Bleeding Angiodysplasia of the Colon

Angiodysplasia should be considered in the differential diagnosis of hematochezia, gastrointestinal bleeding of obscure origin, and chronic iron deficiency anemia. Although the current medical literature lacks well-designed studies of the various therapeutic modalities, several conclusions appear warranted. Diagnosis of the bleeding site during colonoscopy and the use of endoscopic hemostasis techniques (electrocautery or laser) controls bleeding and may prevent rebleeding. When rebleeding occurs, it may be from the previously treated site or a different location. Estrogen-progestin therapy has not been shown effective in controlled trials but is used when other options fail. Surgery should be considered only when endoscopic therapy fails and the site of bleeding is localized. With all therapies, patients should be cautioned regarding the risk of recurrent bleeding.