Diffuse microscopic angiodysplasia and nodular lymphoid hyperplasia in an infant with obscure massive lower gastrointestinal bleeding: a diagnostic challenge

Multiple intestinal atresias associated with angiodysplasia in a newborn

“…Hemingway and Allison [7] also considered the pediatric lesion as congenital when reporting 4 cases of intestinal angiodysplasia associated with Meckel diverticulum. Finally, some morphological and angiographic differences exist between the lesions seen in adults and those observed in children: microscopic examination of adult and pediatric cases shows mostly dilated, tortuous, thin-walled vascular channels in the submucosa and lamina propria; but reported pediatric cases have been described as also having thick submucosal ectatic vessels [9], which led some to refer to these lesions as arteriovenous malformations [6]. In our patient, the vascular lesions also involved the muscularis propria.…”

“…Yet, superficial mucosal erosions, bleeding, and intestinal perforation have been reported as consequences of intestinal angiodysplasia [6,9]; and it would not be unreasonable to think that, in the present case, this vascular anomaly may have led to hemodynamic insufficiency, with the atresias as a result. We do not believe that the angiodysplastic abnormality could have resulted from an intrauterine ischemic event, as, to our knowledge, no such situation has ever been reported.…”

“…However, intestinal perforation and noninfectious colitis have been seen as the initial presentation in some pediatric cases [6,9]. Severity of the intestinal bleeding varies from frank hematochezia [9] to occult blood in the stools and chronic anemia [10].…”

“…However, intestinal perforation and noninfectious colitis have been seen as the initial presentation in some pediatric cases [6,9]. Severity of the intestinal bleeding varies from frank hematochezia [9] to occult blood in the stools and chronic anemia [10]. Depending on the anatomical site, colonoscopy and endoscopy are the most common methods used for diagnosis and treatment [10]; but selective visceral angiography has been recommended for the evaluation of children presenting with lower intestinal bleeding and acute anemia [11].…”

Minimal-invasive surgery for treatment of colo-rectal angiodysplasia in a child

“…Rectal angiodysplasia is a rare lesion of bowel wall in pediatric population, frequently revealed by bleeding. [1][2][3][4][5] Its diagnosis is difficult and made by the combination of multiple techniques. [3][4][5] The usual treatment of colonic and rectal angiodysplasia is an open surgery, with resection of the affected zone.…”