[Intestinal angiodysplasia--a diagnostic and therapeutic challenge]

During an eight-year period we have treated 10 patients for intestinal angiodysplasia complicated by major hemorrhage. This condition represents a degenerative, acquired lesion mostly in elder people consisting of thin-walled vessels of venous origin. Angiodysplasias are usually multiple and predominantly localized in the right colon. Besides localizing the bleeding source the exclusion of concomitant lesions capable of bleeding but not responsible for hemorrhage represents the main diagnostic problem. Segmental colectomy for angiodysplasia is rarely followed by rebleeding when preoperatively the site of hemorrhage has reliably been identified, mainly by angiography. Today the colonoscopic electro- or lasercoagulation of vascular ectasia represents a valuable alternative therapeutic procedure. Subtotal colectomy should be used only as a last resort.