Recurrent Upper Gastrointestinal Bleeding Caused by Gastric Angiodysplasias

Waldemar Simanjuntak

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Abstract

Gastric angiodysplasia, a typical discrete lesion with flat and bright-red color in gastric mucosa and submucosa, is one of the cause of recurrent upper gastrointestinal bleeding. Mostly, angiodysplasia found as multiple lesion in different location. Melena, hematemesis, and chronic anemia is a consequence of untreated gastric angiodysplasia. Sometimes, it is hard to diagnose, because of its similarities with another gastric mucosa lesion and an inadequate gastric distention during endoscopic procedure. Both pharmacological and non-pharmacological therapy were used to treat this condition in daily clinical practice, one of them is argon plasma coagulation as thermal modalities during endoscopy procedure. This therapy promise an effective angiodysplasia therapy to stop upper gastrointestinal bleeding and further complication.Gastric angiodysplasias causing recurrent gastrointestinal bleeding were found in a 73-year old man. He had been hospitalized for several times in the last two years in various hospitals in his home country as well as abroad, because of hematemesis and/or melena. The previous repeated gastroscopic examination by experienced endoscopists revealed erosive gastritis. After receiving blood transfusions, gastroscopy was performed and showed multiple small, flat bright-red mucosal lesions in different size in the stomach. The lesions were succesfully treated with argon plasma coagulation (APC). During a follow-up period of more than 18 months no further recurrent bleeding was observed.

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