Angiodysplasia natural history, complications and prognosis
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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.
- 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.
- 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.
Complications
- Anemia
- Death from excessive blood loss
- Side effects from treatment
- Severe loss of blood from the GI tract
Prognosis
Patients who have bleeding related to this condition despite having had a colonoscopy, angiography, or surgery are likely to have more bleeding in the future. The outlook remains good if the bleeding is controlled.