Endoscopy 2019; 51(04): S252
DOI: 10.1055/s-0039-1681931
ESGE Days 2019 ePosters
Friday, April 5, 2019 09:00 – 17:00: Stomach and small intestine ePosters
Georg Thieme Verlag KG Stuttgart · New York

HEREDITARY HEMORRHAGIC TELANGIECTASIA: DEMOGRAPHIC AND ENDOSCOPIC CHARACTERISTICS OF A LATIN AMERICAN COHORT

A Ramirez Polo
1   Endoscopia, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, Mexico
,
G Grajales Figueroa
1   Endoscopia, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, Mexico
,
R Barreto Zúñiga
1   Endoscopia, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, Mexico
,
F Valdovinos Andraca
1   Endoscopia, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, Mexico
,
LE Zamora Nava
1   Endoscopia, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, Mexico
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

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Aims:

Primary: To describe the demographic characteristics and endoscopic findings of patients with HHT in a third-level center in Mexico. Secondary: To determine the number and type of endoscopic studies and treatment used.

Methods:

Retrospective study of patients with diagnosis of THH made between 1997 – 2017. Review of clinical records and endoscopic reports was made. The frequency of epistaxis, GI hemorrhage, anemia, type of endoscopic treatment, rebleeding and death were determined. To summarize the results, descriptive statistics were used (with STATA v.14.1 program).

Results:

We reviewed 30 cases and 225 endoscopic studies. 50% were women, median age at diagnosis: 41 years (6 – 69). The most frequent place of origin was Mexico City (n = 14, 47%). The most frequent comorbidities were GI pathologies (n = 8, 27%). 23% of patients did not require endoscopic evaluation. 28% of patients had anemia without evidence of clinical hemorrhage. 70% had epistaxis. 14 patients were assessed for GI tract hemorrhage (46.7%). The median of studies per patient was 4.5 (RIQ 3 – 15); the most frequently was upper endoscopy (76%, n = 171); only 2% (n = 5) were VCE. Most of telangiectasia were found in the upper digestive tract (greater curvature, 60%), however the data of active bleeding were more frequent in the middle intestine (2/5 studies, 40%). In relation to endoscopic treatment, the majority (n = 13, 43.3%) was treated with APC. Only 3 patients (10%) were under medical treatment with antiangiogenic drugs. 33% (n = 10) was hospitalized for anemia and/or GI bleeding and 43.3% (n = 13) went to the ER for this reason. 26.7% (n = 8) presented rebleeding despite endoscopic treatment. Two patients died due to recurrent hemorrhage and severe anemia.

Conclusions:

THH is present in our country. Most cases originate in Mexico City. Upper endoscopy was the most frequently performed study for anemia and overt gastrointestinal bleeding. The multidisciplinary management of these patients is indispensable for the treatment of recurrent hemorrhage.