Acquired angiodysplasia as a cause of gastric hemorrhage: a possible consequence of cholesterol embolization

A patient with aortic stenosis and gastrointestinal bleeding due to angiodysplastic (telangiectatic) lesions in the stomach is presented. Biopsy of the lesions showed cholesterol emboli with granuloma formation, intramucosal vascular obstruction, subepithelial ectatic vessels, and epithelial atrophy. The case history appeared to indicate the formation of new lesions over time and a tendency to a regression of some of the least advanced lesions. It is suggested that cholesterol showers from the aortic valve or atheromatous aortic plaques may be one cause of acquired angiodysplastic lesions in the gastrointestinal tract.