Gastrointestinal angiodysplasia

Angiodysplasia of the gastrointestinal tract is common in the population 60 years of age and older and may be the cause of acute and/or chronic bleeding. Colonic angiodysplastic lesions are presumed to be degenerative in nature, secondary to either intermittent obstruction of the submucosal veins or hypoxemia. The pathogenesis of upper intestinal angiodysplasia is most likely related to a degenerative process. The clinical presentation varies from an incidental finding in an otherwise asymptomatic person to occult bleeding or an acute massive hemorrhage. Endoscopy and angiography are useful diagnostic modalities. Management options include surgery, endoscopic obliteration, or angiographic embolization of an identified bleeding angiodysplastic lesion(s). In a subset of patients who have angiodysplasia associated with Osler-Rendu-Weber disease or chronic renal failure, hormonal therapy with estrogen-progesterone may be efficacious.