Angiodysplasia of the colon and small intestine

Angiodysplasia is a vascular malformation of the gastrointestinal tract characterised by fragile blood vessels which have a propensity to bleed.

It is the second most common cause of lower gastrointestinal bleeding in patients aged >60 years.

Patients often complain of intermittent gastrointestinal bleeding without pain.

Lesions may be single or multiple and most commonly in the stomach, small bowel, or right colon.

Diagnosis is primarily by endoscopy.

Treatment is initially endoscopic coagulation; for severe cases, angiographic embolisation and surgical resection may be required.

Re-bleeding may occur in about 40% to 50% of patients with small bowel angiodysplasias.

Angiodysplasia is a vascular malformation of the gastrointestinal tract characterised by fragile blood vessels, which subsequently leads to gastrointestinal bleeding and anaemia.

While some studies suggest the caecum and ascending colon as the most frequent locations of angiodysplasias, the advent of capsule endoscopy has revealed that the small bowel is also a common location.​[1]Jackson CS, Strong R. Gastrointestinal angiodysplasia: diagnosis and management. Gastrointest Endosc Clin N Am. 2017 Jan;27(1):51-62. http://www.ncbi.nlm.nih.gov/pubmed/27908518?tool=bestpractice.com [2]Carey EJ, Leighton JA, Heigh RI, et al. A single-center experience of 260 consecutive patients undergoing capsule endoscopy for obscure gastrointestinal bleeding. Am J Gastroenterol. 2007 Jan;102(1):89-95. http://www.ncbi.nlm.nih.gov/pubmed/17100969?tool=bestpractice.com [3]Bollinger E, Raines D, Saitta P. Distribution of bleeding gastrointestinal angioectasias in a Western population. World J Gastroenterol. 2012 Nov 21;18(43):6235-9. https://pmc.ncbi.nlm.nih.gov/articles/PMC3501771 http://www.ncbi.nlm.nih.gov/pubmed/23180943?tool=bestpractice.com [4]Sami SS, Al-Araji SA, Ragunath K. Review article: gastrointestinal angiodysplasia - pathogenesis, diagnosis and management. Aliment Pharmacol Ther. 2014 Jan;39(1):15-34. http://www.ncbi.nlm.nih.gov/pubmed/24138285?tool=bestpractice.com