Successful treatment with thalidomide for a patient with recurrent gastrointestinal bleeding due to angiodysplasia diagnosed by capsule endoscopy

摘要

Angiodysplasia is a common vascular abnormality which can cause obscure gastrointestinal bleeding (OGIB), especially in patients elder than 60 years.1"3 Patients may present with maroon-colored stool, melena, hematochezia and even hematemesis. The lesions usually present in the mucosal and submu-cosal layers of the bowel wall, consisting of dilated, tortuous and thin-walled small veins, capillaries and arteries lined by endothelium with little smooth muscle.1'4 Conventional therapies such as endoscopic argon plasma coagulation, surgical resection and angiographic embolization, can treat the focal vascular lesion effectively but are less effective for multiple lesions.5 The effect of hormonal therapy6 or oct-reotide7 still remains controversial. Several studies8"10 have shown the successful outcome of thalidomide treatment on angiodysplasia, but none have reported on its long-term effects. Here we reported the use of thalidomide on a case of OGIB that was diagnosed by capsule endoscopy (CE).