EFFECTIVENESS OF ENDOTHERAPY OF SMALL BOWEL ANGIOECTASIAS WITH ARGON PLASMA COAGULATION (APC) THROUGH DOUBLE-BALLOON ENTEROSCOPY (DBE)

Aims Retrospective study of the effectiveness of endoscopic treatment of SB AEs with the application of APC through DBE.

Methods From March 2018 to June 2019, seventeen (17) patients underwent DBE due to SB AEs in our Institution. We compared their haemoglobin (Hb) levels and transfusion requirements before and after the application of endotherapy, as well as the rate of relapse of bleeding.

Results We performed 19 procedures on 17 patients: 9 men/8 women; age range: 57- 85 years (mean age 75.4 years). Four patients underwent retrograde DBE, 11 anterograde DBE and 2 patients had panenteroscopy performed through combined anterograde and retrograde routes. Prior to DBE, all patients undertook a small bowel capsule endoscopy (SBCE). The mean time of follow up was 8.7 months (range: 1-18 months). Hb levels increased from 8.1±0.96 g/dl pre-endotherapy to 10.9±1.58g/dl post-endotherapy (p< 0.001) and remained stable throughout the follow-up period. Transfusion requirements also decreased from 4.6±4.4units/month pre-endotherapy to 0.7±1.06 units/month post-endotherapy (p=0.002). Post-endotherapy, transfusions requirements abated completely in 8 patients, whereas rebleeding occured in 2 patients.

Conclusions SB bleeding secondary to AEs can be effectively treated with the application of APC through DBE. In our experience, endotherapy can lead to significant improvements in Hb levels and a reduction in transfusion requirements in most patients.