What is the role of angiodysplasia in the etiology of lower gastrointestinal (GI) bleeding (LGIB)?

Updated: Jul 26, 2019
  • Author: Burt Cagir, MD, FACS; Chief Editor: BS Anand, MD  more...
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Answer

Angiodysplasia is by far the most common vascular anomaly found in the GI tract. Although the lesions can occur anywhere in the GI tract, they occur most often in the proximal colon. Because bleeding from angiodysplasia is venocapillary in origin, it is generally less vigorous than diverticular bleeding. However, in contrast to diverticular bleeding, about 80% of patients with resolved but untreated angiodysplasia bleeding experience rebleeding. [17]

Saperas et al found that earlier bleeding with a high bleeding rate, overanticoagulation, and multiple angiodysplastic lesions predict an increased risk of recurrent bleeding due to angiodysplasia. [18] The investigators also noted that although there was a better trend for management and prevention of such recurrent bleeding with endoscopic argon plasma coagulation, this therapy was not predictive of a lower rate of hemorrhage recurrence. [18]

Angiodysplasia is believed to be associated with a number of medical conditions, including aortic stenosis, von Willebrand disease, and chronic renal failure. The incidence of angiodysplasia increases with age owing to degeneration of the vascular walls. Angiodysplasia was previously believed to be associated with the presence of aortic stenosis, but data supporting this relationship are lacking.


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