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 e.g., subcutaneous emphysema,[3] perforation of the bowel during argon plasma coagulation[4]
- 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.[5]
- 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.
- ↑ Herrera S, Bordas JM, Llach J, Ginès A, Pellisé M, Fernández-Esparrach G; et al. (2008). "The beneficial effects of argon plasma coagulation in the management of different types of gastric vascular ectasia lesions in patients admitted for GI hemorrhage". Gastrointest Endosc. 68 (3): 440–6. doi:10.1016/j.gie.2008.02.009. PMID 18423466.
- ↑ Ben Soussan E, Mathieu N, Roque I, Antonietti M (2003). "Bowel explosion with colonic perforation during argon plasma coagulation for hemorrhagic radiation-induced proctitis". Gastrointest Endosc. 57 (3): 412–3. doi:10.1067/mge.2003.131. PMID 12612532.
- ↑ 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.