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Die erworbenen kolorektalen Angiodysplasien

Acquired colorectal angiodysplasia

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Coloproctology Aims and scope

Zusammenfassung

Über die Genese, Lokalisationsverteilung, Diagnostik und Therapie der erworbenen Angiodysplasien des Kolons existieren noch Unklarheiten. Analysiert wurden 107 Patienten mit histologisch gesicherter Angiodysplasie des Kolorektums aus dem Untersuchungsgut des Instituts für Pathologie im Klinikum Bayreuth. Zusätzlich wurden 1076 publizierte Fälle aus der Literatur ausgewertet. Das Durch-schnittsalter der Patienten mit Angiodysplasie des Kolons liegt bei 68 Jahren, das Geschlechtsverhältnis ist ausgeglichen. Die herdförmigen Angiodysplasien sind überwiegend im Zökum und Colon ascendens (60,7%), seltener im Sigma (22,4%), Colon transversum, Colon descendens oder Rektum (jeweils 5,6%) lokalisiert. Endoskopisch imponieren die Angiodysplasien als fleckförmige Rötungen, histologisch als Teleangiektasien. Das zur Diagnose führende Hauptsymptom ist die peranale Blutung (56,8%), seltener die Blutungsanämie (12,1%). Vielfach wird die Angiodysplasie aber auch als Zufallsbefund bei der Koloskopie aus anderer Indikation gefunden (25,2%). Bei peranaler Blutung und chronischer Blutungsanämie älterer Patienten sollte immer auch endoskopisch nach einer Angiodysplasie des Kolons gefahndet werden.

Abstract

Uncertainties still persist with regard to the genesis, distribution of location diagnosis and treatment of acquired colorectal angiodysplasia. Material stored at the Institute of Pathology in Bayreuth obtained from a total of 107 patients with histologically confirmed angiodysplasia of the colorectum was analysed. In addition, a further 1,076 cases reported in the literature were evaluated. The average age of patients with angiodysplasia of the colon is 68 years, and the gender distribution is balanced. Focal angiodysplasia is located predominantly in the caecum and ascending colon (60.7%) but less often in the sigmoid (22,4%), transverse colon, descending colon or rectum (each 5.6%). Via the endoscope, angiodysplasia presents as patches of redness, and histologically as teleangiectasia. The main symptom leading to the diagnosis is peranal bleeding (56.8%) or, more rarely, haemorrhagic anaemia (12,1%). In many cases, however, angiodysplasia is discovered incidentally during colonoscopy performed for other indications (25,2%). Peranal bleeding and/or chronic haemorrhagic anaemia in the elderly patient should prompt an endoscopic search for angiodysplasia of the colon.

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Authors and Affiliations

  1. Institut für Pathologie, Klinikum Bayreuth, Preuschwitzer Straße 101, D-95445, Bayreuth

    Manfred Stolte & Sven Hoffmann

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  1. Manfred Stolte
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  2. Sven Hoffmann
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Stolte, M., Hoffmann, S. Die erworbenen kolorektalen Angiodysplasien. Coloproctology 20, 128–133 (1998). https://doi.org/10.1007/BF03044612

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