Angiodysplasia

Question 1

What is it?

Answer 1

Small vascular malformations in GI tract leading to intermittent bleeding and Fe deficient anaemia

Question 2

What conditions are associated with it?

Answer 2

CKD
Aortic stenosis
VWF

Question 3

What are the clinical features?

Answer 3

GI bleeding- malaena or haematochezia
Fe deficiency anaemia symptoms
Aortic stenosis- ejection systolic murmur

Question 4

What are the investigations?

Answer 4

Colonoscopy or upper GI endoscopy- primary diagnostic tool
- look for lesions that are red, flat/slightly raised and ectatic vessels- spider like apparance

Capsule endoscopy
- if OGD inconclusive

Angiography if active bleeding

Question 5

What is the management?

Answer 5

Active bleeding
- endoscopic therapy= first line
- angio if unstable and endoscopy fails

Less severe bleeding
- TXA
- hormonal therapy can be trialed

Iron supplements
Blood transfusion