Jejunal angiodysplasia presenting as acute lower gastrointestinal bleeding

Vascular malformations of the bowel are uncommon sources of gastrointestinal (GI) tract bleeding with the majority of cases occurring in the right colon in elderly patients. Angiodysplasia can be difficult to diagnose, thereby complicating management as well. In the past, the diagnosis of angiodysplasia was rarely made early and rested upon a high index of suspicion in patients with lower GI bleeding and multiple negative diagnostic evaluations. Consequently, surgery was often performed late with increased morbidity and high recurrence rates. With the advent of pre- and intraoperative selective angiography, these vascular malformations are readily demonstrated in most cases and will often respond to conservative interventional radiologic procedures. Failing this, angiographic localization has made segmental resection both safe and quite accurate, thus obviating extensive, blind excision.