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BMJ Case Reports 2009; doi:10.1136/bcr.07.2008.0542
  • Unusual presentation of more common disease/injury

Small bowel angiodysplasia in a patient on haemodialysis: difficulties in diagnosis and management

  1. Smeeta Sinha1,
  2. Jessica L R Williams1,
  3. Helen Eddington1,
  4. Constantina Chrysochou1,
  5. Elizabeth Lamerton2,
  6. Christopher Babbs3,
  7. Alistair Cowie4,
  8. David J Smithard5,
  9. Philip A Kalra1
  1. 1
    Department of Renal Medicine, Salford Royal NHS Foundation Trust , Stott Lane, Salford M6 8HD, UK
  2. 2
    Department of Pharmacy, Salford Royal NHS Foundation Trust, Stott Lane, Salford M6 8HD, UK
  3. 3
    Department of Gastroenterology, Salford Royal NHS Foundation Trust, Stott Lane, Salford M6 8HD, UK
  4. 4
    Department of Radiology, Salford Royal NHS Foundation Trust , Stott Lane, Salford, Greater Manchester M6 8HD, UK
  5. 5
    Department of Medicine, Rochdale Infirmary, Whitehall road, Rochdale, OL12 ONB
  1. philip.kalra{at}srft.nhs.uk
  • Published 27 March 2009

Summary

Angiodysplasia is a common cause of gastrointestinal blood loss in patients with end stage renal disease. Diagnosis is especially difficult when the angiodysplastic lesions are concentrated in the small bowel. This report describes a case of a patient on haemodialysis who had transfusion-dependent anaemia from small bowel angiodysplasia. Endoscopic treatment was unsuccessful, tranexamic acid caused complications with thrombosis, and thalidomide showed no benefit. This case report highlights the problems in the diagnosis and management of this condition in patients on haemodialysis. Early diagnosis and optimisation of the patient for treatment is key to the successful outcomes of such patients.

Footnotes

  • Competing interests: None.

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