Angiodysplasia

Question 1

Angiodysplasia

Answer 1

• one or multiple small (<5mm) mucosal or submucosal vascular malformations (dilated vein)
• common in elderly
• degenerative vascular anomalies
• common site: caecum and ascending colon

Question 2

Clinical feature

Answer 2

• bleeding (continuous chronic intestinal blood loss)
• anaemia
• recurrent acute dark or bright red rectal haemorrhage

Question 3

investigation

Answer 3

Colonoscopy

• bright red 0.5-1cm diameter submucosal lesions with small, dilated vessels visible on close inspection
• invisible in barium enema

Mesenteric angiogram
- contrast medium leak into bowel lumen

Question 4

Treatment

Answer 4

• blood transfusion
• colonoscopic electrocoagulation or argon plasma coagulation
• resection (right hemicolectomy)