Place of plasma argon coagulation in the treatment of vascular abnormalities of the digestive tract in adults

The aim of our study is to evaluate the value of Argon Plasma Coagulation in the treatment of gastrointestinal vascular abnormalities. Patients and methods: This is a descriptive and analytical retrospective study, from January 2009 to September 2020. 198 patients who have benefited from treatment with Argon Plasma Coagulation for vascular anomalies of the digestive tract divided into 2 groups: -Group A: Patients with radial rectitis lesions (n = 107). -Group B: Patients with lesions of digestive angiodysplasia (n = 91). Results: The mean age of our patients was 64.95 ± 9.88 years [43 - 83] in group A, while in group B the mean age was 65.19 ± 14.29 years [40 - 91] with a clear male predominance in 72.5%. The majority of patients in group A were followed for prostate cancer in 33,8%, and 26.3% of patients in group B had chronic renal failure, followed by stomach cancer in 15.8%, and esophageal cancer in 10.5%. Clinical symptomatology was dominated by rectories in 40.2% in group A versus 46.8% in group B. Rectal involvement was dominated in group A in 98.1%, whereas in group B the lesions were mainly located in the stomach in 60.5%. The endoscopic evolution was favorable in all our patients with a clear improvement of rectal lesions and digestive angiodysplasia lesions. The total complication rate in our series was nil. Conclusion: Plasma Argon coagulation is a very effective method in the endoscopic treatment of digestive haemorrhages with good tolerability and a low complication rate. (AU)

Síndrome de Heyde / Heyde Syndrome

RESUMEN Introducción: El síndrome de Heyde es la asociación entre estenosis valvular aórtica y sangrado gastrointestinal, por angiodisplasia intestinal. La base fisiopatológica de ese síndrome parece ser una deficiencia adquirida del factor de Von Willebrand, que lleva al sangrado de malformaciones arteriovenosas angiodisplásicas. Las alternativas de tratamiento incluyen la localización de puntos de sangrado y la cauterización, pero tal opción terapéutica está asociada a alta recurrencia. El reemplazo de la válvula parece ofrecer la mejor esperanza de resolución a largo plazo del sangrado y debe ser considerada en la mayoría de las veces. Objetivos: Presentar el caso de un síndrome de Heyde, una causa infrecuente de hemorragia digestiva. Caso clínico: Paciente de 74 años con antecedentes estenosis aórtica y sangrado gastrointestinal debido a angiodisplasia duodenal localizada en la segunda porción de esta, tratada mediante la escleroterapia. Conclusiones: El síndrome de Heyde es una asociación poco frecuente entre una valvulopatía aortica y sangrado digestivo por una angiodisplasia que puede presentarse en cualquier parte del tubo digestivo(AU)

ABSTRACT Introduction: Heyde syndrome is the association between aortic valve stenosis and gastrointestinal bleeding, due to intestinal angiodysplasia. The pathophysiological basis of this syndrome seems to be acquired Von Willebrand factor deficiency, which leads to bleeding from angiodysplastic arteriovenous malformations. Management alternatives include localization of bleeding points and cauterization, but such a therapeutic option is associated with high recurrence. Valve replacement seems to offer the best hope for long-term solving of bleeding and should be considered for most of the cases. Objectives: To present a case of Heyde syndrome, a rare cause of gastrointestinal bleeding. Clinical case: A 74-year-old patient is presented with a history of aortic stenosis and gastrointestinal bleeding due to duodenal angiodysplasia located in the second portion of it, managed by sclerotherapy. Conclusions: Heyde syndrome is a rare association between aortic valve disease and digestive bleeding due to angiodysplasia that can occur in any part of the digestive tract(AU)

A Case of Heyde's Syndrome with Abnormal von Willebrand Factor / 대한소화기학회지

A 68-year-old woman with known severe aortic stenosis was admitted to the hospital because of hematochezia and dizziness. She had received several blood transfusions over the preceding 3 years and undergone right hemicolectomy 2 years ago for severe lower gastrointestinal bleeding. Postoperative histology revealed angiodysplasia involving the ascending colon. After the hemicolectomy, she continued to have hematochezia and anemia and required additional blood transfusions for anemia. During this admission, platelet count, activated partial-thromboplastin time, von Willebrand factor antigen, and von Willebrand factor ristocetin cofactor were normal. She had a severe deficiency of high-molecular-weight multimers of von Willebrand factor. Colonoscopy showed angiodysplasia in the transverse colon at this time. Successful coagulation of the bleeding angiodysplasia was achieved by argon plasma coagulator. No additional bleeding was observed thereafter. We report a case of Heyde's syndrome with abnormal von Willebrand factor in a patient who presented with intestinal angiodysplasia and aortic stenosis.