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 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 good as the bleeding risk is low.
  • In 90% of cases, angiodysplasias stop bleeding spontaneously which might be the result of the venous nature of angiodysplasias.[3]
  • 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. 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.
  2. 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.
  3. Al-Mehaidib A, Alnassar S, Alshamrani AS (2009). "Gastrointestinal angiodysplasia in three Saudi children". Ann Saudi Med. 29 (3): 223–6. doi:10.4103/0256-4947.51786. PMC 2813652. PMID 19448365.

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