Abstract
Angiodysplasia is a recently recognized important cause of lower intestinal bleeding in older patients. Although angiography is an established procedure for the diagnosis of angiodysplasia, colonoscopy is being used increasingly for evaluation of lower intestinal bleeding. In order to define the nature of bleeding due to angiodysplasia and the appropriate role of colonoscopy, 80 patients diagnosed by angiography, pathology, or colonoscopy were reviewed. Bleeding attributable to angiodysplasia varied from acute life-threatening hemorrhage to occult blood in stools. Thirteen patients with angiodysplasia had no bleeding and were identified incidentally by colonoscopy performed for other indications. Eighty-nine percent of the lesions were located in the right colon and there was a mean of 1.5 angiodysplastic lesions per patient. The sensitivity of colonoscopy compared to angiography and pathology was 68% overall and 81% when the colon was completely examined and lesions were located in the colon. The predictive value of a positive colonoscopic diagnosis was 90% in this population. Colonoscopy should be employed as an initial study in patients with chronic or mild acute rectal bleeding.
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Boley SJ, DiBiase A, Brandt LJ, Sammartano RJ: Lower intestinal bleeding in the elderly. Am J Surg 137:57–64, 1979
Marx FW Jr, Gray RK, Duncan AM, Bakhtier L: Angiodysplasia as a source of intestinal bleeding. Am J Surg 134:125–130, 1977
Meyer CT, Troncale FJ, Galloway S, Sheahan DG: Arteriovenous malformations of the bowel: An analysis of 22 cases and a review of the literature. Medicine 60:36–48, 1981
Baum S, Athanasoulis CA, Waltman AC, Galdabini JJ, Schapiro RH, Warshaw AL, Ottinger LW: Angiodysplasia of the right colon: A cause of gastrointestinal bleeding. Am J Roentgenol 129:789–794, 1977
Boley SJ, Sammartano R, Adams A, DiBiase A, Kleinhaus S, Sprayregen S: On the nature and etiology of vascular ectasias on the colon; degenerative lesions of aging. Gastroenterology 72:650–660, 1977
Mitsudo SM, Boley SJ, Brandt LJ, Montefusco CM, Sammartano RJ: Vascular ectasias of the right colon in the elderly: A distinct pathologic entity. Hum Pathol 10:585–600, 1979
Case Records of the Massachusetts General Hospital. 36-1974. N Engl J Med 291:569–575, 1974
Athanasoulis CA, Galdabini JJ, Waltman AC, Novelline RA, Greenfield AJ, Ezpeleta ML: Angiodysplasia of the colon: A cause of rectal bleeding. Cardiovasc Radiol 1:3–13, 1978
Max MH, Richardson JD, Flint LM, Knutson CO, Schwesinger W: Colonoscopic diagnosis of angiodysplasias of the gastrointestinal tract. Surg Gynecol Obstet 152:195–199, 1981
Tedesco FJ, Griffin JW, Khan AQ: Vascular ectasia of the colon: Clinical, colonoscopic and radiographic features. J Clin Gastroenterol 2:233–238, 1980
Howard OM, Buchanan JD, Hunt RH: Angiodysplasia of the colon: Experience of 26 cases. Lancet 2:16–19, 1982
Miller KD, Tutton RH, Bell KA, Simon BK: Angiodysplasia of the colon. Radiology 132:309–313, 1979
Moore JD, Thompson NW, Appelman HD, Foley D: Arteriovenous malformations of the gastrointestinal tract. Arch Surg 111:381–388, 1976
Baer JW, Ryan S: Analysis of cecal vasculature in the search for vascular malformations. Am J Roentgenol 126:394–405, 1976
Teague RH, Thornton JR, Manning AP, Salmon PR, Read AE: Colonoscopy for investigation of unexplained rectal bleeding. Lancet 1:1350–1352, 1978
Tedesco TJ, Pickens CA, Griffin JW Jr, Sivak MV Jr, Sullivan BH Jr: Role of colonoscopy in patients with unexplained melena; analysis of 53 patients. Gastrointest Endosc 27:221–223, 1981
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Richter, J.M., Hedberg, S.E., Athanasoulis, C.A. et al. Angiodysplasia. Digest Dis Sci 29, 481–485 (1984). https://doi.org/10.1007/BF01296266
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DOI: https://doi.org/10.1007/BF01296266