Angiodysplasia describes a vascular malformation of the GI tract formed by fragile leaky vessels
The angiodysplastic lesions are most common in the caecum and ascending colon. The aetiology has yet to be fully elucidated, but is probably related to degenerative changes associated with increasing age (patients are typically >60).
Typical presentation is with painless, chronic, intermittent lower GI bleed (fresh PR bleed if the lesions are in the colon, and melaena if the lesions are in the upper GI tract). Patients typically have concomitant anaemia, so may present with fatigue, exertional shortness of breath, and weakness. Less commonly, patients present with massive haemorrhage.
On physical examination, the patient may demonstrate signs of anaemia (e.g. conjunctival pallor). PR examination may show fresh blood or melaena. It is important to measure the vital signs to check the patient is haemodynamically stable.