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Angiodysplasia of the colon

• Overview
• Symptoms
• Treatment
• Prevention

Alternative Names:

Vascular ectasia of the colon; Colonic arteriovenous malformation; Colonic angiomas

Treatment:

When a patient is bleeding from the colon, it is important to determine the source of the bleeding and the rate of blood loss. The patient's condition must be evaluated continuously and may require admission to an intensive care unit (ICU). Administration of IV fluids, and blood products may be required.

Once the source of the bleeding is found (usually by angiography or colonoscopy), treatment can begin. As many as 90% of vascular ectasias stop bleeding on their own without any treatment.

When intervention is needed, however, the colonoscope can cauterize (burn) the site of hemorrhage (bleeding). This procedure can be done electrically, with heat or with a laser. Argon plasma coagulation (APC) is a relatively new method of electrocoagulation that uses electrical energy to stop bleeding. The electricity does not come in contact with the tissue. Complications of this procedure include puncture of the colon, as well as possible treatment failure.

Actively bleeding vascular ectasia can also be treated by angiography by clotting the blood supply to the bleeding area of the colon. The use of chemicals that cause the blood vessels to constrict can also be administered, whether by angiography or colonoscope.

In some instances, surgery is the only option. A right hemicolectomy, or removal of the entire right side of the colon, may be required. This remains the treatment of choice for a patient whose ectasia continues to bleed at a dangerously quick rate, despite several therapeutic interventions by angiography and colonoscopy.

Expectations (prognosis):

As mentioned above, bleeding in more than 90% of instances stops on its own. However, patients who have bleeding angiodysplasia despite having had colonoscopy, angiography, or surgery, are likely to have more bleeding in the future.

The goal of repeat endoscopic therapy is to reduce, if not totally eliminate, the number of bleeds, hospitalizations, and transfusions. Surgery may be a cure in some cases. Prognosis remains good if the bleeding is controlled.

Complications:

• Severe loss of blood from the gastrointestinal tract
• Anemia
• Death from excessive blood loss

Calling your health care provider:

Call your health provider if rectal bleeding or black stools occur.

• Review Date: 5/3/2007
• Reviewed By: Jenifer K. Lehrer, MD, Department of Gastroenterology, Frankford-Torresdale Hospital, Jefferson Health System, Philadelphia, PA. Review provided by VeriMed Healthcare Network.

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