Department of Gastroenterology, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
Surg Laparosc Endosc Percutan Tech. 2023 Apr 1;33(2):115-120. doi: 10.1097/SLE.0000000000001159.
Colonic angiodysplasia is a rare disease, it is nevertheless a common cause of lower gastrointestinal (GI) bleeding in older adults. The study summarized the colonoscopic and clinical features of colonic angiodysplasia to raise awareness among endoscopists regarding this disease.
We performed a retrospective study of enrolled patients diagnosed with colonic angiodysplasia between September 2013 and April 2022. Clinical and colonoscopic features of the patients with active bleeding were analyzed and compared with those of patients without bleeding. The comparisons were also conducted between the patients with active lower GI bleeding caused by colonic angiodysplasia and those by other diseases.
In total, 54 eligible patients were included in this study; 55.55% of the participants were aged over 60 years. Ten patients (3 men and 7 women) with colonic angiodysplasia suffered from active lower GI bleeding, which was mainly located in the left and total colon. The patients with type 2 diabetes mellitus, radiotherapy history, antiplatelet drug use, and multiple lesions were more likely to endure lower GI bleeding. The duration between bleeding and admission was longer in the colonic angiodysplasia group than in the other diseases group ( P = 0.043). In the colonic angiodysplasia group, bleeding relapsed in 3 patients, and the recurrence rate was higher than in the other diseases group ( P < 0.001).
Endoscopists should perform colonoscopy scrupulously and consider colonic angiodysplasia as a differential diagnosis in patients with lower GI bleeding, especially for older women and adults with chronic diseases, such as type 2 diabetes mellitus.
结肠血管发育不良是一种罕见的疾病，但它是老年人下消化道（GI）出血的常见原因。本研究总结了结肠血管发育不良的结肠镜和临床特征，以提高内镜医生对此病的认识。
我们对 2013 年 9 月至 2022 年 4 月期间诊断为结肠血管发育不良的患者进行了回顾性研究。分析了有活动性出血的患者的临床和结肠镜特征，并与无出血的患者进行了比较。还比较了因结肠血管发育不良和其他疾病导致的活动性下 GI 出血的患者。
共有 54 名符合条件的患者纳入本研究；55.55%的参与者年龄在 60 岁以上。10 名（3 名男性和 7 名女性）患有结肠血管发育不良的患者出现活动性下 GI 出血，主要位于左半结肠和全结肠。患有 2 型糖尿病、放疗史、抗血小板药物使用和多发性病变的患者更有可能发生下 GI 出血。与其他疾病组相比，结肠血管发育不良组从出血到入院的时间间隔更长（P=0.043）。在结肠血管发育不良组中，有 3 名患者出血复发，复发率高于其他疾病组（P<0.001）。
内镜医生应仔细进行结肠镜检查，并在出现下 GI 出血的患者中考虑结肠血管发育不良作为鉴别诊断，尤其是对于老年女性和患有 2 型糖尿病等慢性病的成年人。
