Department of Clinical Medicine and Surgery, Federico II University, Napoli, Italy.
Department of Clinical Medicine and Surgery, Federico II University, Napoli, Italy.
Dig Liver Dis. 2018 Jun;50(6):542-548. doi: 10.1016/j.dld.2018.02.004. Epub 2018 Feb 15.
Angioectasias (AD) belong to benign vascular malformations of the gastrointestinal tract and are responsible for about 4-7% of upper non variceal bleeding, 30-40% of small bowel occult bleeding and 3-40% of colonic bleeding episodes. Gastrointestinal haemorrhage secondary to AD represents an important diagnostic and therapeutic problem that negatively impacts on the quality of life of patients and heath care costs. Endoscopic interventions are the mainstay in both diagnosis and treatment of vascular malformations. However, in a substantial percentage of the cases, age of the patients, comorbidities, clinical severity of anaemia and blood loss as well as size, site and number of lesions prevent this therapeutic approach. Hormonal therapy, thalidomide and somatostatin analogues have been investigated for their potential role as rescue therapies in controlling AD bleeding although, thus far, no recommendations have been provided on their use in this clinical setting. In order to implement appropriate prescription of pharmacological agents to manage gastrointestinal bleeding due to ADs, the Italian Society of Gastroenterology (SIGE) nominated a panel of experts who reviewed the available clinical literature and produced practical clinical recommendations.
血管扩张症 (AD) 属于胃肠道良性血管畸形，约占上消化道非静脉曲张性出血的 4-7%，小肠隐匿性出血的 30-40%，结肠出血的 3-40%。AD 引起的胃肠道出血是一个重要的诊断和治疗问题，对患者的生活质量和医疗保健费用产生负面影响。内镜介入是血管畸形诊断和治疗的主要方法。然而，在相当大比例的病例中，患者的年龄、合并症、贫血和失血的临床严重程度以及病变的大小、部位和数量都妨碍了这种治疗方法。激素治疗、沙利度胺和生长抑素类似物已被研究用于控制 AD 出血的潜在作用，尽管迄今为止，尚未就其在这种临床情况下的使用提供建议。为了实施适当的处方药物治疗 AD 引起的胃肠道出血，意大利胃肠病学会 (SIGE) 指定了一个专家组，该专家组审查了现有的临床文献，并提出了实用的临床建议。
