Edit concept Question Editor Create issue ticket

Colonic Angiodysplasia

Angiodysplasia of Colon


Presentation

  • An unusual case of a colonic vascular anomaly resembling angiodysplasia associated with right sided diverticular disease is presented.[ncbi.nlm.nih.gov]
  • None of these signs were present in the 8 patients with obscure gastrointestinal bleeding and negative diagnostic investigation of the digestive tract.[ncbi.nlm.nih.gov]
  • During the study period, two patients presented with bleeding from residual AGD and underwent endoscopic treatment.[ncbi.nlm.nih.gov]
  • The patient is presently being followed up.[njcponline.com]
  • The patient presented with anemia unexpectedly before her aortic valve replacement. Colon fiberscopy revealed that colonic angiodysplasia was responsible for the bleeding.[ncbi.nlm.nih.gov]
Anemia
  • The patient presented with anemia unexpectedly before her aortic valve replacement. Colon fiberscopy revealed that colonic angiodysplasia was responsible for the bleeding.[ncbi.nlm.nih.gov]
  • In the subgroup of patients with anemia, mean hemoglobin levels increased from 9.3 (range, 5.5-12.2) g/dl before treatment to 12.6 (range, 7.4-16.7) g/dl after treatment (P 0.01).[ncbi.nlm.nih.gov]
  • Older people may have symptoms such as: Weakness Fatigue Shortness of breath due to anemia They may not have bleeding directly from the colon.[ufhealth.org]
  • Tachycardia ( rapid heart rate ) and hypotension are signs of significant blood loss or long standing anemia and need to be assessed immediately.[healthhype.com]
Asymptomatic
  • OBJECTIVE: The prevalence of colonic angiodysplasia (AD) among healthy asymptomatic people is unknown, and the natural history of these lesions has not been clearly defined.[ncbi.nlm.nih.gov]
  • Dig Ds Sci 1991; 36: (c) Aortic stenosis (d) von Willebrand's disease (e) pulmonary disease No study demonstrate the relationship unrelated to inherited arteriovenous malformations (hereditary hemorrhagic telangiectasia) 10 Asymptomatic Presentation GIB[slideplayer.com]
  • Cases of angiodysplasia in individuals less than 40 years have been documented in the literature. [5], [10] It may be asymptomatic, or present with iron deficiency anemia or positive occult blood.[njcponline.com]
  • The presentation of multiple myeloma can range from asymptomatic to severely symptomatic with complications requiring emergent treatment.[gastrointestinalatlas.com]
  • We compared the UGIB group from angiodysplasia with an asymptomatic control group. The asymptomatic control group was composed of 58 individuals who had incidental findings of angiodysplasia in a health screening center, St.[kjim.org]
Hunting
  • Howard OM, Buchanan JD, Hunt RH. Angiodysplasia of the colon: experience of 28 cases. Lancet 1982;2:16–9. PubMed CrossRef Google Scholar 6. Ruttgeerts P, Van Gompel F, Geboes K.[link.springer.com]
  • View Article PubMed Google Scholar Barkun AN, Bardou M, Kuipers EJ, Sung J, Hunt RH, Martel M, Sinclair P: International Consensus Upper Gastrointestinal Bleeding Conference Group.[bmcgastroenterol.biomedcentral.com]
Pallor
  • On general physical examination, the patient had pallor but no jaundice or enlarged lymph nodes. Abdominal examination was unremarkable, no viscera or mass palpable. On digital rectal examination, no abnormality was detected.[ispub.com]
Collapse
  • The patient subsequently passed massive bloody stool and collapsed, necessitating emergency surgery.[jstage.jst.go.jp]
Yawning
  • By Richard Klasco, M.D Photo Credit Ask Well Photo Credit Why Do We Yawn? Reading about yawning makes people yawn. You are probably yawning right now. By Roni Caryn Rabin Latest Search Latest Articles Search Articles 13844 results for sorted by[nytimes.com]
Melena
  • Black, tarry stools ( melena ) and occasional episodes of bright red blood rectal bleeding ( hematochezia ) may be the only obvious signs of angiodysplasia.[healthhype.com]
  • It is a common cause of lower GI bleeding in the elderly. [1], [2] It may be asymptomatic and discovered incidentally during colonoscopy. [3] Patients may present with hematochezia, melena, positive occult blood test or iron deficiency anemia. [4] It[njcponline.com]
  • Overt bleeding consisted of hematemesis in 3 cases, melena in 34 cases and hematochezia in 18 cases.The sites involved in angiodysplastic lesions were: gastric in 18 cases (26%), small bowel 14 (20%), colon 53 (77%), including predominantly the right[latunisiemedicale.com]
  • The patient was in good health with no history of GI bleeding, such as melena or hematochezia. He had no symptoms. Regarding laboratory findings, his hemoglobin was 14.7 g/dL and hematocrit was 42.3%.[saudijgastro.com]
  • The severity of bleeding ranges from minor, but chronic upper GI blood loss to severe melena and hematemesis that leads to anemia and requires blood transfusion.[bmcgastroenterol.biomedcentral.com]
Hematochezia
  • There was no anorexia, abdominal swelling, diarrhea, or hematochezia. Abdomino-pelvic ultrasonography showed normal findings.[njcponline.com]
  • Black, tarry stools ( melena ) and occasional episodes of bright red blood rectal bleeding ( hematochezia ) may be the only obvious signs of angiodysplasia.[healthhype.com]
  • Table 1: Summary of colonic polypoid arteriovenous malformations reported in the English-language literature Click here to view The most common initial clinical symptom was hematochezia (60%).[saudijgastro.com]
  • Overt bleeding consisted of hematemesis in 3 cases, melena in 34 cases and hematochezia in 18 cases.The sites involved in angiodysplastic lesions were: gastric in 18 cases (26%), small bowel 14 (20%), colon 53 (77%), including predominantly the right[latunisiemedicale.com]
  • Clinical presentation of UGIB from angiodysplasias is usually characterized by maroon-colored stool, melena, or hematochezia. Bleeding usually is self-limited, but it can be chronic, recurrent, or even acute and life threatening.[kjim.org]
Abdominal Cramps
  • cramping and other symptoms Treatment for colonic diseases varies greatly depending on the disease and its severity.[icdlist.com]
Vascular Disease
  • You are more likely to have vascular disease as you get older.[icdlist.com]
  • Vascular diseases of the gastrointestinal tract. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 143. Reviewed By: Michael M.[ufhealth.org]
  • Vascular diseases of the gastrointestinal tract. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 143. Updated by: Michael M.[medlineplus.gov]
  • Atherosclerotic peripheral vascular disease is another comorbidity that could further damage the intestinal vessel walls, especially in older patients, compromising the microcirculation of the large bowel. [10], [11], [12], [13] In favor of the theory[sjkdt.org]
  • Angiodysplasia of the colon: An expression of occlusive vascular disease. Hepatogastroenterology 1987;34:127-31. 3. Foutch PG. Angiodysplasia of the gastrointestinal tract. Am J Gastroenterol 1993;88:807-18. 4.[saudijgastro.com]
Venous Insufficiency
  • Aortic arch syndrome (Medical Encyclopedia) Arterial embolism (Medical Encyclopedia) Arteriogram (Medical Encyclopedia) Cerebral angiography (Medical Encyclopedia) Duplex ultrasound (Medical Encyclopedia) Venous insufficiency (Medical Encyclopedia) Venous[icdlist.com]
Tachycardia
  • Tachycardia ( rapid heart rate ) and hypotension are signs of significant blood loss or long standing anemia and need to be assessed immediately.[healthhype.com]
Flushing
  • The resected specimen was flushed out with heparin-saline solution and injected with a barium-gelatine mixture.[ncbi.nlm.nih.gov]

