Related Experiment Videos
Angiodysplasia. Clinical presentation and colonoscopic diagnosis
Insights
Angiodysplasia, a cause of lower intestinal bleeding, is increasingly diagnosed by colonoscopy. This study found colonoscopy effective, especially for right-sided lesions, recommending it as an initial diagnostic tool.
Area of Science:
- Gastroenterology
- Diagnostic Imaging
Background:
- Angiodysplasia is an emerging cause of lower intestinal bleeding in elderly patients.
- While angiography is established, colonoscopy is increasingly used for diagnosis.
Purpose of the Study:
- To define the bleeding characteristics of angiodysplasia.
- To determine the role of colonoscopy in diagnosing angiodysplasia.
Main Methods:
- Review of 80 patients diagnosed with angiodysplasia via angiography, pathology, or colonoscopy.
- Comparison of colonoscopy findings with angiography and pathology results.
Main Results:
- Bleeding ranged from severe hemorrhage to occult blood.
- 89% of lesions were in the right colon; mean 1.5 lesions/patient.
- Colonoscopy sensitivity was 68% overall, 81% for colonic lesions with complete examination.
- Predictive value of positive colonoscopy was 90%.
Conclusions:
- Colonoscopy is a valuable tool for diagnosing angiodysplasia.
- Recommended as an initial study for chronic or mild acute rectal bleeding.
Abstract:
Angiodysplasia is a recently recognized important cause of lower intestinal bleeding in older patients. Although angiography is an established procedure for the diagnosis of angiodysplasia, colonoscopy is being used increasingly for evaluation of lower intestinal bleeding. In order to define the nature of bleeding due to angiodysplasia and the appropriate role of colonoscopy, 80 patients diagnosed by angiography, pathology, or colonoscopy were reviewed. Bleeding attributable to angiodysplasia varied from acute life-threatening hemorrhage to occult blood in stools. Thirteen patients with angiodysplasia had no bleeding and were identified incidentally by colonoscopy performed for other indications. Eighty-nine percent of the lesions were located in the right colon and there was a mean of 1.5 angiodysplastic lesions per patient. The sensitivity of colonoscopy compared to angiography and pathology was 68% overall and 81% when the colon was completely examined and lesions were located in the colon. The predictive value of a positive colonoscopic diagnosis was 90% in this population. Colonoscopy should be employed as an initial study in patients with chronic or mild acute rectal bleeding.