Gastrointestinal angiodysplasia: a possible component of von Willebrand's disease

Evidence in the literature suggests that von Willebrand's disease constitutes part of a mesenchymal syndrome accompanied by coagulopathy. The cases of two patients with symptomatic intestinal angiodysplasia and concurrent von Willebrand's disease are summarized along with the eight cases previously reported in the literature. All ten cases were in adults ranging in age from 34 to 80 years (average, 58 years). The vascular lesions were located in the stomach or duodenum (four cases), right colon (three cases), and terminal ileum (two cases). One patient had angiodysplasia of the stomach, jejunum, and sigmoid colon. While the prevalence is unknown, these ten cases linking gastrointestinal angiodysplasia with von Willebrand's disease appear to reflect an association greater than more coincidence. Coagulation testing, including determination of template bleeding time and partial thromboplastin time, should probably be performed in all patients bleeding from gastrointestinal angiodysplasia to screen for von Willebrand's disease.