Multiple Polypoid Angiodysplasia with Obscure Overt Bleeding

Area of Science:

• Gastroenterology
• Vascular Medicine
• Surgical Oncology

Background:

• Angiodysplasia (AD) is a significant cause of gastrointestinal bleeding.
• While flat lesions are common, polypoid AD is a rare morphological variant.
• Patients on antiplatelet therapy present unique challenges in managing gastrointestinal bleeding.

Purpose of the Study:

• To report a rare case of multiple polypoid angiodysplasia in the small bowel.
• To discuss the diagnostic and therapeutic challenges in managing this condition.
• To highlight the surgical approach for complex cases of angiodysplasia.

Main Methods:

• A 60-year-old male with a history of myocardial infarction on antiplatelet agents presented with severe anemia and hematochezia.
• Diagnostic workup included capsule endoscopy, enteroscopy, computed tomography, and angiography.
• Surgical resection was performed due to the multifocal nature and location of the lesions, and the risk associated with antiplatelet use.

Main Results:

• Multifocal polypoid vascular lesions were identified in the jejunum.
• Histological examination confirmed the diagnosis of angiodysplasia.
• The patient recovered well following surgical resection and resumed antiplatelet therapy.

Conclusions:

• Multiple polypoid angiodysplasia of the small bowel is a rare but significant cause of gastrointestinal bleeding.
• Surgical intervention may be necessary when endoscopic treatment is not feasible.
• Careful consideration of antiplatelet therapy is crucial in the management of patients with angiodysplasia.