Angiodysplasia differential diagnosis

Angiodysplasia Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Angiodysplasia from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
History and Symptoms
Physical Examination
Laboratory Findings
CT
MRI
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Angiodysplasia differential diagnosis On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Angiodysplasia differential diagnosis All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Angiodysplasia differential diagnosis
CDC on Angiodysplasia differential diagnosis
Angiodysplasia differential diagnosis in the news
Blogs on Angiodysplasia differential diagnosis
Directions to Hospitals Treating Angiodysplasia
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: Nikita Singh, M.D.[2]

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 from other diseases that cause hematochezia, melena, and iron deficiency anemia such as:

• Diverticulitis
• Hemorrhoids
• Colon cancer
• Massive upper GI bleed
• Inflammatory bowel disease

Diseases	Clinical manifestations						Para-clinical findings							Gold standard
	Symptoms			Physical examination
							Lab Findings			Imaging			Histopathology
	Abdominal pain	Lower GI Bleed	Symptom 3	Physical exam 1	Physical exam 2	Physical exam 3	Lab 1	Lab 2	Lab 3	Imaging 1	Imaging 2	Imaging 3
Diverticulitis	+	+	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	- (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	+/-	+/-	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	+	+	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	+	+/-	Abdominal pain	Tachycardia, fever,	Occult blood on digital rectal exam	Anal fistulas, abscesses	Microcytic anemia	Leukocytosis	Elevated ESR, CRP	Abdominal X ray - free air, bowel obstruction, toxic megacolon	Barium studies	Ultrasound/CT/MRI	UC- crypt abscess Crohn's- transmural involvement, granulomas	Endoscopy
Angiodysplasia	-	+ (occult)	No abdominal pain	Signs of anemia	Systolic ejection murmur (if aortic stenosis)	Rarely, orthostasis or hypotension	Microcytic anemia	Renal and liver function tests	Coagulation studies	Radionuclide scanning	CTA/MRA	Upper GI endoscopy and colonoscopy	Tortuous, dilated veins, venules and capillaries in the colonic mucosa and submucosa	Endoscopy