Treatment

  • Endoscopic treatment resulted in a therapeutic success rate of 100 %, and no recurrence of bleeding was observed in 85 % of the patients (11/13) after treatment.[ncbi.nlm.nih.gov]
  • In two others, the need for transfusions was lessened considerably after treatment. The last patient died of terminal cardiac failure. No complications occurred during treatment.[ncbi.nlm.nih.gov]
  • In the subgroup of patients with anemia, mean hemoglobin levels increased from 9.3 (range, 5.5-12.2) g/dl before treatment to 12.6 (range, 7.4-16.7) g/dl after treatment (P 0.01).[ncbi.nlm.nih.gov]
  • Endoscopic treatment increased among patients in a university practice setting (vs community setting, OR, 2.53; 95% CI, 1.96-3.27) and decreased in Northwest geographic locations (vs Southwest, OR, 0.60; 95% CI, 0.43-0.84).[ncbi.nlm.nih.gov]
  • Methods of treatment include coagulation biopsy, segmental colon resection and right hemicolectomy.[ncbi.nlm.nih.gov]

Prognosis

  • Outlook (Prognosis) People who have bleeding related to this condition despite having had colonoscopy, angiography, or surgery are likely to have more bleeding in the future. The outlook remains good if the bleeding is controlled.[ufhealth.org]
  • Controversial issue Conclusion 26 Conclusion Angiodysplasia - common cause of LGIB of elderly Diagnosis – difficult, combination techniques Treatment – individualized Controversial - systemic hormonal therapy - incidental angiodysplasia 27 Conclusion Prognosis[slideplayer.com]
  • […] 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 Treatment and prognosis[radiopaedia.org]

