Upper gi angiodysplasia: rare reason of gastrointestinal bleeding, experiences on three patients

Introduction: The angiodysplasia is a main arteriovenosus malformatio in the submucosa, occurs in the ileocoecal region, the ascendent colon and the small gut area, but rarely in the stomach or the duodenal area. Macroscopicaly the size of 0,5–1cm, bright red colored, flat or mild rising laesios covered with slim epithel. The majority of the patients are over 60 years, appear clinically in haematochesia or melaena. Repeated bleedings are common, with some checkups, often lack of bleeding source localisation.

Patients: In the period from 2005 to 2008 we processed three cases suffering from angiodysplasia generating gastrointestinal bleeding. Gender: three men, 67–73 and 81yrs old at the time of observation. During their checkup we identified the reason of the bleeding by multiple gastroscopy, colonoscopy, in one case with urgent intestinal angiography, at two with using capsule endoscopy combined with CT enteroclysis. All three patients were multitransfused. The recurrent gastrointestinal bleeding were treated only with endoscopic bleeding alleviation (unipolar coagulation, Argon-plasma coagulation), and with combination with surgery, and surgery alone.

Conclusion: Although the angiodysplasia occuring in the stomach and the colon system appears to be rare reason of the gastrointestinal bleedings, it should be concidered to think on it in cases of multiple unsuccessful diagnosis. Application of various diagnostic methods results more exact diagnosis, and the use of combined various endoscopic treatment and surgery usually becomes successful.