Evidence of small-bowel involvement in hereditary hemorrhagic telangiectasia

A capsule-endoscopic study

M. Ingrosso, C. Sabbà, A. Pisani, M. Principi, M. Gallitelli, A. Cirulli, A. Francavilla

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

Background and Study Aims: Hereditary hemorrhagic telangiectasia (HHT) is an autosomal-dominant vascular disorder leading to telangiectases and arteriovenous malformations of the skin, mucosa, and viscera. Telangiectases in the upper gastrointestinal tract are known, but data regarding possible small-bowel involvement are scarce due to the technical difficulty of exploring the entire gastrointestinal tract. The aim of the present study was to use capsule endoscopy (CE) to determine the prevalence of small-bowel telangiectases in HHT patients. Patients and Methods: From December 2001 to September 2002, 20 consecutive adult HHT patients at an interdepartmental HHT center were prospectively evaluated. All patients underwent esophagogastroduodenoscopy (EGD) followed by CE within 24 h. The telangiectases were scored according to commonly accepted criteria by two endoscopists and two observers of the video-capsule images, who were blinded to each other's findings. Results: EGD revealed gastric telangiectases in 15 of the 20 patients (75%), while CE demonstrated small-bowel involvement in 10 of 18 patients (56%; images were not recorded for two patients due to battery failure). No preferential site for telangiectasia was found between the jejunum and the terminal ileum. All patients who were positive on CE were also found to have gastric involvement at EGD. Patients with small-bowel telangiectases were significantly older than those without (62.5 years vs. 45 years; P <0.02). Conclusions: This study established a 56% prevalence of small-bowel telangiectases in patients with HHT. This new endoscopic technique will probably change the etiological diagnosis of occult bleeding in HHT patients (which is too often attributed only to epistaxis) and may also be able to alter treatment strategies in HHT patients with gastrointestinal bleeding.

Original languageEnglish
Pages (from-to)1074-1079
Number of pages6
JournalEndoscopy
Volume36
Issue number12
DOIs
Publication statusPublished - Dec 2004

Fingerprint

Hereditary Hemorrhagic Telangiectasia
Capsules
Telangiectasis
Capsule Endoscopy
Digestive System Endoscopy
Stomach
Hemorrhage
Epistaxis
Upper Gastrointestinal Tract
Viscera
Arteriovenous Malformations
Jejunum
Ileum
Blood Vessels
Gastrointestinal Tract
Mucous Membrane

ASJC Scopus subject areas

  • Medicine (miscellaneous)

Cite this

Ingrosso, M., Sabbà, C., Pisani, A., Principi, M., Gallitelli, M., Cirulli, A., & Francavilla, A. (2004). Evidence of small-bowel involvement in hereditary hemorrhagic telangiectasia: A capsule-endoscopic study. Endoscopy, 36(12), 1074-1079. https://doi.org/10.1055/s-2004-826045

Evidence of small-bowel involvement in hereditary hemorrhagic telangiectasia : A capsule-endoscopic study. / Ingrosso, M.; Sabbà, C.; Pisani, A.; Principi, M.; Gallitelli, M.; Cirulli, A.; Francavilla, A.

In: Endoscopy, Vol. 36, No. 12, 12.2004, p. 1074-1079.

Research output: Contribution to journalArticle

Ingrosso, M, Sabbà, C, Pisani, A, Principi, M, Gallitelli, M, Cirulli, A & Francavilla, A 2004, 'Evidence of small-bowel involvement in hereditary hemorrhagic telangiectasia: A capsule-endoscopic study', Endoscopy, vol. 36, no. 12, pp. 1074-1079. https://doi.org/10.1055/s-2004-826045
Ingrosso M, Sabbà C, Pisani A, Principi M, Gallitelli M, Cirulli A et al. Evidence of small-bowel involvement in hereditary hemorrhagic telangiectasia: A capsule-endoscopic study. Endoscopy. 2004 Dec;36(12):1074-1079. https://doi.org/10.1055/s-2004-826045
Ingrosso, M. ; Sabbà, C. ; Pisani, A. ; Principi, M. ; Gallitelli, M. ; Cirulli, A. ; Francavilla, A. / Evidence of small-bowel involvement in hereditary hemorrhagic telangiectasia : A capsule-endoscopic study. In: Endoscopy. 2004 ; Vol. 36, No. 12. pp. 1074-1079.
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