Colonic angiodysplasia is a degenerative vascular malformation of the gastrointestinal tract characterized by fragile and leaky blood vessels.
Second most common cause of lower gastrointestinal bleeding in patients >60 years of age.
Lesions may be single or multiple and are located most commonly in the ascending colon and cecum.
Bleeding stops spontaneously in >90% of patients.
Patients often complain of intermittent gastrointestinal bleeding without pain.
Treatment is initially endoscopic coagulation; for severe cases, angiographic embolization and surgical resection may be required.
A degenerative vascular malformation of the gastrointestinal tract characterized by fragile and leaky blood vessels. Subsequently, gastrointestinal bleeding and anemia occur. Lesions, single or multiple, are located most commonly in the cecum and ascending colon.
History and exam
Key diagnostic factors
- gastrointestinal bleeding
Other diagnostic factors
- age >60 years
- shortness of breath
- end-stage renal disease
- von Willebrand disease
- aortic stenosis
- cardiovascular disease
- increasing age
1st investigations to order
- blood type and crossmatch
- blood chemistry
- fecal occult blood
Investigations to consider
- CT angiography (CTA)
- selective mesenteric angiography
- technetium Tc-99m radionuclide scan
- wireless capsule enteroscopy
- push enteroscopy
- magnetic resonance angiography (MRA)
hemodynamically unstable (severe hemorrhage)
Aidan Shaw, MRCS, FRCR (IR)
Consultant Interventional Radiologist
Maidstone and Tunbridge Wells NHS Trust
AS declares that he has no competing interests.
Dr Aidan Shaw would like to gratefully acknowledge Dr Heather Lee and Dr William Speake, previous contributors to this topic.
HL declares that she has no competing interests. WS declares that he has no competing interests.
Alessandro Fichera, MD, FACS, FASCRS
Department of Surgery
University of Chicago
AF declares that he has no competing interests.
David J. Hackam, MD, PhD
Associate Professor of Pediatric Surgery
University of Pittsburgh School of Medicine
DJH declares that he has no competing interests.
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