Danesh B J, Spiliadis C, Williams C B, Zambartas C M
St. Mark's Hospital, London, UK.
Int J Colorectal Dis. 1987 Nov;2(4):218-22. doi: 10.1007/BF01649509.
Angiodysplasia of the colon was diagnosed in 31 out of 1,050 patients (3%) presenting with rectal bleeding or anaemia, among 10,000 colonoscoped at St. Mark's Hospital. The lesions were identified in 16 out of 879 (2%) patients with rectal bleeding, in 15 out of 171 (9%) patients with anaemia, and in a further three patients without features of blood loss. The angiodysplasia lesions were predominantly in the right colon (76%) and occurred with a similar frequency (12%) in the transverse and the left colon. Affected patients (59% male and 41% female) were in the older age group (53-89 years; mean age 69.5 years) but only one patient had known aortic valve disease. Angiodysplasia is an important diagnosis to consider in patients presenting with colonic bleeding or anaemia because it can be treated in the majority of cases by endoscopic electrocoagulation. However in our experience it is less common (3%) than previously suggested by other authors (40-67%). Endoscopic over-diagnosis is possible when intramucosal capillaries with no bleeding tendency on local traumatisation or biopsy are included in the diagnosis but these lesions are not true angiodysplasia.
在圣马克医院接受结肠镜检查的10000例患者中，1050例因直肠出血或贫血就诊的患者中有31例（3%）被诊断为结肠血管发育异常。在879例直肠出血患者中有16例（2%）发现病变，在171例贫血患者中有15例（9%）发现病变，另有3例无失血特征的患者也发现了病变。血管发育异常病变主要位于右半结肠（76%），横结肠和左半结肠的发生率相似（12%）。受影响的患者（男性59%，女性41%）年龄较大（53 - 89岁；平均年龄69.5岁），但只有1例患者患有已知的主动脉瓣疾病。对于出现结肠出血或贫血的患者，血管发育异常是一个需要考虑的重要诊断，因为在大多数情况下可以通过内镜电凝治疗。然而，根据我们的经验，它比其他作者先前报道的（40 - 67%）要少见（3%）。当诊断中包括局部创伤或活检时无出血倾向的黏膜内毛细血管，但这些病变并非真正的血管发育异常时，内镜过度诊断是可能的。
