Intestinal vascular ectasias: a new look at an old disease

Seventeen patients had rectal bleeding and intestinal vascular ectasia. Actual bleeding from the ectasia was seen in five patients. The average age of the 17 patients was 60.2 years, but 41% were under the age of 60. Melena was common initially. Both colonoscopy and angiography had a high degree of diagnostic accuracy, but angiography failed to demonstrate some lesions seen by colonoscopy. We consider these examinations complementary. Intraoperative endoscopy with transillumination was of value of determining the distribution of those lesions that had not been completely demonstrated by colonoscopy and angiography. We have used intraoperative endoscopy to guide the eventual amount of bowel resection, and intraoperative marking with this technic has resulted in a more specific pathologic examination. There has been no operative mortality. Six patients have re-bled from sources other than vascular ectasia.