Angiodysplasia history and symptoms

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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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History

• Many patients with angiodysplasia lack symptoms. Others present with GI bleeding or its consequences.
• The incidence of active GI bleed in patients with angiodysplasia is less than 10%. However, because these lesions may be located throughout the GI tract and because the rate of bleeding may be variable, presentation ranges from bloody vomiting or rectal bleeding to occult iron deficiency anemia.
• Bleeding is usually chronic or recurrent and, in most cases, low grade and painless because of the venous source.
• GI bleeding from small bowel lesions has occurred in as many as 22% of patients. In 50% of patients with gastric/stomach and duodenal angiodysplasia have multiple lesions / EGD with colon lesions associated in 20%. Lesions in the colon are more frequently multiple than single.
• Bloody vomit frequently is observed in patients with angiodysplasia of the upper GI tract. Presentation with low grade chronic bleeding is typical and may have had bleeding from days to years. Bleeding from colon lesions most often is chronic and low grade, but as many as 15% of patients present with acute massive hemorrhage.
• Patients may present with rectal bleeding (0-60%), melena (passing black tarry bloody stool) (0-26%), occult blood positive stool (4-47%), or iron deficiency anemia (0-51%).
• Spontaneous cessation of bleeding (90%) is the rule for lesions located in any part of the GI tract

Symptoms

• Hematochezia ( 60%)
• Melena ( 26%)
• Hematemesis observed in angiodysplasia of the upper GI tract.