Small bowel vascular angiodysplasia
This patient had a balloon-assisted endoscopy which confirmed the jejunal angioectasia and the lesions were ablated with a marker applied to the site of intervention. Congestive enteropathy was also noted at endoscopy.
Angioectasia is the most common cause of obscure gastrointestinal bleeding.
- they consist of thin tortuous veins that lack an internal elastic layer.
- peak incidence: 7th and 8th decades of life
Endoscopy: angioectasias consist of punctate or patchy areas of erythema, 2–10 mm in size.
CT: focal punctate or discoid areas of enhancement <5 mm in size or bulbous swelling of the intramural vessels in the wall of the small bowel, especially in the jejunum.Enhancement is brightest during the enteric phase and fades somewhat during the delayed phase. These lesions don't enhance during the arterial phase, which distinguishes them from arterial lesions.