Abstract
Angiectasia may be responsible for up to 1.2% to 8% all episodes of upper gastrointestinal bleeding. Among 170 patients with angiectasia of the stomach at Omiya Medical Center, Jichi Medical School from April 1990 to April 2000, 10 cases (5.9%) experienced episodes of bleeding. Four cases with active bleeding were managed by endoscopic therapy (clippig in 2 cases, EMR in 1 case, heater probe coagulation in 1 case) , and all four cases were successfully controlled. Long-term observation was possible in two cases. Case 2 : there has been no recurrence of angiectasia for 7 years since endoscopic mucosal resection (EMR) . Case 4 : there was an angiectasia appeared at the same place of site in the stomach 2 years after clipping, and a blood test showed anemia. Clipping is easier and safer than EMR, but might permit recurrences of an angiectasia.
Endoscopic therapy is now the most widely used method for treating bleeding angiectasia. The use of ethanol injection, endoscopic ligation, clipping, microwave coagulation, heater probe coagulation, and EMR have been reported. Some of the authors reported no recurrence in brief follow-up periods from 1 month to 5 months. However, treatments should not be judged as recurrence-free in periods of less than one year, at minimum, and continuation endoscopic examination is necessary.
