Angiodysplasia as a cause of upper gastrointestinal bleeding

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Abstract
Angiodysplasia of the stomach, the proximal part of the small intestine, or both was diagnosed in 30 patients by upper gastrointestinal (GI) endoscopy over a 40-mo. period. This diagnosis represented 4% of 676 patients referred over the same time period for endoscopic examination of suspected upper GI bleeding. Twenty-three patients (77%) had experienced at least one episode of overt bleeding (hematemesis or melena) prior to diagnosis. Multiple gastroduodenal angiodysplastic lesions were found in 19 (63%) of the patients, and additional colonic angiodysplasia was detected in 6 of 12 patients who also underwent colonoscopy. Renal insufficiency was significantly more prevalent in the patients with angiodysplasia than in a comparison group of similar age with upper GI bleeding from other lesions (60% vs. 24%). Angiodysplasia, although uncommon, should be considered in the differential diagnosis of both occult and overt upper GI bleeding. The lesion appears to be associated with renal insufficiency.