Angiodysplasia

Question 1

what is angiodysplasia?

Answer 1

A degenerative vascular malformation (specifically dilated arteriovenous malformation) of previously healthy blood vessels in the GI tract

Question 2

angiodysplasia etymology?

Answer 2

angio - vessel
dys- bad
plasia - formation

Question 3

what happens to vessel diameter?

what does this cause?

Answer 3

wide (BVs dilated)

bleeding –> anaemia

Question 4

in angiodysplasia, which BVs (arteries or veins) is particularly dialted?

Answer 4

veins

Question 5

Locations of angiodysplasia?
-2

and %?

Answer 5

small bowel (15%)  
large bowel  (77%)

Question 6

in which parts of large bowel is there most angiodysplasia?

Answer 6

ascending colon and caecum

Question 7

what can be said about the sort of bleeding that occurs?

- 5 features

Answer 7

no pain 
intermittent 
ceases spontaneously
90% of time it is not a lot of bleeding 
episodes between bleeding can be really long

Question 8

Massive haemorrhage never occurs with angiodysplasia.

true or false?

Answer 8

false

Question 9

RFs?

-3

Answer 9

Age
Von Willebrand disease
End-stage Renal disease

Question 10

how can you differentiate if it is a upper GI or lower GI bleeding on the symptoms?

Answer 10

Melaena – Upper GI bleed

Fresh rectal bleeding – Lower GI bleed

Question 11

symptoms for a low grade bleed?

-5

Answer 11

SOB 
Fatigue 
Weakness
Pallor  
Melaena or fresh rectal bleeding

Question 12

symptoms for a high grade bleed/massive haemorrhage?

-2

Answer 12

Haematochezia

Haematemesis

Question 13

define Haematochezia?

Answer 13

fresh blood passing through anus

Question 14

define Haematemesis?

Answer 14

vomit blood

Question 15

Haematochezia etymology?

Answer 15

haem - blood

chezia - to defecate

Question 16

Haematemesis etymology?

Answer 16

haem - blood

emesis - vomit

Question 17

symptoms for a low grade bleed?

-5

Answer 17

SOB 
Fatigue 
Weakness
Pallor  
Melaena or fresh rectal bleeding

Question 18

with angiodysplasia, why does pt experience 
SOB 
Fatigue 
Weakness
Pallor

Answer 18

because of anaemia/

there are classic symptoms & signs of anaemia

Question 19

Gold.S Ix for upper GI bleed?

Answer 19

endososcopy

Question 20

Gold.S Ix for lower GI bleed?

Answer 20

Colonoscopy

Question 21

1st line blood Ix for angiodysplasia? (1)

result?

Answer 21

FBC - anaemia (low Hb)

Question 22

which lab test can be used to check if stool has blood in it?

Answer 22

Faecal occult blood test

Question 23

if acute massive haemorrhage or endoscopy inconclusive what is the 2nd line Ix to diagnose?

Answer 23

Mesenteric angiography

Question 24

1st line definitive treatment?

for a low grade bleed

Answer 24

Endoscopic argon plasma coagulation

Question 25

2nd line definitive treatment?

for a low grade bleed

Answer 25

Mesenteric angiography with transcatheter superselective embolisation (interventional radiology)

Question 26

1st line definitive treatment?
(for acute massive haemorrhage)

under this method what gets deployed at the bleeding site to stop the bleeding?

Answer 26

Mesenteric angiography with superselective transcatheter embolisation (interventional radiology)

platinum coil

Question 27

explain argon plasma coagulation?

Answer 27

Probe ejects stream of argon gas, electric current from the same probe ionises the argon gas to create plasma. Plasma is hot, the heat cauterises the lesion (thermal effect).

Question 28

vitals for high grade bleed?

-2

Answer 28

Hypotension

Tachycardia