Angiodysplasia Flashcards
What is angiodyplasia?
formation of arteriovenous malformations between previously healthy blood vessels e.g. in Caecum and ascending colon
What does acquired angiodypasia begin as?
reduced submucosal venous drainage in the colon due to chronic and intermittent contractions of the colon, giving rise to dilated and tortuous veins, this causes loss of pre-capillary sphincter competency and then forms small arterio venous communications- small tuft of dilated vessels
What are some congenital causes of angiodysplasia?
Hereditary haemorrhagic telangiectasia and heyde syndrome
What are some clinical features of angiodysplasia?
Rectal bleeding and anaemia, may be present as haematemesis or malena
How does angiodysplasia present?
Asymptomatic and found in a colonoscopy, painless PR bleed, acute haemorrhage
What are the differential diagnosis of angiodysplasia?
oesophageal varices, GI malignancy, diverticular disease, coagulopathy
What blood tests should be done in angiodysplasia?
routine bloods, FBC as 10% will have iron deficiency anaemia, U and E, LFTs and clotting, group and save, cross match
what imaging would be done for someone with angiodysplasia?
upper GI endoscopy and or colonoscopy depending on bleeding site, can also do a wireless capsule endoscopy, mesenteric angiography
what are the risk factors for a poor outcome with angiodysplasia?
advancing age, liver disease, hypovolaemic shock and inpatients
What is the supportive treatment for anigiodysplasia?
bed rest, iv fluid, tranexamic acid
What are some management options for persistant or severe angiodysplasia?
Endoscopy- use electrical current and argon
Mesenteric angiography- small bowel lesions that cant be treated endoscopically, catheterise and embolism
Surgery can be done with resection and anastomosis od bowel
What are the complications of angiodysplasia?
Re bleeding post therapy
