Is the Angiodisplasia of the Small Bowel a Real Source of Obscure GI Bleeding ( OGIB) or Just an Aging Alteration of Small Bowel?

DDW Report 2004 New Orleans: Capsule Endoscopy

“…Whether angiodysplastic lesions seen on CE are really the source of bleeding is sometimes debated. Whereas previous studies have shown that such lesions also occur in patients being examined for other reasons, or even in volunteers [50], a retrospective study found a higher rate of arterial (58 % vs. 22 %) and venous (52 % vs. 32 %) angiodysplasias in patients examined for ODB than for other reasons [51] ± but what is the authors' source for this differentiation into arterial and venous? Finally, a cost analysis found that CE with a prevalence of 50 % saved between C = 517 (in Germany) and C = 2240 (in Switzerland) in comparison with PE [52].…”

Gastrointestinal Bleeding

“…The clinical significance of incidentally discovered vascular lesions in the gut is an issue that is increasingly being recognized, particularly in the era of capsule endoscopy, with more frequent detection of such lesions in the small bowel. Often there is no direct evidence that such lesions are the cause of bleeding, but angiodysplasias were found more frequently in patients with obscure gastrointestinal bleeding in comparison with a control group [27]. On the basis of their experience in 23 patients with arteriovenous malformations of the gut, another group recommends obliterating these lesions, irrespective of whether or not they appear to be a source of bleeding, as they are a potential source of massive hemorrhage [28].…”