Angiodysplasia Flashcards
what is angiodysplasia?
A degenerative vascular malformation (specifically dilated arteriovenous malformation) of previously healthy blood vessels in the GI tract
angiodysplasia etymology?
angio - vessel
dys- bad
plasia - formation
what happens to vessel diameter?
what does this cause?
wide (BVs dilated)
bleeding –> anaemia
in angiodysplasia, which BVs (arteries or veins) is particularly dialted?
veins
Locations of angiodysplasia?
-2
and %?
small bowel (15%) large bowel (77%)
in which parts of large bowel is there most angiodysplasia?
ascending colon and caecum
what can be said about the sort of bleeding that occurs?
- 5 features
no pain intermittent ceases spontaneously 90% of time it is not a lot of bleeding episodes between bleeding can be really long
Massive haemorrhage never occurs with angiodysplasia.
true or false?
false
RFs?
-3
Age
Von Willebrand disease
End-stage Renal disease
how can you differentiate if it is a upper GI or lower GI bleeding on the symptoms?
Melaena – Upper GI bleed
Fresh rectal bleeding – Lower GI bleed
symptoms for a low grade bleed?
-5
SOB Fatigue Weakness Pallor Melaena or fresh rectal bleeding
symptoms for a high grade bleed/massive haemorrhage?
-2
Haematochezia
Haematemesis
define Haematochezia?
fresh blood passing through anus
define Haematemesis?
vomit blood
Haematochezia etymology?
haem - blood
chezia - to defecate
Haematemesis etymology?
haem - blood
emesis - vomit
symptoms for a low grade bleed?
-5
SOB Fatigue Weakness Pallor Melaena or fresh rectal bleeding
with angiodysplasia, why does pt experience SOB Fatigue Weakness Pallor
because of anaemia/
there are classic symptoms & signs of anaemia
Gold.S Ix for upper GI bleed?
endososcopy
Gold.S Ix for lower GI bleed?
Colonoscopy
1st line blood Ix for angiodysplasia? (1)
result?
FBC - anaemia (low Hb)
which lab test can be used to check if stool has blood in it?
Faecal occult blood test
if acute massive haemorrhage or endoscopy inconclusive what is the 2nd line Ix to diagnose?
Mesenteric angiography
1st line definitive treatment?
for a low grade bleed
Endoscopic argon plasma coagulation
2nd line definitive treatment?
for a low grade bleed
Mesenteric angiography with transcatheter superselective embolisation (interventional radiology)
1st line definitive treatment?
(for acute massive haemorrhage)
under this method what gets deployed at the bleeding site to stop the bleeding?
Mesenteric angiography with superselective transcatheter embolisation (interventional radiology)
platinum coil
explain argon plasma coagulation?
Probe ejects stream of argon gas, electric current from the same probe ionises the argon gas to create plasma. Plasma is hot, the heat cauterises the lesion (thermal effect).
vitals for high grade bleed?
-2
Hypotension
Tachycardia
