The Endoscopic Detection and Treatment of Vascular Ectasia in the Gastrointestinal Tract —A One Year Experience at Karolinska Hospital—

Vascular ectasia of the upper and lower gastrointestinal tract (GIT) is occasionally seen at diagnostic endoscopy. The therapeutic relevance of these lesions are not always immediately clear. The aim of this study was to review a single institution's experience in the endoscopic diagnosis and treatment of GIT vascular ectasia. In order to identify and determine the characteristics and clinical course of patients with vascular ectasia, records of all adult patients undergoing upper or lower GIT endoscopy between September 1996 and August 1997 were reviewed. During the study period 2547 gastroscopies and 1759 colonoscopies were performed. Eighteen patients (0.7%) were diagnosed with vascular ectasia of the upper GIT and 23 patients (1.6%) the lower GIT. Mean age was 72.7 years and the majority of patients were male. A large percentage of patients had coexisting systemic disease. Anemia without overt GIT bleeding was the presenting clinical sign in 67% of upper GIT and 43% of lower GIT vascular ectasia. Fourteen patients received endoscopic treatment for upper GIT and 18 for lower GIT vascular ectasia. Endoscopic treatment was effective in 12 (86%) and 14 patients (78%) with upper and lower GIT vascular ectasia, respectively. Follow‐up ranged from 2 to 12 months. There was only one death in each group, both due to systemic diseases unrelated to vascular ectasia. Vascular ectasia of the GIT is a not infequent cause of upper and lower gastrointestinal bleeding and might be occult. Patients are usually elderly with coexisting systemic disease. Multi‐modality endoscopic management is the first line of treatment for this condition and seems both effective and safe.