Bleeding angiodysplasia of the colon

Abstract

Angiodysplasia should be considered in the differential diagnosis of hematochezia, gastrointestinal bleeding of obscure origin, and chronic iron deficiency anemia. Although the current medical literature lacks well-designed studies of the various therapeutic modalities, several conclusions appear warranted. Diagnosis of the bleeding site during colonoscopy and the use of endoscopic hemostasis techniques (electrocautery or laser) controls bleeding and may prevent rebleeding. When rebleeding occurs, it may be from the previously treated site or a different location. Estrogen-progestin therapy has not been shown effective in controlled trials but is used when other options fail. Surgery should be considered only when endoscopic therapy fails and the site of bleeding is localized. With all therapies, patients should be cautioned regarding the risk of recurrent bleeding.

Pharmacological Therapy of Vascular Malformations of the Gastrointestinal Tract

“…Junquera et al (22) also noted that the risk of rebleeding was amplified with an increasing transfusion requirement before current bleeding. In contradistinction, a summary of reports of various coagulative therapy for both upper and lower GI bleeds resulting mainly from AD is shown in In view of success achieved with endoscopic therapy, the primary role of surgery has diminished (35). Interestingly, however, an earlier comparison of outcomes among patients treated surgically, endoscopically or with nonpharmacological supportive therapy showed no significant differences in outcomes among the three modalities of treatment.…”