Abstract
Colonic angiodysplasia is a vascular lesion of the colon that may become the source of low grade chronic or intermittently massive rectal bleeding.
It is a lesion of the elderly, almost always found in the cecum and the ascending colon. Etiology and pathogenesis are unknown. The diagnosis can be made with angiography based on the demonstration of a vascular tuft and early opacification of draining veins. Right hemicolectomy is the mode of therapy. The lesions are minute, and in resected specimens they can be found only with special vessel injection techniques. Histologically, the lesions represent clusters of dilated vessels, mostly veins, in the mucosa and submucosa of the cecum and ascending colon.
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Athanasoulis, C.A., Baum, S., Galdabini, J., Ring, F. J.: Angiodysplasia of the intestinal tract as a cause of recurrent bleeding. In: Progress in Gastroenterology, edited by G.B. Jerzy, New York, Grune and Stratton (in press)
Athanasoulis, C.A., Waltman, A.C., Baum, S., Phillips, D., Novelline, R.A.: The role of arteriography in colonic hemorrhage. In: Gastrointestinal Emergencies, edited by H.R. Clearfield, V.P. Dinoso, New York, Grune and Stratton, 1976, pp. 159–165
Athanasoulis, C.A., Waltman, A.C., Novelline, R.A., Krudy, A.G., Sniderman, K.W.: Angiography: Its contribution to emergency management of gastrointestinal hemorrhage. Radiol. Clin. North Am. 14:265–280, 1976
Baer, J.W., Ryan, S.: Analysis of cecal vasculature in the search for vascular malformations. Am. J. Roentgenol. Radium Ther. Nucl. Med. 126:394–405, 1976
Bartelheimer, W., Remmele, W., Ottenjann, R.: Coloscopic recognition of hemangiomas in the colon ascendens. Endoscopy 4:109–114, 1972
Baum, S.: Small vessel angiography of the gut. In: Small Vessel Angiography Imaging, Morphology, Physiology, and Clinical Applications, edited by S.K. Hilal. St. Louis Mosby, 1973, pp. 454–478
Baum, S., Athanasoulis, C.A.: Diagnostic studies in colonic affections: Part V, Angiography. In: Gastroenterology, 3rd ed., edited by H.L. Bockus, Philadelphia, Saunders, 1976, Vol. II, pp. 866–886
Baum S., Athanasoulis, C.A., Waltman, A.C.: Acquired vascular ectasias of cecum and right colon as a cause of chronic gastrointestinal bleeding. Essay 181, Scientific Program, 58th Scientific Assembly and Annual Meeting, Radiological Society of North America, Chicago, Ill., 1972
Baum, S., Athanasoulis, C.A., Waltman, A.C.: The angiographic diagnosis and control of large bowel bleeding. Dis. Colon Rectum 17:446–453, 1974
Baum, S., Athanasoulis, C.A., Waltman, A.C.: Angiography in the diagnosis and therapy of hemorrhage from the large bowel. Radiology 15:427–433, 1975
Baum, S., Athanasoulis, C.A., Waltman, A.C., Galdabini, J., Schapiro, R., Warshaw, A., Ottinger, L.W.: Angiodysplasia of the right colon as a cause of chronic gastrointestinal bleeding (abstr.). Gastroenterology 68:862, 1975
Baum S., Athanasoulis, C.A., Waltman, A.C., Galdabini, J., Schapiro, R., Warshaw, A., Ottinger, L.W.: Angiodysplasia of the right colon: A cause of gastrointestinal bleeding. Am. J. Roentgenol. Radium Ther. Nucl. Med. (in press)
Baum, S., Athanasoulis, C.A., Waltman, A.C., Ring, E.J.: Gastrointestinal hemorrhage: Angiographic diagnosis and control. Adv. Surg. 7:149–198, 1973
Bean, W.B.: The cutaneous arterial spider: A survey. Medicine 24:243–331, 1945
Bentley, P.G.: The bleeding caecal angioma: A diagnostic problem. Br. J. Surg. 63:455–457, 1976
Boijsen, E., Reuter, S.R.: Angiography in diagnosis of chronic unexplained melena. Radiology 89:413–419, 1967
Boley, S.J., Sammartano, R., Adams, A., DiBiase, A., Kleinhaus, S., Sprayregen, S.: Vascular ectasias of the colon—degenerative lesions of aging (abstr.). Gastroenterology 70:765, 1976
