Elsevier

The Lancet

Volume 335, Issue 8695, 21 April 1990, Pages 953-955
The Lancet

CLINICAL PRACTICE
Treatment of bleeding gastrointestinal vascular malformations with oestrogen-progesterone

https://doi.org/10.1016/0140-6736(90)91010-8Get rights and content

Abstract

10 patients with frequent and severe bleeding from gastrointestinal vascular malformations took part in a double-blind, placebo-controlled, crossover trial of a daily dose of 0·05 mg ethinyloestradiol plus 1 mg norethisterone given by mouth. Each arm of the trial lasted 6 months. Oestrogen-progesterone significantly decreased the transfusion need from 10·9 to 1·1 units packed cells (p<0·003). While on oestrogen-progesterone 2 of 9 patients required transfusions (mean 1·1 units packed cells per patient over 6 months), whereas all patients had to be transfused while on placebo (mean 10·9 units per patient over 6 months; p=0·002 for number of patients). No significant excess of side-effects was noted with the active agents. The findings indicate that oestrogen-progesterone is an effective treatment for severely bleeding gastrointestinal vascular malformations.

References (26)

  • Rl Protell et al.

    The heater probe: a new endoscopic method for stopping massive gastrointestinal bleeding

    Gastroenterology

    (1978)
  • Y. Nagamine et al.

    New embolization method using estrogen: effect of estrogen on microcirculation

    Surg Neurol

    (1983)
  • Jd Richardson et al.

    Bleeding vascular malformations of the intestine

    Surgery

    (1978)
  • Jt Schwartz et al.

    Gastric radiotherapy as treatment of hereditary hemorrhagic telangiectasia

    Br Med J

    (1963)
  • P. Rutgeerts et al.

    Long term results of treatment of vascular malformations of the gastro-intestinal tract by neodymium-YAG laser

    Gut

    (1985)
  • Bh Rogers

    Endoscopic electrocoagulation of vascular abnormalities of the gastrointestinal tract in 51 patients

    Gastrointest Endosc

    (1982)
  • W. Young et al.

    The recurrent upper gastrointestinal bleeding in hereditary hemorrhagic telangiectasia successfully treated by endoscopic sclerotherapy

    Gastrointest Endosc

    (1982)
  • J. Van Isveldt et al.

    Neodymium-Yag laser therapy of vascular malformations of the gastrointestinal tract

    Acta Gastroenterol Belgica

    (1988)
  • E. Matthys-Vliegen

    Laser treatment of intestinal vascular abnormalities

    Int J Colorect Dis

    (1989)
  • Hj Koch et al.

    Hormonal management of hereditary hemorrhagic telangiectasia

    JAMA

    (1952)
  • E. Blackburn

    Longterm treatment of epistaxis with oestrogens

    Br Med J

    (1963)
  • T. McCaffrey et al.

    Management of epistaxis in hereditary hemorrhagic telangiectasia

    Arch Otolaryngol

    (1977)
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