Polidocanol injection therapy for small-bowel hemangioma by using double-balloon endoscopy.

Abstract

BACKGROUND AND AIMS:

Small-bowel hemangioma is a rare disease that often causes active bleeding. The standard therapeutic method for small-bowel hemangioma is surgical resection. The aim of this study was to evaluate the usefulness of polidocanol injection (PDI) for small-bowel hemangiomas.

METHODS:

This study included 12 patients with obscure GI bleeding (6 male; mean age 62 years) with 39 small-bowel hemangiomas; patients were treated with PDI by using double-balloon endoscopy (DBE). EUS with DBE was performed before PDI. The lesions were divided into 2 groups according to tumor size: Group A (size <10 mm; 20 lesions) and group B (size ≥10 mm; 19 lesions). The outcomes of PDI treatment for small-bowel hemangioma were evaluated between the 2 groups. Additionally, in order to standardize the amount of PDI injected, the total amount of polidocanol according to lesion size was calculated.

RESULTS:

There was no difference in the location of lesions and treatment times between the 2 groups. Group B had a significantly higher injection time per lesion (P < .05) and amount of polidocanol per lesion than group A (P < .01). Rebleeding occurred in only 1 case (8%). There were no adverse events related to PDI. The contribution ratio between the lesion size and amount of polidocanol showed a correlation (r = 0.77). The optimal amount of polidocanol for small-bowel hemangioma was determined to be 0.2 mL/mm.

CONCLUSIONS:

PDI is an easy, safe, and effective method to treat small-bowel hemangiomas.

• Authors: Atsushi Igawa, Shiro Oka, Shinji Tanaka, Sayoko Kunihara, Makoto Nakano, Kazuaki Chayama
• Journal: Gastrointestinal endoscopy (Gastrointest Endosc) Vol. 84 Issue 1 Pg. 163-7 (Jul 2016) ISSN: 1097-6779 [Electronic] United States
• PMID: 26907744 (Publication Type: Journal Article)
• Copyright: Copyright © 2016 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

Chemical References

• Sclerosing Solutions
• Polidocanol
• Polyethylene Glycols

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Double-Balloon Enteroscopy (methods)
• Female
• Gastrointestinal Hemorrhage (etiology, therapy)
• Hemangioma (complications, therapy)
• Humans
• Ileal Neoplasms (complications, therapy)
• Injections, Intralesional
• Jejunal Neoplasms (complications, therapy)
• Male
• Middle Aged
• Polidocanol
• Polyethylene Glycols (therapeutic use)
• Retrospective Studies
• Sclerosing Solutions (therapeutic use)
• Young Adult