Anesthetic Protocol For Patients With Hereditary Hemorrhagic Telangiectasia Undergoing Enteroscopy For Angiodysplastic Lesions: A Case Report

Hereditary hemorrhagic telangiectasia (HHT), also known as Osler-Weber-Rendu syndrome, is a rare genetic disorder that poses significant perioperative challenges due to the risk of bleeding. We report the case of a 47-year-old male with HHT undergoing double-balloon enteroscopy (DBE) for gastrointestinal angiodysplastic lesions. Preoperative preparation included detailed screening for anemia, coagulation status, and arteriovenous malformations (AVMs). Anesthetic considerations included airway management strategies to prevent and detect telangiectasia rupture, maintenance of hemodynamic stability, and post-procedural bleeding management. Intraoperative measures included careful intubation, hemodynamic monitoring, and mitigation of embolic risks. The procedure was completed successfully, managing over 100 lesions without incident. This case highlights the importance of personalized perioperative protocols, intraoperative vigilance, and post-operative care which are crucial for the successful management of patients with HHT. We present our HHT-specific anesthetic protocol from a hematology center to address the unique challenges of HHT in endoscopic clinics, contributing to safer outcomes for patients with this rare genetic disorder.