Vascular and Miscellaneous Lesions of the Small Bowel: Lymphangiectasia, Diverticulum, Amyloidosis, Celiac Disease, and Others

Abstract

Most vascular lesions of the intestine appear endoscopically similar and can be foci of bleeding. Angioectasia (formerly angiodysplasia) is a degenerative lesion and is the most common cause of small bowel bleeding. Typical angioectasias present as millimeter-sized cherry-red areas with radiating vessels. Telangiectasia is similar to angioectasia but can be differentiated from this entity based on its distribution throughout the bowel wall, its association with cutaneous lesions, and its hereditary character. Hemangiomas are tumors consisting of proliferating vessels, and their presence may be one of the presentations of a cutaneous hemangioma syndrome. Lymphangiectasia refers to dilated lymphatic vessels that can be observed endoscopically as multiple nodular or polyp-like protrusions with whitish tops. Sporadic lymphangiectasias appear similar to yellow or white submucosal plaques. Diverticular disorders, duplication cyst, amyloidosis, and celiac disease of the small bowel will be also discussed in this chapter.