Endoscopic treatment of small bowel hemangiomas via double-balloon enteroscopy: A single-center comparative study

Abstract

BACKGROUND

Previous studies have not clarified a universally acknowledged treatment approach that can eradicate small bowel hemangiomas while minimizing harm to patients. Although studies have indicated that endoscopic interventions have promising treatment effects with minimal invasiveness, no comparison of different types of endoscopic therapies has been conducted.

AIM

To compare the clinical efficacy, safety, and procedural outcomes of lauromacrogol injection, argon plasma coagulation (APC), and endoscopic ligation via double-balloon enteroscopy for the treatment of small bowel hemangiomas, and to identify lesion-specific optimal endoscopic strategies.

METHODS

Seventy-five participants were enrolled in this study. Thirteen patients received conservative treatment, 20 received lauromacrogol injection, 22 underwent APC, 18 underwent endoscopic ligation therapy, and two received hemostatic clip therapy. Key indicators and prognostic information for different treatment methods were compared between conservative-interventional and within interventional therapies. Categorical variables were compared using the χ² or Fisher’s exact test, and continuous variables were compared using the Student’s t-test or Wilcoxon rank sum test.

RESULTS

Compared with conservative therapy, interventional therapy was associated with a lower rebleeding rate. Compared with ligation therapy, lauromacrogol therapy was associated with less intraprocedural bleeding and showed a higher technical success rate and shorter operative duration. Compared with lauromacrogol and ligation therapies, APC was associated with a shorter procedure duration, a higher technical success rate, and less intraprocedural bleeding.

CONCLUSION

Our observational data suggest that lauromacrogol injection may be a more suitable option for raised small bowel hemangiomas, while APC may be preferable for flat lesions.

Keywords: Small bowel hemangioma; Double-balloon enteroscopy; Lauromacrogol injection; Argon plasma coagulation; Endoscopic ligation; Obscure gastrointestinal bleeding

Core Tip: Small bowel hemangioma is a rare but important cause of obscure gastrointestinal bleeding, and the optimal endoscopic treatment strategy remains unclear. This single-center retrospective study is the first to compare lauromacrogol injection, argon plasma coagulation, and endoscopic ligation via double-balloon enteroscopy. Our findings suggest that lauromacrogol injection is safer and more effective for raised lesions, while argon plasma coagulation is the optimal option for flat hemangiomas, providing practical guidance for endoscopists in clinical decision-making.