Case # 1 Diagnosis: Small bowel angioectasias causing obscure overt gastrointestinal bleeding and anemia.
Angioectasias Most common vascular abnormality of the GI tract Most frequent cause of recurrent gastrointestinal bleeding Commonly located in the colon, but can be seen throughout the entire gastrointestinal tract Bleeding from angioectasias is usually recurrent and low grade, though 15% of patients present with massive hemorrhage
Angioectasias Treatment options: Hormonal therapy Angioembolization Endoscopic evaluation with push enteroscopy, double balloon enteroscopy coupled with BICAP cauterization or argon plasma coagulation
References Boley SJ, Brandt LJ. Dig Dis Sci 1986;31: 26S-42S. “Vascular Lesions of the Gastrointestinal Tract” In: Sleisenger and Fordtran’s Gastrointestinal and Liver Disease, 9 th edition.