Clinical Endoscopy

Case Report

Multiple Polypoid Angiodysplasia with Obscure Overt Bleeding: Jooyoung Lee, Sung Wook Hwang, Jihye Kim, Jinwoo Kang, Gyeong Hoon Kang, Kyu Joo Park, Jong Pil Im, Joo Sung Kim; Clin Endosc 2016;49(1):91-96. Published online January 28, 2016; DOI: https://doi.org/10.5946/ce.2016.49.1.91

Angiodysplasia (AD) is increasingly being recognized as a major cause of gastrointestinal bleeding. Morphologically flat lesions are common types of AD, whereas the polypoid types are rare. We report a case of multiple polypoid AD in the small bowel causing severe anemia and requiring surgical treatment. A 60-year-old male patient visited our hospital with dyspnea and hematochezia. He had a history of myocardial infarction and was taking both aspirin and clopidogrel. Capsule endoscopy, enteroscopy, computed tomography, and angiography revealed multifocal vascular lesions with a polypoid shape in the jejunum. Surgical resection was performed because endoscopic treatment was considered impossible with the number and the location of lesions. The risk of recurrent bleeding related to the use of antiplatelet agents also contributed to the decision to perform surgery. AD was histologically diagnosed from the surgical specimen. He resumed taking both aspirin and clopidogrel after surgery. He fully recovered and has been doing well during the several months of follow-up.

Citations

Citations to this article as recorded by

Intraoperative Endoscopic-Guided Bowel Resection for Persistent Gastrointestinal Bleeding Caused by Angiodysplasia: A Case Report and Literature Review
Emily Fellows, Joy Harris, Tania Kibble, Nicholas M. McDonald, Nabeel Azeem, James V. Harmon
The Surgery Journal.2023; 09(04): e112. CrossRef
Ileal angiodysplasia presentation as a bowel obstruction: A case report
Ons Ghdes, Ali Gaja, Ahlem Blel, Hichem Jarraya, Najla Mnif
International Journal of Surgery Case Reports.2017; 39: 301. CrossRef
Solitary Polypoid Angiodysplastic Lesion Mimicking a Tumor in the Jejunum
Abhishek D. Polavarapu, Mayurathan Kesavan, Vivek V. Gumaste, Monika Wrzolek, Elias Purow
ACG Case Reports Journal.2017; 4(1): e83. CrossRef

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Original Article

A Randomized Controlled Clinical Study Comparing the Diagnostic Accuracy of the Histologic Prediction for Colorectal Polyps Depending on the Use of Either Magnified or Nonmagnified Narrow Band Imaging: Jin Joo Kim, Kyoung Sup Hong, Joo Sung Kim, Hyun Chae Jung; Clin Endosc 2015;48(6):528-533. Published online November 30, 2015; DOI: https://doi.org/10.5946/ce.2015.48.6.528

Abstract PDF PubReader ePub

Background
/Aims: The aim of this study was to compare the diagnostic capabilities of narrow band imaging (NBI) colonoscopy with and without optical magnification in differentiating neoplastic from nonneoplastic colorectal polyps.
Methods
Between April 2012 and March 2013, 122 patients with colorectal polyps detected by using diagnostic conventional colonoscopy were prospectively enrolled. A total of 236 polyps were evaluated with NBI, in vivo in real time during therapeutic colonoscopy, by one experienced endoscopist. Whether magnification was used or not was determined by randomization. After an in vivo real-time endoscopic prediction of histology, all lesions were endoscopically excised. Surgical pathologic reports were used as the criterion standards. The sensitivity (Sn), specificity (Sp), positive predictive value (PPV), and negative predictive value (NPV) of identifying neoplastic polyps were calculated.
Results
A total of 236 lesions with an average size of 5.6 mm in 122 patients were assessed (159 neoplastic, 77 nonneoplastic). The Sn, Sp, PPV, and NPV in differentiating neoplastic from nonneoplastic lesions with the magnified NBI were 97.5%, 83.3%, 94.0%, and 92.6%, respectively, whereas those of the nonmagnified NBI group were 97.5%, 85.1%, 91.7%, and 95.2%, respectively.
Conclusions
Nonmagnified NBI colonoscopy distinguishes neoplastic from nonneoplastic colorectal polyps as accurately as does magnified NBI colonoscopy.

Citations

Citations to this article as recorded by

Utility of the narrow-band imaging international colorectal endoscopic classification for optical diagnosis of colorectal polyp histology in clinical practice: a retrospective study
Yasuhiko Hamada, Kyosuke Tanaka, Masaki Katsurahara, Noriyuki Horiki, Reiko Yamada, Tomomi Yamada, Yoshiyuki Takei
BMC Gastroenterology.2021;[Epub] CrossRef
Feasibility of using narrow band imaging international colorectal endoscopic classification for diagnosing colorectal neoplasia in China: A multicenter pilot observational study
Qing Wei Zhang, Jing Jing Zhang, Ai Ming Yang, Jian Qiu Sheng, Yu Lan Liu, Zhao Shen Li, Hai Ying Chen, Nan Feng, Qing Wei Jiang, Peng Jin, Li Ming Zhang, Hong Yu Fu, Yun Jie Gao, Zhi Zheng Ge, Xiao Bo Li
Journal of Digestive Diseases.2020; 21(2): 88. CrossRef
Narrow-Band Imaging: Clinical Application in Gastrointestinal Endoscopy
Sandra Barbeiro, Diogo Libânio, Rui Castro, Mário Dinis-Ribeiro, Pedro Pimentel-Nunes
GE - Portuguese Journal of Gastroenterology.2019; 26(1): 40. CrossRef
The value of narrow band imaging in diagnosis of head and neck cancer: a meta-analysis
Hui Zhou, Jing Zhang, Linghong Guo, Ji Nie, Chenjing Zhu, Xuelei Ma
Scientific Reports.2018;[Epub] CrossRef
Comparison of narrow-band imaging and confocal laser endomicroscopy for the detection of neoplasia in Barrett's esophagus: A meta-analysis
Yi-Quan Xiong, Shu-Juan Ma, Hao-Yue Hu, Jing Ge, Li-Zhi Zhou, Shu-Ting Huo, Min Qiu, Qing Chen
Clinics and Research in Hepatology and Gastroenterology.2018; 42(1): 31. CrossRef
Endoscopic classification for colorectal tumors using narrow‐band imaging
Gian Eugenio Tontini, Helmut Neumann
Digestive Endoscopy.2016; 28(5): 537. CrossRef
Narrow Band Imaging as an Efficient and Economical Tool in Diagnosing Colorectal Polyps
Naoki Muguruma, Tetsuji Takayama
Clinical Endoscopy.2015; 48(6): 461. CrossRef

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