Advances in gastrointestinal vascular bleeding disorders: Successful sirolimus treatment in colonic angioectasia

World J Gastroenterol. 2025 Jan 28;31(4):100718. doi: 10.3748/wjg.v31.i4.100718.

Abstract

Background: Gastrointestinal (GI) vascular bleeding disorders pose significant clinical challenges due to their complex pathogenesis and varied treatment responses. Despite advancements in diagnostic and therapeutic techniques, optimal management strategies remain elusive, necessitating further research.

Aim: To assess research trends and clinical advancements in GI vascular bleeding disorders, highlighting key themes and therapeutic progress.

Methods: A bibliometric analysis was conducted using the Web of Science Core Collection database, reviewing publications from 2000 to 2024 to identify trends, high-frequency keywords, and key contributions from leading research institutions. In addition, a case study highlighted the effective application of sirolimus in managing colonic angioectasia in a patient with recurrent GI bleeding who had not responded to previous treatments.

Results: The analysis reviewed 470 scholarly articles from 203 countries, involving 2817 authors across 1502 institutions. The United States led in publication contributions, with strong collaborations with countries like China, England, and Germany. A significant trend was observed in the shift from traditional endoscopic interventions to pharmacological therapies, particularly highlighting the successful use of sirolimus in treating colonic angioectasia. High-frequency keywords such as "angiodysplasia", "colon", and "management" were identified, indicating key research themes. The study also noted a growing interest in drug therapies, as evidenced by the increasing prominence of keywords like "thalidomide" since 2018.

Conclusion: This study links bibliometric analysis and clinical insights, highlighting the shift to pharmacological management in GI vascular bleeding disorders to improve patient outcomes.

Keywords: Angioectasia; Gastrointestinal bleeding; Pharmacological; Sirolimus; Vascular anomalies.

Publication types

  • Review
  • Case Reports

MeSH terms

  • Angiodysplasia* / complications
  • Angiodysplasia* / diagnosis
  • Angiodysplasia* / drug therapy
  • Bibliometrics
  • Colon / blood supply
  • Colon / pathology
  • Colonic Diseases* / diagnosis
  • Colonic Diseases* / drug therapy
  • Gastrointestinal Hemorrhage* / diagnosis
  • Gastrointestinal Hemorrhage* / drug therapy
  • Gastrointestinal Hemorrhage* / etiology
  • Gastrointestinal Hemorrhage* / therapy
  • Humans
  • Sirolimus* / therapeutic use
  • Treatment Outcome

Substances

  • Sirolimus