Rainoldi J, Naves A, Sola T, Miguel J C
Acta Gastroenterol Latinoam. 1982;12(3):217-23.
According to Gerald Rogers et. al., we believe about the usefulness of colonoscopy and endoscopic biopsy using Williams' forcep (hot biopsy forcep) for the diagnosis and final treatment of colon vascular ectasias. This method should be used immediately after the hemorrhage has finished. Angiography is prescribed when: 1) endoscopy suggests or confirm the presence of vascular ectasias in order to establish the degree of lesions and the therapeutic management. 2) When the caecum cannot be reached by the colonoscope. 3) When endoscopy is negative and there is firm clinic assumption of ectasias but the colonoscopic study has been done to much later after the bleeding stopped. Selective angiography would be the first prescription in case of bleeding which doesn't stop quickly with the necessity of immediate therapeutic measures taking into account the difficulties of intrahemorrhagic colonoscopy. Five cases are presented to support this point of view concerning the diagnosis of vascular ectasias of the right colon and considerations are made about local treatment by mean of colonoscopy and hot biopsy forcep which, when it's possible, has less morbidity and mortality than surgery, specially in attention than this is an entity concerning elderly patients.
根据杰拉尔德·罗杰斯等人的观点,我们对结肠镜检查以及使用威廉姆斯钳(热活检钳)进行内镜活检在结肠血管扩张症诊断和最终治疗中的效用进行了探讨。这种方法应在出血停止后立即使用。在以下情况时会进行血管造影:1)内镜检查提示或确认存在血管扩张症,以便确定病变程度和治疗方案。2)结肠镜无法到达盲肠时。3)内镜检查结果为阴性,但临床上高度怀疑存在血管扩张症,且结肠镜检查在出血停止后很久才进行。对于出血不能迅速停止且需要立即采取治疗措施的情况,考虑到出血时进行结肠镜检查的困难,选择性血管造影将是首选方案。本文介绍了5个病例以支持关于右半结肠血管扩张症诊断的这一观点,并对通过结肠镜检查和热活检钳进行局部治疗进行了探讨。在可能的情况下,这种治疗方式的发病率和死亡率低于手术,特别是考虑到这是一种涉及老年患者的疾病。