Angiodysplasias Successfully Treated with A Combination of Endoscopic Band Ligation and Argon Plasma Coagulation: A Case Report

A 74-year-old Japanese man was admitted to our hospital due to repeated episodes of upper gastrointestinal (GI) bleeding, anemia and melena, which he had suffered for the preceding two years. We performed several panendoscopic and angiographic examinations, but could not discover the cause of his anemia. In addition, we performed jejunectomy because arteriovenous malformation (AVM) was suspected to exist in the jejunum. However, we found no evidence of AVM in the resected portion of the jejunum. During an endoscopic GI study on his seventh admission, we found hemorrhaging gastric angiodysplasia (AGD) in the upper body of the stomach. Moreover, we found another small AGD in the lower body of the stomach. We treated these lesions endoscopically using a combination of hemoclip, endoscopic band ligation and argon plasma coagulation. When diagnosing patients presenting with the symptoms described herein, the physician should consider small AGDs and check the GI tract accordingly, to prevent unnecessary resections. In the present subject, there has been no further bleeding and no other lesions have been detected in his upper GI on endoscopic examination during a 12-month follow up.