Gastrointestinal angiodysplasia

Dr Henry Knipe et al.

Gastrointestinal angiodysplasias or angioectasias are one of the most common causes of occult gastrointestinal bleeding.

Patients can present with symptoms and signs upper or lower gastrointestinal bleeding although they can commonly be an incidental finding. 

Peak incidence occurs in patients in their 60-70s 3

Angiodysplasia refers to dilated, thin-walled blood vessels (capillaries, venules, veins) found in the mucosa and submucosa of the gastrointestinal tract. The pathogenesis is unclear 3. They are multiple in ~50% of cases 1,2, and can be found throughout the gastrointestinal tract, but most commonly in the caecum and right colon on the antimesenteric border. 

Associations
CT
  • appear as focal areas (< 5 mm) of contrast enhancement in the bowel wall (most prominent in the enteric phase 3)
  • early filling of an antimesenteric vein 4
Angiography
  • ectatic vessels but no mass 6
  • early venous enhancement indicating arteriovenous shunting

Approximately 50% of gastrointestinal haemorrhage from angiodysplasia ceases without intervention. Endovascular treatment is generally not effective and first-line treatment is interventional endoscopy. There is a post-treatment bleeding rate of ~25% 2,4.

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Article Information

rID: 40751
Section: Pathology
Tag: cases
Synonyms or Alternate Spellings:
  • Gastrointestinal angiodysplastic lesions (GIADs)
  • Gastrointestinal angioectasias
  • Angiodysplasia of gastrointestinal tract

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