Hemingway A P
Academic Department of Radiology, Royal Hallamshire Hospital, Sheffield, UK.
Blood Rev. 1989 Sep;3(3):147-51. doi: 10.1016/0268-960x(89)90011-8.
Angiodysplasia, a condition of unknown aetiology, is thought to represent the commonest cause of obscure gastrointestinal bleeding, particularly in the elderly population. The lesions of angiodysplasia, which are small (less than 5 mm) and usually multiple, consist of microvascular abnormalities in the mucosa and submucosa of the bowel wall. They are most commonly found in the caecum and right side of the colon, but have been observed in the stomach, ileum and elsewhere in the colon. The diagnosis is made by either selective visceral angiography and/or colonoscopy, but the lesions cannot be detected on barium studies or with the naked eye at laparotomy. Localisation of the abnormalities by the histopathologist is greatly facilitated by special injection techniques demonstrating the blood vessels of resected colonic specimens prior to fixation and section. Treatment may be conservative (iron replacement) if the anaemia is not severe, by endoscopic fulguration or by colonic resection. Other common causes of gastrointestinal blood loss should always be excluded before the final diagnosis of angiodysplasia is accepted. Although the condition is well recognised as a significant cause of gastrointestinal blood loss a number of questions remain to be answered. The true incidence of angiodysplasia in the population is not known, the aetiology of the condition remains a mystery, although many theories abound.
血管发育异常是一种病因不明的病症，被认为是隐匿性胃肠道出血最常见的原因，在老年人群中尤为如此。血管发育异常的病变较小（小于5毫米）且通常为多发，由肠壁黏膜和黏膜下层的微血管异常组成。它们最常见于盲肠和结肠右侧，但在胃、回肠及结肠其他部位也有发现。诊断通过选择性内脏血管造影和/或结肠镜检查进行，但在钡剂造影检查或剖腹手术时肉眼无法检测到这些病变。在固定和切片之前，通过特殊注射技术显示切除的结肠标本血管，极大地便于病理学家对异常进行定位。如果贫血不严重，治疗可以是保守的（补充铁剂），也可通过内镜电凝或结肠切除术。在最终确诊血管发育异常之前，应始终排除胃肠道失血的其他常见原因。尽管该病症被公认为胃肠道失血的重要原因，但仍有许多问题有待解答。血管发育异常在人群中的真实发病率尚不清楚，尽管有许多理论，但该病症的病因仍是个谜。
