Localized telangiopathy of the stomach and duodenum diagnosed and treated endoscopically. Case reports and review.
During the period from January, 1976 to December, 1979 we performed 5000 upper gastrointestinal endoscopic examinations. Of these 650 were for gastrointestinal bleeding. In nine patients we found, endoscopically localized mucosal vascular abnormalities of the stomach and duodenum. Repeated endoscopic examinations were necessary in four cases before the correct diagnosis was made. Three telangiopathies (as we prefer to call them) were found incidentally, and in six cases endoscopy was performed because of gastrointestinal bleeding. In five of the six cases with bleeding, the telangiopathy (TAP) probably was the bleeding lesion. The treatment of choice is endoscopic, either by electrodestruction with mono-polar current, or by removal with a diathermy snare. Neither barium meal x-rays of the upper gastrointestinal tract in five cases, nor exploratory laparotomy in two cases, revealed the telangiopathies. There has been no rebleeding after the treatment, except for one case in which another TAP of the small or large bowel is implicated.