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[Colorectal angiodysplasias (vascular ectasias). Endoscopic morphology, localization and incidence]
Abstract:
In a prospective study, angiodysplasias were looked for in 824 patients during total coloscopy. Such angiodysplasias were discovered in 30 patients (3.6%). The endoscopic morphology varied, most of the angiodysplasias being smaller than 5 mm (23 patients), with a homogeneous structure in 19, spider-like extensions in only 11 patients. In 13 patients there were multiple angiodysplasias. Two or more segments of the colon were affected in 7 patients. Site of lesions was as follows: in 19 patients in the caecum and/or ascending colon; descending colon, sigmoid and/or rectum in 16; transverse colon in 3 patients. Histological confirmation was obtained in 9 of 20 patients who had a biopsy. Right-sided colectomy for bleeding angiodysplasias (resulting in anaemia) is indicated only if endoscopic coagulation has failed and other colorectal sources of bleeding (neoplasm, diverticulum or polyp) and especially angiodysplasias in the left colon or rectum have been excluded by endoscopy or angiography.