Angiodysplasia differential diagnosis: Difference between revisions
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Angiodysplasia must be differentiated from diverticulitis, hemorrhoids, colon cancer, massive upper GI bleed and inflammatory bowel disease. | Angiodysplasia must be differentiated from diverticulitis, hemorrhoids, colon cancer, massive upper GI bleed and inflammatory bowel disease. | ||
{| class="sortable mw-collapsible | {| class="sortable mw-collapsible" | ||
|- style="background: #4479BA; color: #FFFFFF; text-align: center;" | |- style="background: #4479BA; color: #FFFFFF; text-align: center;" | ||
! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |<small>Diseases</small> | ! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |<small>Diseases</small> | ||
| colspan="6" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" | | | colspan="6" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |<small>Clinical manifestations</small> | ||
! colspan="7" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |<small>Para-clinical findings</small> | ! colspan="7" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |<small>Para-clinical findings</small> | ||
| colspan="1" rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" | | | colspan="1" rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |<small>Gold standard</small> | ||
|- | |- | ||
| colspan="3" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" | | | colspan="3" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |<small>Symptoms</small> | ||
! colspan="3" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |<small>Physical examination</small> | ! colspan="3" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |<small>Physical examination</small> | ||
|- | |- | ||
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| style="background: #F5F5F5; padding: 5px;" |<small>MRI abdomen</small> | | style="background: #F5F5F5; padding: 5px;" |<small>MRI abdomen</small> | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
| style="background: #F5F5F5; padding: 5px;" |Colonoscopy after resolution of inflammation | | style="background: #F5F5F5; padding: 5px;" |<small>Colonoscopy after resolution of inflammation</small> | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |<small>Hemorrhoids</small> | | style="background: #DCDCDC; padding: 5px; text-align: center;" |<small>Hemorrhoids</small> | ||
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| style="background: #F5F5F5; padding: 5px;" |<small>Anal pain</small> | | style="background: #F5F5F5; padding: 5px;" |<small>Anal pain</small> | ||
| style="background: #F5F5F5; padding: 5px;" |<small>Anal protrusion</small> | | style="background: #F5F5F5; padding: 5px;" |<small>Anal protrusion</small> | ||
| style="background: #F5F5F5; padding: 5px;" |<small>Skin tags</small> | |||
| style="background: #F5F5F5; padding: 5px;" |<small>Fistulas or fissures</small> | |||
| style="background: #F5F5F5; padding: 5px;" |<small>Prolapsed hemorrhoid</small> | |||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
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| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" |<small>External hemorrhoids - distal to dentate line.</small> | ||
<small>Internal hemorrhoids - proximal to dentate line.</small> | |||
| style="background: #F5F5F5; padding: 5px;" |<small>Anoscopy</small> | | style="background: #F5F5F5; padding: 5px;" |<small>Anoscopy</small> | ||
|- | |- | ||
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| style="background: #F5F5F5; padding: 5px;" |<small>Bowel habits change</small> | | style="background: #F5F5F5; padding: 5px;" |<small>Bowel habits change</small> | ||
| style="background: #F5F5F5; padding: 5px;" |<small>Weight loss</small> | | style="background: #F5F5F5; padding: 5px;" |<small>Weight loss</small> | ||
| style="background: #F5F5F5; padding: 5px;" |<small>Lmyphadenopathies</small> | |||
| style="background: #F5F5F5; padding: 5px;" |<small>Abdominal mass</small> | |||
| style="background: #F5F5F5; padding: 5px;" |<small>Hepatomegaly (metastasis)</small> | |||
| style="background: #F5F5F5; padding: 5px;" |<small>Tumor marker - CEA</small> | |||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
| style="background: #F5F5F5; padding: 5px;" |<small>CT with contrast chest, abdomen and pelvis</small> | |||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" |Majority of colorectal cancers are carcinomas. | ||
| style="background: #F5F5F5; padding: 5px;" |<small>Colonoscopy</small> | | style="background: #F5F5F5; padding: 5px;" |<small>Colonoscopy</small> | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |<small>Massive upper GI bleed</small> | | style="background: #DCDCDC; padding: 5px; text-align: center;" |<small>Massive upper GI bleed</small> | ||
| style="background: #F5F5F5; padding: 5px;" |Hematemesis | |||
| style="background: #F5F5F5; padding: 5px;" |Abdominal pain | |||
| style="background: #F5F5F5; padding: 5px;" |Melena | |||
| style="background: #F5F5F5; padding: 5px;" |Hemodynamic instability | |||
| style="background: #F5F5F5; padding: 5px;" |Upper abdominal tenderness | |||
| style="background: #F5F5F5; padding: 5px;" |Pale skin | |||
| style="background: #F5F5F5; padding: 5px;" |Acute bleeding - normocytic anemia | |||
| style="background: #F5F5F5; padding: 5px;" |Elevated BUN-to-Creatinine ratio >30:1 | |||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
| style="background: #F5F5F5; padding: 5px;" |CT angiography | |||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" |Endoscopy | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |<small>Inflammatory bowel disease</small> | | style="background: #DCDCDC; padding: 5px; text-align: center;" |<small>Inflammatory bowel disease</small> | ||
Revision as of 03:59, 3 September 2021
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Angiodysplasia differential diagnosis On the Web |
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Risk calculators and risk factors for Angiodysplasia differential diagnosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:
Overview
Angiodysplasia must be differentiated from other diseases that cause hematochezia, melena, and iron deficiency anemia , such as hemorrhoids, diverticular disease and colon cancer.
Differentiating Angiodysplasia from other Diseases
Angiodysplasia must be differentiated from diverticulitis, hemorrhoids, colon cancer, massive upper GI bleed and inflammatory bowel disease.
| Diseases | Clinical manifestations | Para-clinical findings | Gold standard | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Symptoms | Physical examination | |||||||||||||
| Lab Findings | Imaging | Histopathology | ||||||||||||
| Symptom 1 | Symptom 2 | Symptom 3 | Physical exam 1 | Physical exam 2 | Physical exam 3 | Lab 1 | Lab 2 | Lab 3 | Imaging 1 | Imaging 2 | Imaging 3 | |||
| Diverticulitis | Abdominal cramps | Bloating | Diarrhoea | Left lower quadrant abdominal tenderness | Bowel sounds hypoactive/normoactive | Fever | Leukocytosis | Elevated ESR and CRP | Radiological test of choice - CT of abdomen and pelvis with contrast | Abdominal Ultrasound | MRI abdomen | Colonoscopy after resolution of inflammation | ||
| Hemorrhoids | Hematochezia | Anal pain | Anal protrusion | Skin tags | Fistulas or fissures | Prolapsed hemorrhoid | External hemorrhoids - distal to dentate line.
Internal hemorrhoids - proximal to dentate line. |
Anoscopy | ||||||
| Colon cancer | Tenesmus | Bowel habits change | Weight loss | Lmyphadenopathies | Abdominal mass | Hepatomegaly (metastasis) | Tumor marker - CEA | CT with contrast chest, abdomen and pelvis | Majority of colorectal cancers are carcinomas. | Colonoscopy | ||||
| Massive upper GI bleed | Hematemesis | Abdominal pain | Melena | Hemodynamic instability | Upper abdominal tenderness | Pale skin | Acute bleeding - normocytic anemia | Elevated BUN-to-Creatinine ratio >30:1 | CT angiography | Endoscopy | ||||
| Inflammatory bowel disease | ||||||||||||||
| Angiodysplasia | ||||||||||||||