What's Angiodysplasia? - Short notes

Angiodysplasia is a common (and is the most common) vascular lesion found in the gastrointestinal tract.

It's a degenerative change of blood vessels that occurs in previously normal vessels. The blood vessel smooth muscle layer becomes thin and the vessel wall becomes weak and ectatic and can easily rupture leading to significant acute or chronic bleeding (causing iron deficiency anemia).

Although it manifests with gastrointestinal bleeding, it can be asymptomatic for long time.  

During endoscopy they appear as small bright red spots, sometimes shows spider-like appearance of the vessels.

They occur in any part of the gastrointestinal tract, most commonly the cecum and the ascending colon.

Angiodysplasia is diagnosed by :

·       Endoscopy (Upper and/or lower)

·       Small-bowel enteroscopy

·       Mesenteric angiography: for localizing active bleeding that cannot be localized by endoscopy

·       Capsule enteroscopy: to detect small-bowel angiodysplasia

Treatment:

·       Endoscopy with Argon Plasma Coagulation (APC)

·       Embolisation of the bleeding lesion detected during angiography.

·       Octreotide: helps decrease bleeding

·       Surgery : for numerous lesions or severe refractory bleeding

·       Long-term iron supplement

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