Angiodysplasia natural history, complications and prognosis: Difference between revisions
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==Natural History== | ==Natural History== | ||
* Small bowel angiodysplasia (SBA) contributes to 50% of obscure GI bleeding.<ref name="pmid26540240">{{cite journal| author=Holleran G, Hall B, Zgaga L, Breslin N, McNamara D| title=The natural history of small bowel angiodysplasia. | journal=Scand J Gastroenterol | year= 2016 | volume= 51 | issue= 4 | pages= 393-9 | pmid=26540240 | doi=10.3109/00365521.2015.1102317 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26540240 }} </ref> | *[[Small bowel]] angiodysplasia (SBA) contributes to 50% of obscure GI bleeding cases.<ref name="pmid26540240">{{cite journal| author=Holleran G, Hall B, Zgaga L, Breslin N, McNamara D| title=The natural history of small bowel angiodysplasia. | journal=Scand J Gastroenterol | year= 2016 | volume= 51 | issue= 4 | pages= 393-9 | pmid=26540240 | doi=10.3109/00365521.2015.1102317 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26540240 }} </ref> | ||
* SBA tends to re-bleed more than angiodysplasia of the colon and stomach. | *SBA tends to re-bleed more than angiodysplasia of the [[colon]] and [[stomach]]. | ||
* In a retrospective study, re-bleeding occurred after about 11 months of diagnosis in 80% of patients, and 3.5% died as a direct result of bleeding.<ref name="pmid26540240">{{cite journal| author=Holleran G, Hall B, Zgaga L, Breslin N, McNamara D| title=The natural history of small bowel angiodysplasia. | journal=Scand J Gastroenterol | year= 2016 | volume= 51 | issue= 4 | pages= 393-9 | pmid=26540240 | doi=10.3109/00365521.2015.1102317 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26540240 }} </ref> | *In a retrospective study, re-bleeding occurred after about 11 months of diagnosis in 80% of patients, and 3.5% died as a direct result of bleeding.<ref name="pmid26540240">{{cite journal| author=Holleran G, Hall B, Zgaga L, Breslin N, McNamara D| title=The natural history of small bowel angiodysplasia. | journal=Scand J Gastroenterol | year= 2016 | volume= 51 | issue= 4 | pages= 393-9 | pmid=26540240 | doi=10.3109/00365521.2015.1102317 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26540240 }} </ref> | ||
* Multiple lesions and valvular heart diseases have been found to increase the risk of re-bleeding. | *Multiple lesions and [[valvular heart diseases]] have been found to increase the risk of re-bleeding. | ||
* Apart from recurrence of bleeding, some other concerns in the natural history of angiodysplasia are transfusion requirements, hospital readmissions, and requirement endoscopic, pharmacological, or surgical therapy. | *Apart from recurrence of bleeding, some other concerns in the natural history of angiodysplasia are [[Blood transfusion|transfusion]] requirements, hospital readmissions, and requirement [[endoscopic]], [[pharmacological]], or surgical therapy. | ||
* In asymptomatic people, the course of angiodysplasia is benign, and the bleeding risk is low. Consequently, treatment is not required for incidentally found lesions.<ref name="pmid7717311">{{cite journal| author=Foutch PG, Rex DK, Lieberman DA| title=Prevalence and natural history of colonic angiodysplasia among healthy asymptomatic people. | journal=Am J Gastroenterol | year= 1995 | volume= 90 | issue= 4 | pages= 564-7 | pmid=7717311 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7717311 }} </ref> | *In [[asymptomatic]] people, the course of angiodysplasia is [[benign]], and the bleeding risk is low. Consequently, treatment is not required for incidentally found lesions.<ref name="pmid7717311">{{cite journal| author=Foutch PG, Rex DK, Lieberman DA| title=Prevalence and natural history of colonic angiodysplasia among healthy asymptomatic people. | journal=Am J Gastroenterol | year= 1995 | volume= 90 | issue= 4 | pages= 564-7 | pmid=7717311 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7717311 }} </ref> | ||
==Complications== | ==Complications== | ||
* | *[[Iron deficiency anemia|Iron-deficiency anemia]] | ||
*Death from excessive blood loss | *Death from excessive blood loss | ||
*Side effects from treatment | *Side effects from treatment | ||
Line 24: | Line 24: | ||
==Prognosis== | ==Prognosis== | ||
The prognosis of angiodysplasia in asymptomatic patients is favorable as the bleeding risk is low. | |||
In 90% of cases, angiodysplasias stop bleeding spontaneously. The venous nature of angiodysplasias may be the cause of the spontaneous cessation of bleed. | |||
Advanced age, severe bleeding and hemodynamic instability, and the presence of co-morbid medical conditions like coronary artery disease, type 2 diabetes mellitus may contribute to mortality in these cases. | |||
==References== | ==References== |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Nikita Singh, M.D.[2]
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Overview
Natural History
- Small bowel angiodysplasia (SBA) contributes to 50% of obscure GI bleeding cases.[1]
- SBA tends to re-bleed more than angiodysplasia of the colon and stomach.
- In a retrospective study, re-bleeding occurred after about 11 months of diagnosis in 80% of patients, and 3.5% died as a direct result of bleeding.[1]
- Multiple lesions and valvular heart diseases have been found to increase the risk of re-bleeding.
- Apart from recurrence of bleeding, some other concerns in the natural history of angiodysplasia are transfusion requirements, hospital readmissions, and requirement endoscopic, pharmacological, or surgical therapy.
- In asymptomatic people, the course of angiodysplasia is benign, and the bleeding risk is low. Consequently, treatment is not required for incidentally found lesions.[2]
Complications
- Iron-deficiency anemia
- Death from excessive blood loss
- Side effects from treatment
- Severe loss of blood from the GI tract
Prognosis
The prognosis of angiodysplasia in asymptomatic patients is favorable as the bleeding risk is low.
In 90% of cases, angiodysplasias stop bleeding spontaneously. The venous nature of angiodysplasias may be the cause of the spontaneous cessation of bleed.
Advanced age, severe bleeding and hemodynamic instability, and the presence of co-morbid medical conditions like coronary artery disease, type 2 diabetes mellitus may contribute to mortality in these cases.
References
- ↑ 1.0 1.1 Holleran G, Hall B, Zgaga L, Breslin N, McNamara D (2016). "The natural history of small bowel angiodysplasia". Scand J Gastroenterol. 51 (4): 393–9. doi:10.3109/00365521.2015.1102317. PMID 26540240.
- ↑ Foutch PG, Rex DK, Lieberman DA (1995). "Prevalence and natural history of colonic angiodysplasia among healthy asymptomatic people". Am J Gastroenterol. 90 (4): 564–7. PMID 7717311.