Angiodysplasia of the colon is a condition of stretched and fragile blood vessels in the colon that results in occasional loss of blood from the gastrointestinal (GI) tract. Angiodysplasia of the colon is not related to cancers or other disease of the blood vessels. Men and women are equally at risk for developing angiodysplasia of the colon. Most patients are older than 50 years. Patients who have bleeding angiodysplasia despite having had colonoscopy, angiography, or surgery, are likely to have more bleeding in the future.
Angiodysplasia of the colon has been seen in about 3% of "nonbleeding persons" and in about 5% of patients evaluated for blood in the stool, anemia, or hemorrhage. The exact mechanism of development of angiodysplasia is not known. One prominent hypothesis accounts for the high prevalence of these lesions in the right colon and is based on the Laplace law. Angiodysplasia occurs with equal frequency in men and women.
Angiodysplasia Treatment
Diagnosis of angiodysplasia is often accomplished with endoscopy , either colonoscopy or esophagogastroduodenoscopy (EGD). Once the source of the bleeding is found (usually by angiography or colonoscopy), treatment can begin. As many as 90% of vascular ectasias stop bleeding on their own without any treatment. Selective infusion of vasopressin is less effective than embolization.
Symptoms of Angiodysplasia
The symptoms vary. Often, in elderly patients, the symptoms are anemia, weakness, fatigue, and shortness of breath. In most cases, bleeding presents as bright red blood but also can be maroon in color or melena. There may not be any signs of bleeding directly from the colon. Others may have occasional mild or severe bleeding episodes with bright red blood coming from the rectum.
- Usually occurs after age 70 but can be seen after age 50
- Usually painless
- Bleeding may be in tiny amounts and lead to fatigue, weakness, and shortness of breath secondary to anemia.
- Bright red blood passed from rectum (bleeding may be massive)
- Tarry black stool (melena)
- Vomiting blood or coffee-ground material
Angiodysplasia Caues
- Damaged veins as above
- Congenital (born with these abnormal vessel connections)
- Hereditary hemorrhagic telangiectasia (a rare genetic disease)
- Autoimmune diseases such as Scleroderma