Intestinal Phlebectasias Treated by Endoscopic Injection Sclerotherapy at Double-Balloon Endoscopy

Intestinal phlebectasias are venous varicosities, without portal hypertension, consisting of a markedly dilated tortuous vein with a normal vascular wall and scant connective tissue stroma. The jejunum is the most commonly involved site, and so the lesions had usually been beyond the reach of a conventional endoscope before the advent of videocapsule endoscopy (VCE) and double-balloon endoscopy (DBE). This case series demonstrated that VCE was useful for screening and DBE enabled diagnosis and endoscopic treatment for bleeding lesions deep within the small bowel. Heretofore, surgery had been the only definitive therapy for intestinal phlebectasias, but is employed sparingly because of their multiplicity and extent. Enteroscopic injection sclerotherapy using polidocanol proved beneficial for extinguishing phlebectasias. Although intestinal phlebectasias relapse, repeated enteroscopic injection sclerotherapy might preclude bleeding and anemia. This article is part of an expert video encyclopedia.