Höchter W, Weingart J, Kühner W, Frimberger E, Ottenjann R
Endoscopy. 1985 Sep;17(5):182-5. doi: 10.1055/s-2007-1018495.
In a prospective study, the occurrence of angiodysplasia was investigated by total colonoscopy in 1938 patients. Angiodysplasia was found in 59 patients, i.e. 3%. 12 out of 59 patients were admitted for acute or chronic peranal hemorrhage or anemia. 47 out of 59 patients were asymptomatic. The site of the lesions was as follows: cecum 37%, ascending colon 17%, transverse colon 7%, descending colon 7%, sigmoid colon 18% and rectum 14%. Histological confirmation was obtained in 15 out of 37 biopsies. The endoscopic appearance was variable, most of the vascular dilatations being smaller than 5 mm (n = 47), with a homogeneous (n = 35) or inhomogeneous (n = 24) structure and a regular (n = 34) or irregular (n = 25) border. The lesions were single (n = 34) as well as multiple (n = 25), they were usually flat (n = 54), seldom slightly prominent (n = 5). Concomitant pathological findings in the bowel were diagnosed in 33 out of 59 patients: diverticula in 32%, adenomas in 24% and carcinomas in 8.5%. Right hemicolectomy for bleeding angiodysplasia is indicated only if endoscopic therapy has failed and other colorectal sources of bleeding, and especially angiodysplasia in the left colon and rectum have been excluded by endoscopy or angiography.
在一项前瞻性研究中，通过全结肠镜检查对1938例患者的血管发育异常情况进行了调查。59例患者发现有血管发育异常，即占3%。59例患者中有12例因急性或慢性肛周出血或贫血入院。59例患者中有47例无症状。病变部位如下：盲肠37%，升结肠17%，横结肠7%，降结肠7%，乙状结肠18%，直肠14%。37例活检中有15例获得了组织学确诊。内镜表现各异，大多数血管扩张小于5mm（n = 47），结构均匀（n = 35）或不均匀（n = 24），边界规则（n = 34）或不规则（n = 25）。病变为单发（n = 34）以及多发（n = 25），通常为扁平状（n = 54），很少有轻度隆起（n = 5）。59例患者中有33例诊断出肠道合并病理结果：憩室占32%，腺瘤占24%，癌占8.5%。仅在内镜治疗失败且排除了其他结直肠出血来源，特别是通过内镜或血管造影排除了左半结肠和直肠的血管发育异常时，才考虑对出血性血管发育异常进行右半结肠切除术。
