Angiodysplasia: Lower Intestinal Blood Loss
Causes
The primary theory regarding the cause is colon spasms leading to blood vessel enlargement. This is most commonly found in older patients due to the degeneration that occurs in blood vessels with aging.
It may be related to other blood vessel diseases such as Osler-Weber-Render syndrome. It is different from diverticulitis, which is also a common intestinal bleeding condition in older patients.
Images of angiodysplasic lesions may be viewed on endoatlas.com.
Symptoms
Though symptoms may vary, the most common are:
- Shortness of breath
- Anemia
- Fatigue
- Weakness
- Mild or severe bleeding episodes (bright red blood coming from rectum)
- Dark or black, tarry stools
Pain is not a symptom of angiodysplasia, but abdominal pain is associated with diverticulitis.
Diagnosis
Several different tests may be used to diagnose this condition. They include colonoscopy, stool guaiac test, angiography and CBC.
Treatment
Because bleeding from the colon can be a serious issue, it is important that a patient get diagnosed quickly. Rapidity of blood loss as well as source of the bleeding will help determine the treatment course taken.
Hospital admittance may be in order along with the administration of IV fluids.
Other possible courses of treatment include cauterization, argon plasma coagulation, and surgery in some instances. Surgery is only used in extreme cases of blood loss in which other treatments have failed. Right helicolectomy (surgical removal of the right side of the colon) is the name of this surgical procedure.
Complications include side effects from the treatment and problems related to blood loss such as anemia and death.
Prognosis
The prognosis is good for patients in which the bleeding can be controlled. For other patients, the likelihood of re-occurrence is high, and the goal then becomes to minimize or eliminate, where possible, the number of future reoccurrences through therapy.
Sources
Angiodysplasia of the colon. Medline Plus. U.S. National Library of Medicine and the National Institutes of Health. Updated 1/28/2009 by David Dugdale, III, MD; George F Longstreth, MD. Reviewed by David Zieve, MD, MHA.
Angiodysplasia of the colon – Overview. University of Maryland Medical Center. Updated 1/28/2009 by David Dugdale, III, MD; George F Longstreth, MD. Reviewed by David Zieve, MD, MHA.
Angiodysplasia. Springerlink – Journal Articles. James M Richter, Marci R Christensen, Graham A Colditz and Norman S Nishioka. June 24, 1988.
Diverticulitis. Medline Plus. U.S. National Library of Medicine and the National Institutes of Health. Updated 1/28/2009 by David Dugdale, III, MD; George F Longstreth, MD. Reviewed by David Zieve, MD, MHA.
