Colonic angiodysplasia These are dilated, thin walled, tortous submucosal veins related to ageing, mostly in those over 60 years.
Histologically the vein has very thin muscle coat, it is weak and liable to bleed, in most cases this is chronic bleeding causing anemia, occasionally massive bleeding culminating in hypovolemic shock is seen.
This condition is strongly associated with aortic stenosis, this is called
Heyde syndrome, it is also associated with vascular malformations in skin and oral mucosa in
Hereditary hemorrhagic telangiectasia. It can be diagnosed by
colonoscopy (see above fig) and dealt with by colonoscopic diathermy or argon laser, if massive bleeding is present surgery is needed with on table colonoscopy to detect the site of bleeding, if this is not possible colectomy may be done.
Barium enema is avoided, it is unhelpful and
can mask the lesions on subsequent colonoscopy, selective mesenteric angiography can at times detect these lesions.
