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Endoscopy 2008; 40(1): 23-29
DOI: 10.1055/s-2007-967039
Original article

© Georg Thieme Verlag KG Stuttgart · New York

Gastrointestinal telangiectasia: a study by EGD, colonoscopy, and capsule endoscopy in 75 patients

L.  Polese1 , R.  D’Incà1 , I.  Angriman1 , M.  Scarpa1 , D.  Pagano1 , C.  Ruffolo1 , F.  Lamboglia1 , G.  C.  Sturniolo1 , D.  F.  D’Amico1 , L.  Norberto1
  • 1Department of Surgical and Gastroenterological Sciences, University of Padova, Italy
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Publication History

submitted 6 April 2007

accepted after revision 2 September 2007

Publication Date:
05 December 2007 (online)

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Commentaire de travail de L. Polese et al., pp. 23Endoscopy 2008; 40(01): 89-89
DOI: 10.1055/s-0032-1306802

Background:The distribution of lesions in the gastrointestinal tract in patients with sporadic telangiectasia is at present unknown.

Patients and methods:75 patients with sporadic telangiectasia underwent esophagogastroduodenoscopy (EGD), capsule endoscopy, and colonoscopy. Endoscopic diagnosis of telangiectasia and gastrointestinal bleeding were required for enrollment in the study. Hemorrhagic diathesis, co-morbidity, number of blood transfusions, and subsequent management were also noted.

Results:35 of the patients presented with gastroduodenal vascular lesions, 51 with small-bowel lesions, and 28 with colonic lesions. 67 % of patients in whom EGD found telangiectasia also presented small-bowel vascular lesions at capsule endoscopy and 43 % colonic lesions at colonoscopy. 54 % percent of patients with positive colonoscopy also presented gastroduodenal lesions and 48 % small-bowel lesions. Patients with known duodenal lesions were more likely to have small-bowel lesions at capsule endoscopy (odds ratio [OR] 10.19, 95 % CI 2.1 - 49.33, P = 0.003). Patients with associated diseases, such as liver cirrhosis, chronic renal failure, or heart valvulopathy, presented more severe disease requiring blood transfusions (OR 6.37, 95 % CI 1.39 - 29.2, P = 0.015). The number of blood transfusions correlated with the number of sites affected (R = 0.35, P = 0.002). The detection of new lesions at capsule endoscopy allowed new treatment in 46 % of patients. Mean follow-up was 18 months.

Conclusions:Sporadic telangiectasia is a multifocal disease potentially involving the whole digestive tract. Patients with duodenal telangiectasia show a higher risk of jejunal or ileal lesions. Capsule endoscopy is a useful diagnostic tool for the detection of such small-bowel vascular lesions, indicating a more specific prognosis and treatment strategy.

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L. Polese, MD

Clinica Chirurgica I
Policlinico Universitario

Via Giustiniani 2
35128 Padova
Italy

Fax: 0039-049656145

Email: linopolese@hotmail.com