Mucosal biopsy of vascular ectasia (angiodysplasia) of the large bowel detected during routine colonoscopic examination

Stamm, Bernhard; Heer, M; Bühler, H; Ammann, R

doi:10.1111/j.1365-2559.1985.tb02844.x

Cited by 23 publications

(3 citation statements)

References 15 publications

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“…Similar to our case, endoscopic biopsy is generally of low diagnostic yield as significant histological abnormalities are submucosal in angiodysplasia 12. Histologically, these lesions consisted of dilated, distorted, tortuous, thin-walled vessels that were lined by endothelium, with little or no smooth muscle and no inflammation, fibrosis, or atherosclerosis 13.…”

Section: Discussionsupporting

confidence: 71%

Solitary Polypoid Angiodysplastic Lesion Mimicking a Tumor in the Jejunum

Polavarapu

Kesavan

Gumaste

et al. 2017

ACG Case Reports Journal

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Small bowel bleeding should be considered in patients with overt or occult gastrointestinal hemorrhage after normal upper and lower endoscopic examination. Angiodysplasia appearing as multiple flat vascular tufts is the most common cause of small bowel bleeding in patients over 40 years old. Polypoid angiodysplasia, however, is extremely rare. This report illustrates a unique case of solitary polypoid angiodysplasia in the jejunum of an adult with chronic kidney disease, who presented with an occult gastrointestinal bleed. The angiodysplasia mimicked tumorous growth, potentially indicative of malignant neoplasm. The patient underwent surgical resection and was histologically diagnosed as having angiodysplasia.

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Section: Discussionsupporting

confidence: 71%

Solitary Polypoid Angiodysplastic Lesion Mimicking a Tumor in the Jejunum

Polavarapu

Kesavan

Gumaste

et al. 2017

ACG Case Reports Journal

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“…Stamm et al 19 concluded that this finding confirms the endoscopic diagnosis of vascular ectasia, but it must be emphasized that ectatic vessels may be present in the lamina propria with other conditions, such as diverticulosis, 20 in the stalk of an adenomatous polyp, and at an anastomotic site.…”

Section: P Resentation Of C Asementioning

confidence: 66%

Case 34-1995

Castillo¹,

Ahmed²

1995

N Engl J Med

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A 77-year-old woman was admitted to the hospital because of chronic gastrointestinal bleeding with increasing weakness and dyspnea.There was a 17-year history of gastrointestinal bleeding with an undetermined source, despite extensive evaluation on multiple admissions to this hospital that were characteristically complicated by severe anemia, with hematocrit levels as low as 13 percent, and congestive heart failure. Seven of the hospitalizations were during the two years before the current admission, and the most recent was four months before the current admission. During the 10 years before admission, the patient had received approximately 240 transfusions. Detailed panendoscopic examinations with angiographic studies 12 and 18 years before admission were unrevealing, and repeated upper and lower gastrointestinal endoscopic examinations in more recent years also failed to disclose the source of bleeding. During the three months before admission, the number of transfusions required increased to one or two every other week. Ten days before admission the patient had a hematocrit of 20 percent and was given two transfusions. After a day of improvement she had increasing weakness and dyspnea and was readmitted to the hospital.There was a history of chronic atrial fibrillation that was managed with digoxin; anticoagulant therapy was not considered a reasonable option. A cardiac ultrasonographic study, performed five months before admission, revealed left ventricular hypertrophy, with an ejection fraction of 61 percent and mild mitral regurgitation. The patient had had an appendectomy many years earlier. A right radical mastectomy had been performed 34 years before admission. She had had a stroke 25 years before admission, which resolved without residual problems. Twenty months before admission the patient had a bout of acute renal failure that was ascribed to treatment with trimethoprim-sulfamethoxazole, with an increase in the creatinine level to 3.7 mg per deciliter (330 m mol per liter); in recent months her base-line creatinine level had been 2.0 mg per deciliter (180 m mol per liter). An infiltrating ductal carcinoma of the left breast, demonstrated on biopsy nine months before admission, was managed by a lumpectomy; tamoxifen provoked nausea and vomiting and was discontinued. A left nephrectomy had been performed 30 years before admission, after multiple urologic procedures for urolithiasis. The patient had stopped smoking many years earlier and drank no alcohol. There was no history of hypertension, angina pectoris, or myocardial infarction.The temperature was 36.8 ° C, the pulse was 70, and the respirations were 28. The blood pressure was 150/80 mm Hg. The weight was 85.9 kg.On physical examination the patient was pale, massively obese, and in moderate respiratory distress. No lymphadenopathy was found. The head and neck were normal; the jugular venous pressure was obscured. Inspiratory crackles were heard over the lower third of both lung bases. The heart rhythm was irregular; S 2 was normally split, and a gr...

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“…Histologically, angiodysplasia resembles telangiectasia, and is characterized by dilated and tortuous vessels. 16) Intracranial aneurysm associated with angiodysplasia is rarely reported. 2,7) The present case has several unique points: two large intracranial aneurysms identified at a young age (21 years); association of nevi, which were histologically confirmed as angiodysplasia; and revascularization after surgical occlusion within a short time (11 days).…”

Section: Discussionmentioning

confidence: 99%

Rapid Revascularization After Therapeutic Parent Artery Occlusion for a Large Intracavernous Carotid Artery Aneurysm -Case Report-

Kagawa

Shimizu

Matsumoto

et al. 2007

Neurol. Med. Chir.(Tokyo)

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A 21-year-old woman presented with an unruptured large intracavernous aneurysm, which was spontaneously revascularized via unusual collateral pathways a short time after extracranial-intracranial bypass and surgical ligation of the proximal internal carotid artery. The patient had been treated for a large basilar trunk aneurysm with intraaneurysmal embolization using Guglielmi detachable coils, and an intracavernous carotid artery aneurysm treated conservatively. Two years later, the patient presented with right abducens nerve palsy, and was referred to our hospital. She had small nevi in the right forehead and eyelid. Cerebral angiography revealed enlargement of the intracavernous aneurysm. Superficial temporal artery-middle cerebral artery bypass followed by surgical carotid artery ligation were performed, and good patency of bypass and disappearance of the aneurysm were confirmed by intraoperative angiography. However, follow-up magnetic resonance angiography and cerebral angiography on the 20th postoperative day revealed revascularization of the internal carotid artery and the intracavernous carotid artery aneurysm via unusual collateral pathways. Subsequently, the recurrent aneurysm and the recanalized internal carotid artery were occluded by endovascular procedures. Histological examination of the nevus showed lack of properly organized vascular structures, and the diagnosis was angiodysplasia. The early development of unusual collateral pathway, and aneurysm formation at a young age might be related to the angiodysplasia. Revascularization is possible within a short time even in cases of intracavernous carotid artery aneurysm successfully treated with surgical ligation of the parent artery.

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Mucosal biopsy of vascular ectasia (angiodysplasia) of the large bowel detected during routine colonoscopic examination

Cited by 23 publications

References 15 publications

Solitary Polypoid Angiodysplastic Lesion Mimicking a Tumor in the Jejunum

Solitary Polypoid Angiodysplastic Lesion Mimicking a Tumor in the Jejunum

Case 34-1995

Rapid Revascularization After Therapeutic Parent Artery Occlusion for a Large Intracavernous Carotid Artery Aneurysm -Case Report-

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