Igawa Atsushi, Oka Shiro, Tanaka Shinji, Kunihara Sayoko, Nakano Makoto, Chayama Kazuaki
Department of Gastroenterology and Metabolism, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
Department of Endoscopy and Medicine, Hiroshima University, Hiroshima, Japan.
Gastrointest Endosc. 2016 Jul;84(1):163-7. doi: 10.1016/j.gie.2016.02.021. Epub 2016 Feb 22.
Small-bowel hemangioma is a rare disease that often causes active bleeding. The standard therapeutic method for small-bowel hemangioma is surgical resection. The aim of this study was to evaluate the usefulness of polidocanol injection (PDI) for small-bowel hemangiomas.
This study included 12 patients with obscure GI bleeding (6 male; mean age 62 years) with 39 small-bowel hemangiomas; patients were treated with PDI by using double-balloon endoscopy (DBE). EUS with DBE was performed before PDI. The lesions were divided into 2 groups according to tumor size: Group A (size <10 mm; 20 lesions) and group B (size ≥10 mm; 19 lesions). The outcomes of PDI treatment for small-bowel hemangioma were evaluated between the 2 groups. Additionally, in order to standardize the amount of PDI injected, the total amount of polidocanol according to lesion size was calculated.
There was no difference in the location of lesions and treatment times between the 2 groups. Group B had a significantly higher injection time per lesion (P < .05) and amount of polidocanol per lesion than group A (P < .01). Rebleeding occurred in only 1 case (8%). There were no adverse events related to PDI. The contribution ratio between the lesion size and amount of polidocanol showed a correlation (r = 0.77). The optimal amount of polidocanol for small-bowel hemangioma was determined to be 0.2 mL/mm.
PDI is an easy, safe, and effective method to treat small-bowel hemangiomas.
小肠血管瘤是一种罕见疾病，常导致活动性出血。小肠血管瘤的标准治疗方法是手术切除。本研究旨在评估聚多卡醇注射（PDI）治疗小肠血管瘤的有效性。
本研究纳入12例不明原因消化道出血患者（6例男性；平均年龄62岁），共39个小肠血管瘤；采用双气囊小肠镜（DBE）对患者进行聚多卡醇注射治疗。在聚多卡醇注射前进行超声内镜联合双气囊小肠镜检查。根据肿瘤大小将病变分为两组：A组（大小<10mm；20个病变）和B组（大小≥10mm；19个病变）。评估两组聚多卡醇注射治疗小肠血管瘤的效果。此外，为规范聚多卡醇注射量，计算了根据病变大小所需的聚多卡醇总量。
两组病变部位和治疗次数无差异。B组每个病变的注射时间（P<.05）和每个病变的聚多卡醇用量均显著高于A组（P<.01）。仅1例（8%）发生再出血。未出现与聚多卡醇注射相关的不良事件。病变大小与聚多卡醇用量之间的贡献率呈相关性（r=0.77）。确定小肠血管瘤聚多卡醇的最佳用量为0.2 mL/mm。
聚多卡醇注射是一种治疗小肠血管瘤简便、安全且有效的方法。
