Treatment

Recurrent small bleeds can sometimes be managed by CO2 laser. Only vessels smaller than 0.5 mm will respond to such treatment. Slightly larger vessels will coagulate in response to Nd: YAG laser treatment. Should active resuscitation be appropriate, volume replacement with crystalloids and blood will be necessary.

Radiation treatment is the mainstay of palliative therapy in these cases: it often stops bleeding within a matter of days. Occasional patients presenting with haemodynamically significant haemorrhage may be candidates for more aggressive therapy. Even patients with T3/T4 lesions can attain a five-year survival rate of up to 25%.

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