19th July 2023

Angiodysplasia

Angiodysplasia is the presence of vascular malformations in the GI tract, most commonly the ascending colon and caecum. This results in fragile blood vessels that are prone to leaking, causing GI bleeding. This disease predominantly affects older patients but is also found in those with aortic stenosis, end stage renal failure requiring dialysis, left ventricular assist devices and Von Willebrand disease. Patients may be asymptomatic, or present with GI bleeding and/or symptoms of iron deficiency anaemia. Diagnosis is made during endoscopy (upper GI, colonoscopy and/or capsule endoscopy) or CT angiography if persistent active GI bleeding. Management involves stabilisation with fluid and blood products if bleeding causes haemodynamic instability and, if persistent, uncontrollable bleeding, treatment options include mesenteric angiography and embolisation, colonoscopy with electrocautery, photocoagulation, clipping or epinephrine injections, or surgical bowel resection.