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Medicine (MD/DO)
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First Aid
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First Aid for the USMLE Step 1 (2023)
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Angiodysplasia

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Angiodysplasia

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Angiodysplasia

Angel-disc
DikeHAfifi
13 KEY FACTS
PATHOPHYSIOLOGY
Tortuous Dilation of Vessels
Dilated Tortoise Vessels

Angiodysplasia is characterized by tortuous dilation of vessels in the mucosal and submucosal layers of the gastrointestinal tract.

Fragile Blood Vessels
Fragile-box of Blood Vessels

The blood vessels in this disorder are fragile, making them easier to rupture and lead to bleeding.

Right-Sided Colon
Writing-right Colon

Angiodysplasia is most common in the right-sided colon. Precisely 77% of cases are found in the cecum or proximal ascending colon. Other sites that may be seen are jejunum and ileum, found in 15% of cases.

SIGNS AND SYMPTOMS
Hematochezia
He-man-cheese

Bleeding on angiodysplasia may commonly result in low-grade hematochezia, which is described as bright red blood in the stool.

Painless
No Pain-bolts-sign

Painless bloody stool is a characteristic seen in angiodysplasia. These can differentiate it from external hemorrhoid, which is painful.

DIAGNOSIS
Endoscopy
Endoscopy

Endoscopy is the diagnostic tool used for gastrointestinal bleeding. It helps to find the source of the bleeding.

Angiography
Angel-with-Angiography

Angiography is commonly used if the source of bleeding is still unknown or the patient is in an unstable hemodynamic. It also can be used for therapeutic purposes.

ASSOCIATIONS
Von Willebrand Disease
Van Willy-brand

The association between angiodysplasia and Von Willebrand Disease has been known for more than 40 years. Von Willebrand Disease causes an abnormality of the blood vessel, affecting the lower gastrointestinal tract and resulting in angiodysplasia.

Aortic Stenosis
A-orca made of Stone

Angiodysplasia has been associated with aortic stenosis, which is compiled in a syndrome called Heyde syndrome. It is present with aortic stenosis, GI bleeding from angiodysplasia lesions, and anemia. Valve replacement surgery can help to cure this condition.

Elderly
Old-person

This disorder is the second most common cause of lower gastrointestinal bleeding in the elderly.

Chronic Renal Failure
Damaged kidney

It is reported that half of the chronic renal failure patients with recurrent gastrointestinal bleeding are found to result from angiodysplasia. Degenerative vascular involvement is thought to be associated with the pathogenesis of this condition.

TREATMENT
Supportive
Supportive IV Bags

Initial treatment for angiodysplasia is hemodynamic resuscitation, monitoring, and blood transfusion if indicated.

Surgery
Surgeon

Surgery is used in patients who fail with other treatments and have heavy bleeding that needs multiple blood transfusions.

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