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FRONTIERS IN MEDICAL CASE REPORTS - Volume 3; Issue 6, (Nov-Dec, 2022)

Pages: 1-02
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Vascular Ectasia in Esophagus: An Unusual Place

Author: Christian Ospina, Fabian Puentes, Lazaro Arango

Category: Clinical Case Reports

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Introduction

Vascular Ectasia is an anomaly that can be congenital or acquired. When it’s acquired, occurs in patients over 60 years of age (Foutch and Rex, 1995) with comorbidities associated with end-stage chronic kidney disease, Von Willebrand disease, and aortic stenosis (Jackson and Gerson, 2014). The most frequent site is colon, (cecum 37%) and less frequently at the stomach (4-7%); In esophagus are only few cases described.

Clinical Image

A 67-year-old patient consults with abdominal pain, heartburn and weight loss. Personal history includes osteoarthritis, Asthma; siblings with lung cancer. An EGD was performed with evidence of a single vascular ectasia in the distal esophagus, as an incidental finding. Expectant management was decided (Fig. 1).


Figure 1: Single 8 mm vascular ectasia in the distal esophagus.

Discussion

Vascular ectasia is a rare entity associated with described comorbidities. Is diagnosis is endoscopic, showing lesions of 5-10 mm, flat, cherry-red with tree-like fern-like pattern (Shindler, 2004). Regarding incidental treatment, they don’t require intervention. Therapy with APC, electrocoagulation, or clips is recommended if bleeding.

References:

Foutch PG, Rex DK. Prevalence and natural history of colonic angiodysplasia among healthy asymptomatic persons. Am J Gastroenterol 1995; 90: 564.

Jackson CS, Gerson LB. Management of gastrointestinal angiodysplastic lesions: a systematic review and meta-analysis. Am J Gastroenterol 2014; 109: 474.

Shindler DM. Aortic stenosis and gastrointestinal bleeding. Arch Intern Med 2004; 164: 103.