Etiology

  • Etiology and pathogenesis are unknown. The diagnosis can be made with angiography based on the demonstration of a vascular tuft and early opacification of draining veins. Right hemicolectomy is the mode of therapy.[ncbi.nlm.nih.gov]
  • While there are recognized limitations to this technique, including the inability to detect active bleeding, this small study shows that helical CT angiography may have a role in the diagnostic evaluation of patients with lower GI bleeding of unclear etiology[aafp.org]
  • On the nature and etiology of vascular ectasias of the colon: degenerative lesions of aging. Gastroenterology 1977;72:650–60. PubMed Google Scholar 8. Groff WL. Angiodysplasia of the colon. Dis Colon Rectum 1983;26:64–7. PubMed Google Scholar 9.[link.springer.com]
  • Etiology: Thought to be caused by the higher wall tension of cecum (due to larger diameter) and result from (intermittent) venous occlusion/focal dilation of vessels. [2] Gross Cecum - classic location.[librepathology.org]
  • The condition occurs mainly in older women and is of unknown etiology.[merckmanuals.com]

Epidemiology

  • We investigated the epidemiology and management of colonic angiodysplasia by using a national endoscopy database.[ncbi.nlm.nih.gov]
  • Am J Gastroenterol. 1989;84: 9 Epidemiology (b) Cirrhosis Naveau S et al.[slideplayer.com]
  • May be associated with aortic stenosis; known as Heyde syndrome. [1] Epidemiology: Older people.[librepathology.org]
  • Bleeding can also be acute. 2/3 of cases in patients 70 years of age Epidemiology Incidence The exact incidence of angiodysplasia is unknown.[unboundmedicine.com]
  • Epidemiological investigation of the prevalence of von Willebrand's disease . Blood 1987; 69 :454–459. 49. Chey WD , Hasler WL , Bockenstedt PL . Angiodysplasia and von Willebrand's disease type IIB treated with estrogen/progesterone therapy .[nature.com]
Sex distribution
Age distribution

Pathophysiology

  • Lesions are usually located in the right colon and, although the pathophysiology is unknown, most are probably acquired as the result of a degenerative process associated with aging.[ncbi.nlm.nih.gov]
  • Etiology and Pathophysiology Exact pathophysiology is unknown. Lesions develop from chronic, low-grade obstruction of submucosal veins as a result of increased smooth muscle contractility.[unboundmedicine.com]
  • Vascular ectasias also occur in association with a number of systemic diseases (eg, renal failure, cirrhosis, CREST syndrome [calcinosis cutis, Raynaud phenomenon, esophageal dysmotility, sclerodactyly, telangiectasias]—see Pathophysiology ) and after[merckmanuals.com]
  • Pathophysiology: Classically described in the colon, angiodysplasia can occur throughout the gastrointestinal tract.[gastrointestinalatlas.com]
  • Bleeding stops spontaneously in the majority of patients, but rebleeding may occur. 4 Lesions are usually located in the right colon and, although the pathophysiology is unknown, most are probably acquired as the result of a degenerative process associated[ispub.com]

Prevention

  • Prevention There are no current guidelines to prevent angiodysplasia of the colon.[cancercarewny.com]
  • Prevention There is no known prevention. Images References Brandt LJ, Aroniadis OC. Vascular disorders of the gastrointestinal tract. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran’s Gastrointestinal and Liver Disease. 10th ed.[ufhealth.org]
  • There is no known way to prevent angiodysplasia of the colon. Last reviewed November 2008 by ]] Daus Mahnke, MD ]] Please be aware that this information is provided to supplement the care provided by your physician.[empowher.com]
  • There is no known prevention. Vascular ectasia of the colon; Colonic arteriovenous malformation; Hemorrhage - angiodysplasia; Bleed - angiodysplasia Brandt LJ, Aroniadis OC. Vascular disorders of the gastrointestinal tract.[medlineplus.gov]
  • A few clips were placed to prevent delayed bleeding since the patient needed to remain on multiple blood-thinning agents.[retroflexions.com]

Ask Question

5000 Characters left Format the text using: # Heading, **bold**, _italic_. HTML code is not allowed.
By publishing this question you agree to the TOS and Privacy policy.
• Use a precise title for your question.
• Ask a specific question and provide age, sex, symptoms, type and duration of treatment.
• Respect your own and other people's privacy, never post full names or contact information.
• Inappropriate questions will be deleted.
• In urgent cases contact a physician, visit a hospital or call an emergency service!