EAJAIC
Eurasian Journal of Anesthesiology and Intensive Care

The Eurasian Journal of Anesthesiology and Intensive Care (EAJAIC) is an independent-unbiased, peer-reviewed, "double-blind", and open-access journal of current national and international issues and reviews for original clinical and experimental research, interesting case reports, differential diagnoses, editorial opinions, letters to the editor, and educational papers in anesthesiology, algology, and intensive care medicine.

ISSN: Active
eISSN: 3023-6738
Creative Commons CC BY-NC-ND 4.0 International License.
EndNote Style

Online Manuscript System

Index
Case Report
Anesthesia management in double balloon enteroscopy for a patient with hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu)
Abstract
This case report discusses the anesthesia management of a 70-year-old male with Hereditary Hemorrhagic Telangiectasia (HHT), also known as Osler-Weber-Rendu disease, who underwent double balloon enteroscopy (DBE) for the treatment of gastrointestinal angiodysplasia. The patient, with a history of anemia requiring frequent blood transfusions, was managed with deep sedation using a combination of midazolam, dexmedetomidine, and propofol during the procedure. The sedation approach was tailored to the patient's comorbidities and preference against general anesthesia. The procedure was completed successfully without complications, and the patient was discharged the following day. The use of dexmedetomidine and propofol ensured stable hemodynamy and airway security, making it an effective sedation strategy for complex gastrointestinal procedures in elderly patients. The report highlights the importance of appropriate sedation protocols, particularly for patients with multiple comorbidities, and emphasizes the need for further research on sedation depth monitoring to optimize anesthetic care.

Keywords : Anesthesia, double balloon enteroscopy, hereditary hemorrhagic telangiectasia, Osler-Weber-Rendu

Download Article


1. Seebauer CT, Kuehnel T, Uller W, Bohr C, Andorfer KE. Diagnostik und behandlung der hereditären hämorrhagischen teleangiektasie [diagnostic criteria and treatment of hereditary hemorrhagic telangiectasia]. Laryngorhinootologie. 2020;99(10):682-693. doi:10.1055/ a-1220-7045
2. Solela G, Adamseged M, Mohammed A. Hereditary hemorrhagic telangiectasia in a 42-year-old Ethiopian man presenting with severe anemia and high-output heart failure: a case report with literature review. Clin Case Rep. 2023;11(7):e7694. doi:10.1002/ccr3.7694
3. Alkhalid Y, Darji Z, Shenkar R, et al. Multidisciplinary coordinated care of hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu disease).Vasc Med. 2023;28(2):153-165. doi:10.1177/1358863X231151731
4. Kjeldsen AD, Kjeldsen J. Gastrointestinal bleeding in patients with hereditary hemorrhagic telangiectasia. Am J Gastroenterol. 2000;95(2): 415-418. doi:10.1111/j.1572-0241.2000.01792.x
5. Mora-Luján JM, Iriarte A, Alba E, et al. Gastrointestinal bleeding in patients with hereditary hemorrhagic telangiectasia: risk factors and endoscopic findings. J Clin Med. 2019;9(1):82. doi:10.3390/jcm9010082
6. May A, Friesing-Sosnik T, Manner H, Pohl J, Ell C. Long-term outcome after argon plasma coagulation of small-bowel lesions using double-balloon enteroscopy in patients with midgastrointestinal bleeding. Endoscopy. 2011;43(9):759-765. doi:10.1055/s-0030-1256388
7. Bizid S, Sabbah M, Ben Abdallah H, Haddad W, Bouali R, Abdelli N. Argon plasma coagulation in the management of symptomatic gastrointestinal angiodysplasia: experience in 69 consecutive patients. Tunis Med. 2015;93(10):606-611.
8. Olmos JA, Marcolongo M, Pogorelsky V, Herrera L, Tobal F, Dávolos JR. Long-term outcome of argon plasma ablation therapy for bleeding in 100 consecutive patients with colonic angiodysplasia. Dis Colon Rectum. 2006;49(10):1507-1516. doi:10.1007/s10350-006-0684-1
9. Rondonotti E, Spada C, Adler S, et al. Smallbowel capsule endoscopy and device-assisted enteroscopy for diagnosis and treatment of small-bowel disorders: European society of gastrointestinal endoscopy (ESGE) technical review. Endoscopy. 2018;50(4):423-446. doi:10.1055/a-0576- 0566
10. Goudra B, Singh PM. ERCP: the unresolved question of endotracheal intubation. Dig Dis Sci. 2014;59(3):513-519. doi:10.1007/s10620-013-2931-3
11. Thomson M, Venkatesh K, Elmalik K, van der Veer W, Jaacobs M. Double balloon enteroscopy in children: diagnosis, treatment, and safety. World J Gastroenterol. 2010;16(1):56-62. doi:10.3748/wjg.v16.i1.56
12. Sidhu R, Turnbull D, Haboubi H, et al. British society of gastroenterology guidelines on sedation in gastrointestinal endoscopy. Gut. 2024;73(2):219-245. doi:10.1136/gutjnl-2023-330396.
13. Chen M, Sun Y, Li X, et al. Effectiveness of single loading dose of dexmedetomidine combined with propofol for deep sedation of endoscopic retrograde cholangiopancreatography (ERCP) in elderly patients: a prospective randomized study. BMC Anesthesiol. 2022;22(1): 85. doi:10.1186/s12871-022-01630-8
14. Tran TT, Beutler SS, Urman RD. Moderate and deep sedation training and pharmacology for nonanesthesiologists: recommendations for effective practice. Curr Opin Anaesthesiol. 2019;32(4):457-463. doi:10. 1097/ACO.0000000000000758
15. Tuzlalı H, Özhan Çaparlar C, Erdem G. Total diz protezi ameliyatlarında sedasyon ajanlarının kognitif fonksiyon u¨zerindeki etkileri: Prospektif gözlemsel klinik çalışma. Turkiye Klinikleri J Anest Reanim. 2024;22(3): 76-83. doi:10.5336/anesthe.2024-105640
16. Wu Y, Zhang Y, Hu X, Qian C, Zhou Y, Xie J. A comparison of propofol vs. dexmedetomidine for sedation, haemodynamic control and satisfaction, during esophagogastroduodenoscopy under conscious sedation. J Clin Pharm Ther. 2015;40(4):419-425. doi:10.1111/jcpt.12282
17. Cheng K, Kin-Kong Li M, Sze K, et al IDDF2022-ABS-0012 Safety of dexmedetomidine-based conscious sedation regime in prolonged gastrointestinal endoscopy Gut. 2022;71(Suppl 2):A107-A108. doi:10. 1136/gutjnl-2022-IDDF.139
18. Tabari M, Moradi A, Rezaieh GA, Aghasizadeh M. Effects of midazolam and dexmedetomidine on cognitive dysfunction following open-heart surgery: a comprehensive review. Brain Behav. 2025;15(4):e70421. doi:10. 1002/brb3.70421
Article available in :
Volume 2, Issue 2, 2025
Page : 73-76
https://doi.org/10.51271/EAJAIC-0033
Article Information
Received : 25 Mar 2025
Accepted : 29 Nis 2025
Published : 07 May 2025
Corresponding Author :

Oya Çimen: Department of Anesthesiology and Reanimation, Ankara Etlik City Hospital, Ankara, Turkiye

[email protected]
Citation : Çimen O, Kale O. Anesthesia management in double balloon enteroscopy for a patient with hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu). Eur J Anesthesiol Intens Care. 2025;2(2):73-76.

Read: 1107
Download : 992
Cited: 0
_Footer