From the Guidelines
For perirectal bleeding due to angiodysplasia, the bleeding vessels that can be cauterized to stop the bleeding are typically the vasa recta, which are the small blood vessels supplying the area of bleeding, as identified by superselective angiogram 1. To stop bleeding in angiodysplasia causing rectal bleeding, the following steps can be taken:
- Identify the source of bleeding using imaging studies such as CTA of the abdomen and pelvis 1
- Perform selective angiograms of the superior and inferior mesenteric arteries to image the site of bleeding 1
- Use superselective angiogram of the end vessel vasa recta supplying the area of bleeding to identify the exact site of bleeding 1
- Perform microcoil or glue embolization of the vasa recta correlating with the site of bleeding to decrease blood flow and achieve hemostasis 1 Alternatively, endoscopic techniques such as argon plasma coagulation, bipolar electrocoagulation, or heater probe thermocoagulation can be used to cauterize the submucosal arterioles and venules in the gastrointestinal tract 1. The goal of these procedures is to stop blood flow through the abnormal vessels and prevent further bleeding, while minimizing the risk of complications such as ischemia of the bowel 1. It is essential to monitor patients for signs of recurrent bleeding following the procedure and consider medical therapy with hormonal agents or octreotide as adjunctive treatment for patients with recurrent or multiple lesions 1.
From the Research
Blood Vessel Cauterization for Angiodysplasia
The blood vessel cauterized to stop bleeding in angiodysplasia (abnormal blood vessel formation) causing rectal bleeding is not explicitly specified in the provided studies. However, the studies discuss the treatment of angiodysplasia using argon plasma coagulation (APC) and other methods.
Treatment Methods
- Argon plasma coagulation (APC) is a recognized treatment modality for colonic angiodysplasia, as reported in studies 2, 3, 4, 5, 6.
- APC has been shown to be effective in arresting bleeding and preventing recurrent bleeding from GI angiodysplasias 2, 4, 5.
- A novel method of treating colonic angiodysplasia using a submucosal injection of a saline epinephrine solution followed by the application of APC has been proposed 3.
- Injection therapy using adrenaline and polidocanol has also been used to treat bleeding angiodysplasia in the upper gastrointestinal tract, but APC has been found to be more effective with lower complications 5.