Resposta à Hormonoterapia em Doente com Hemorragia por Angioectasias do Intestino Delgado Diagnosticada por Cápsula Endoscópica

F. J. Velasco, A. Ramos, B. Peixe, F. Açucena, D. Sousa, H. Guerreiro, J. Conde E Silva ¹

 

Resumo

A cápsula endoscópica do intestino delgado é um método diagnóstico efectivo para o diagnóstico da hemorragia gastrointestinal de origem obscura. O tratamento médico adequado da hemorragia por angioectasias intestinais ainda é controverso. O tratamento hormonal tem sido o mais frequentemente descrito mas os resultados não são uniformes e a endoscopia por cápsula endoscópica não tem sido utilizada em ensaios terapêuticos controlados. Apresentamos o caso de um doente de 78 anos que teve vários episódios de hemorragia gastrointestinal desde que iniciou tratamento com varfarina. A endoscopia por cápsula do intestino delgado foi diagnóstica, mostrando múltiplas angioectasias, algumas com hemorragia activa. Desde que a terapia com estro génios-progestagénios foi instituída não voltou a apresentar episódios de hemorragia e os níveis de hemoglobina aumentaram.

 

 

Summary

Small bowel capsule endoscopy is an effective diagnostic tool for patients with obscure gastrointestinal bleeding. Optimal medical therapy for intestinal angioectasia bleeding remains controversial. Hormonal therapy has been reported as effective, but no uniform results relative to its beneficial effect have been proved, and there are no therapeutic controlled trials using capsule endoscopy as a diagnostic method. We pre sent the case of a 87-year-old man who suffered from recurrent severe gastrointestinal bleeding since he started on warfarin therapy. Small bowel capsule was diagnostic, showing multiple angioectasias, some of them with active bleeding. Since estrogen-progestragen therapy was introduced no other bleeding episodes occurred and haemoglobin levels increased.

 

 

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Bibliografia

 

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(1)Serviço de Gastrenterologia, Hospital Central de Faro, Faro, Portugal.

 

Correspondência:

Francisco J. Velasco

Serviço de Gastrenterologia - Hospital Central de Faro

Rua Leão Penedo s/n

8000-382 Faro

Tel.: (+351) 289 891 210

Fax: (+351) 289 891 112

e-mail: franciscojavier@clix.pt

 

Recebido para publicação: 14/05/2007

Aceite para publicação: 03/03/2008