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International Journal of Colorectal Disease

, Volume 31, Issue 12, pp 1869–1873 | Cite as

Risk factors for active bleeding from colonic angiodysplasia confirmed by colonoscopic observation

  • Naoyuki NishimuraEmail author
  • Motowo Mizuno
  • Yuichi Shimodate
  • Akira Doi
  • Hirokazu Mouri
  • Kazuhiro Matsueda
  • Hiroshi Yamamoto
Original Article

Abstract

Purpose

Colonic angiodysplasia is an important cause of lower gastrointestinal bleeding in the elderly. Here, we investigated the risk factors for bleeding from colonic angiodysplasia seen at endoscopy.

Methods

We conducted a retrospective case-control study by reviewing records of 435 patients with angiodysplasia at colonoscopy from November 2006 to November 2015 in our hospital. To identify risk factors for active bleeding, the following were analyzed: age, sex, comorbidities, use of antithrombotic drugs and non-steroidal anti-inflammatory drugs, and the size and location of the lesions.

Results

Among the 435 patients, active bleeding from angiodysplasia was observed at endoscopy in 29 patients (6.7 %). Using multivariate analysis, we identified advanced age (odds ratio 5.15, 95 % confidence interval, 1.61–16.5), comorbidity of heart disease (6.88, 1.04–45.5), use of anticoagulant drug (4.22, 1.21–14.7), multiple lesions (6.67, 1.77–25.2), and small lesions (≤5 mm) (17.7, 4.90–64.0) as independent and significant risk factors for active bleeding. Actively bleeding colonic angiodysplasia lesions were very small in most cases (1–2 mm, 24/29, 83 %) and predominantly located in the right-side colon (26/29, 90 %). All of the 29 patients with active bleeding were successfully and safely treated endoscopically, but re-bleeding occurred in nine patients (31 %, 9/29) during the follow-up period of 2–84 months.

Conclusions

Multiple and small colonic angiodysplasia lesions in patients of advanced age, with heart disease, or receiving anticoagulants have increased risk for bleeding. We should be aware that small colonic angiodysplasia lesions in the right-side colon at colonoscopy in these patients may be a source of bleeding.

Keywords

Angiodysplasia Colon Active bleeding Risk factor 

Notes

Acknowledgments

None.

Compliance with ethical standards

Conflicts of interest

The authors declare that they have no competing interests.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Naoyuki Nishimura
    • 1
    Email author
  • Motowo Mizuno
    • 1
  • Yuichi Shimodate
    • 1
  • Akira Doi
    • 1
  • Hirokazu Mouri
    • 1
  • Kazuhiro Matsueda
    • 1
  • Hiroshi Yamamoto
    • 1
  1. 1.Department of Gastroenterology and HepatologyKurashiki Central HospitalOkayamaJapan

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