Boley, S.J., Sammartano, R., Adams, A., Biase, A., Kleihaus, S., Sprayregen, S.: On the nature and etiology of vascular ectasias of the colon: Degenerative lesions of aging. Gastroenterology 72:650–660, 1977
Boley, S.J., Sprayregen, S., Sammartano, R.: The pathophysiologic basis for the angiographic signs of vascular ectasias of the colon. Radiology (in press)
Boss, E.G., Rosenbaum, J.M.: Bleeding from the right colon associated with aortic stenosis. Am. J. Dig. Dis. 16:269–275, 1971
Case Records of the Massachusetts General Hospital (Case 36 1974). N. Engl. J. Med. 291–575, 1974
Cody, M.C., O'Donovan, P.B., Hughes, R.W.: Idiopathic gastrointestinal bleeding and aortic stenosis. Am. J. Dig. Dis. 19:393–398, 1974
Cooperman, A.M., Felly, K.A., bernatz, P.E., Huizenga, K.A.: Arteriovenous malformation of the intestine. Arch. Surg. 104:284–287, 1972
Corry, P.J., Bartlett, M.K., Cohen, R.B.: Erosions of the cecum: A cause of massive hemorrhage. Am. J. Surg. 119:106–110, 1970
Crichlow, R.W., Mosenthal, W.T., Spiegel, P.K., House, R.K. Arteriovenous malformations of the bowel: An obscure cause of bleeding. Am. J. Surg. 129:440–448, 1975
Galloway, S.J., Casarella, W.J., Shimkin, P.M.: Vascular malformations of the right colon as a cause of bleeding in patients with aortic stenosis. Radiology 113:11–15, 1974
Genant, H.K., Ranninger, L.: Vascular dysplasias of the ascending colon: Report of two cases and review of the literature Am. J. Roentgenol. Radium Ther. Nucl. Med. 115:349–354 (1972)
Gentry, R.W., Dockerty, M.B., Clagett, O.T.: Vascular malformations and vascular tumors of the gastrointestinal tract (abstr.). Int. Surg. 88:281–323, 1949
Heycock, J.B., Dickinson, P.H.: Haemangiomata of the intestine. Br. Med. J. 1:620–621, 1951
Heyde, E.C.: Gastrointestinal bleeding in aortic stenosis. N. Engl. J. Med. 259:196, 1958
Hollingsworth, G.: Haemangiomatus lesions of the colon. Br. J. Radiol. 24:220–222, 1951
Margulis, A.R., Heinbecker, P., Bernard, H.R.: Operative mesenteric arteriography in the search for the site in unexplained gastrointestinal hemorrhage. Surgery 48:534–539, 1960
McNamara, J.J., Austen, W.G.: Gastrointestinal bleeding occurring in patients with acquired valvular heart disease. Arch. Surg. 97:538–540, 1968
Moore, J.D., Thompson, N.W., Appelman, H.D., Foley, D.: Arteriovenous malformations of the gastrointestinal tract. Arch. Surg. 111:381–388, 1976
Retzlaff, J.A., Hagedorn, A.B., Bartholomew, L.G.: Abdominal exploration for gastrointestinal bleeding of obscure origin. JAMA 177:104–107, 1961
Reynolds, D.G.: Injection techniques in the study of intestinal vasculature under normal conditions and in ulcerative colitis. In: Vascular Disorders of the Intestine, edited by S.J. Boley, S.S. Schwartz, L.F. Williams, New York, Appleton-Century-Crofts, 1971, pp. 383–395
Rogers, B.H., Adler, F.: Hemangiomas of the cecum. Gastroenterology 71:1079–1082, 1976
Skibba, R.M., Hartong, W.A., Mantz, F.A.: Angiodysplasia of the cecum: Colonoscopic diagnosis. Gastrointest. Endosc. 22:117–179, 1976
Welch, C.E.: Abdominal Surgery. N. Engl. J. Med. 293: 858–864; 908–912, 957–964, 1975
Whitehouse, C.H.: Solitary angiodysplastic lesiosn in the ileocaecal region diagnosed by angiography. Gut 14:977–982, 1973
Williams, R.C., Jr.: Aortic stenosis and unexplained gastrointestinal bleeding. Arch. Intern. Med. 108:103–107, 1961
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Athanasoulis, C.A., Galdabini, J.J., Waltman, A.C. et al. Angiodysplasia of the colon: A cause of rectal bleeding. Cardiovasc Radiol 1, 3–13 (1978). https://doi.org/10.1007/BF02551967
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DOI: https://doi.org/10.1007/BF02551967