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Questions 1–20
Published in Anna Kowalewski, SBAs and EMQs in Surgery for Medical Students, 2021
Angiodysplasia is a small vascular malformation of the gastrointestinal system. It is a cause of unexplained gastrointestinal bleeding. The lesions are often multiple and most frequently occur in the ascending colon and the caecum.
Gastrointestinal tract and salivary glands
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
Iron deficiency anaemia can be due to numerous causes including diet and non-GI causes of blood loss. Where GI blood loss is suspected, endoscopy is the primary test. For patients who are unfit for endoscopy CTC, plain CT (or barium enema) may be used as described under ‘change in bowel habit’ above. However, colonoscopy is the only test other than selective angiography that will detect angiodysplasia – patches of abnormal mucosal blood vessels that may bleed. When small bowel angiodysplasia is considered as a cause for anaemia, capsule endoscopy can be of value.
Management of lower gastrointestinal bleeding
Published in David Westaby, Martin Lombard, Therapeutic Gastrointestinal Endoscopy A problem-oriented approach, 2019
The use of hormonal (oestrogen–progesterone) treatment to treat diffuse angiodysplasia has some advocates. The available data are, however, unclear and suggest that hormonal therapy is most effective in patients with renal failure and Osler–Weber–Rendu syndrome. In contrast, its use in an unselected cohort of 64 patients with small bowel angiodysplasia resulted in no improvement in transfusion requirements and no cessation of bleeding [41].
Gastrointestinal bleeding in von Willebrand patients: special diagnostic and management considerations
Published in Expert Review of Hematology, 2023
Edwin Ocran, Nicholas L.J. Chornenki, Mackenzie Bowman, Michelle Sholzberg, Paula James
Gastrointestinal (GI) angiodysplasia comprise abnormal, tortuous, dilated capillaries primarily within the mucosal and submucosal layers of the GI tract [21,22]. They are the most common GI tract vascular abnormality in the general population [21,23]. The prevalence of angiodysplasia increases with age and in healthy asymptomatic individuals aged 60 years and older was historically around 1% but has been shown recently to be anywhere from between 5% and 10%, based on improved diagnostics [22,24,25]. Angiodysplastic lesions may occur anywhere in the GI tract as multiple diffuse lesions but are commonly found in the small bowel [26] and often consist of only endothelium without smooth muscle [24,27]. These lesions are generally not associated with any hereditary or systemic diseases [24,28]. They are implicated in about 10% of GI bleeding cases and are responsible for approximately 50% of GI bleeding from the small intestine [22].
Long-term treatment with thalidomide for severe recurrent hemorrhage from intestinal angiodysplasia in Glanzmann Thrombasthenia
Published in Platelets, 2021
Francesco Paciullo, Tiziana Fierro, Filippo Calcinaro, Gianfranco Zucca Giucca, Paolo Gresele, Loredana Bury
Gastrointestinal angiodysplasia (GIA) is a digestive tract vascular malformation characterized by localized ectasia and thinning of mucosal vessels due to abnormal angiogenesis with a high tendency to bleed. GIA can localize in any tract of the digestive system and represents the most common cause of occult gastrointestinal bleeding (GIB) [1]. GIB secondary to angiodysplasia typically tends to recur and is associated with frequent hospitalizations and need of transfusions, especially in patients with underlying hemostatic disorders. Indeed, an association between GIA and von Willebrand disease (VWD) has been well documented, with a prevalence of 2% and 4.5% in type 2 and type 3 VWD vs 0.8% in the general population, probably due to the involvement of von Willebrand factor in neo-angiogenesis [2]. Endoscopic interventional procedures represent the therapy of choice of GIA, but often fail to solve GIB due to the difficulty in locating and/or reaching the lesion [3].
Long-term results with lanreotide in patients with recurrent gastrointestinal angiodysplasias bleeding or obscure gastrointestinal bleeding. Benefits in efficacy and procedures consumption
Published in Scandinavian Journal of Gastroenterology, 2018
Santiago Frago, Javier Alcedo, Edgar Martín Pena-Galo, María Lázaro, Leticia Ollero, Natalia de la Llama
The current study recruited patients with digestive bleeding due to angiodysplasia and others of uncertain origin. In both a common diagnosis and therapeutic management strategy had been applied, according to the recommendations of the scientific societies [1,2] and the variations in anticoagulants/antiplatelet consumption were limited (three stopped them and two started them). While most previous research with somatostatin analogues had focussed on patients with angiodysplasia bleeding [16–20], Molina-Infante et al. [21], also included patients with digestive bleeding of uncertain origin, reaching good overall results and similar effectiveness of octreotide in both clinical profiles.