity and Specificity
• Sex Distribution
• Telangiectasis (diagnosis, epidemiology, therapy)