Angiodysplasia of Stomach and Duodenum Symptoms, Causes, Diagnosis, Radiology, Treatment

Content:

• What is Angiodysplasia of Stomach?
• Angiodysplasia of Duodenum 
• Angiodysplasia of Stomach Symptoms
• Angiodysplasia of Stomach Causes
• Angiodysplasia of Stomach Diagnosis
• Angiodysplasia of Stomach Radiology
• Angiodysplasia of Stomach Treatment

What is Angiodysplasia of Stomach?

Angiodysplasia of the stomach is a vascular abnormality characterized by dilated, fragile blood vessels in the stomach lining, which can cause gastrointestinal bleeding. This condition is often associated with aging and underlying vascular disorders, leading to chronic or intermittent blood loss. While some cases are asymptomatic, others may present with symptoms such as anemia, fatigue, and melena (dark stools).

Angiodysplasia of Duodenum

Angiodysplasia of the duodenum refers to similar vascular abnormalities occurring in the first section of the small intestine (duodenum). This condition can lead to upper gastrointestinal bleeding, presenting as anemia, hematemesis (vomiting blood), or melena. Diagnosis often requires endoscopy or angiography, and treatment depends on the severity of bleeding.

Angiodysplasia of Stomach Symptoms

Symptoms vary depending on the extent of bleeding and may include:

• Gastrointestinal bleeding (vomiting blood or black, tarry stools)
• Iron deficiency anemia, leading to weakness, dizziness, or pale skin
• Fatigue due to chronic blood loss
• Abdominal discomfort or pain in some cases
• Severe cases may lead to hypotension or shock due to significant blood loss.

Angiodysplasia of Stomach Causes

Angiodysplasia of the stomach is caused by abnormal blood vessel formation in the stomach lining, leading to fragile, dilated vessels prone to bleeding. While the exact cause remains unclear, several factors contribute to its development. Aging is a primary risk factor, as blood vessels naturally weaken over time, making them more susceptible to dilation and rupture. 

Chronic kidney disease is also linked to angiodysplasia, as impaired kidney function affects blood circulation and vascular integrity. Additionally, heart diseases, such as aortic stenosis, can alter blood flow dynamics, leading to vascular malformations. Coagulation disorders and the use of blood thinners increase the likelihood of bleeding from these fragile vessels. 

Mechanical stress in the stomach lining, caused by increased pressure or reduced oxygen supply (ischemia), may also trigger vessel dilation and malformation. In some cases, genetic predisposition or underlying gastrointestinal disorders can contribute to the development of this condition.

Angiodysplasia of Stomach Diagnosis

Angiodysplasia of the stomach is diagnosed through a combination of clinical evaluation, endoscopic procedures, and imaging tests. Endoscopy (esophagogastroduodenoscopy or EGD) is the primary diagnostic tool, allowing direct visualization of abnormal blood vessels in the stomach lining. 

If endoscopy does not detect the source of bleeding, capsule endoscopy may be used to examine the gastrointestinal tract in greater detail. Angiography, a specialized imaging test using contrast dye, is helpful in identifying active bleeding and abnormal blood flow patterns. 

CT angiography or MRI may also be used in cases where traditional endoscopy is inconclusive. Blood tests, including a complete blood count (CBC), help assess anemia levels caused by chronic bleeding. Additionally, fecal occult blood tests may be conducted to detect hidden blood in the stool. The choice of diagnostic method depends on the severity of symptoms, the presence of active bleeding, and the patient's overall condition.

Angiodysplasia of Stomach Radiology

Radiological imaging plays a crucial role in diagnosing angiodysplasia of the stomach, especially when endoscopic findings are inconclusive. CT angiography (CTA) is one of the most effective techniques, using contrast dye to highlight abnormal blood vessels and detect active bleeding. It provides detailed images of vascular malformations and can help guide treatment planning. 

Magnetic Resonance Angiography (MRA) is another advanced imaging method that offers a non-invasive way to visualize blood flow and vascular abnormalities. Conventional angiography, performed by injecting contrast dye into the arteries, is particularly useful in cases of severe or ongoing bleeding, as it allows for both diagnosis and potential therapeutic interventions, such as embolization. 

Additionally, red blood cell (RBC) scintigraphy, a nuclear medicine scan, may be used to identify slow, intermittent bleeding sources. Radiological imaging complements endoscopy and helps in cases where lesions are small, deep, or difficult to detect using standard methods.

Angiodysplasia of Stomach Treatment

The treatment for angiodysplasia of the stomach depends on the severity of symptoms, particularly the extent of bleeding. In mild cases, where bleeding is minimal or stops on its own, monitoring and managing underlying conditions such as chronic kidney disease or heart disease may be sufficient.

For active or recurrent bleeding, endoscopic treatment is the first-line approach. Argon plasma coagulation (APC), electrocoagulation, or laser therapy can be used to cauterize abnormal blood vessels and stop bleeding. If endoscopic therapy is ineffective, angiographic embolization may be performed, where a catheter is used to inject a blocking agent into the bleeding vessel to prevent further hemorrhage.

In cases of severe or persistent bleeding, medications such as hormonal therapy (octreotide) or antiangiogenic agents (thalidomide, bevacizumab) may help reduce bleeding episodes. Blood transfusions may be necessary for patients with significant anemia. Surgical intervention, such as partial gastrectomy (removal of the affected stomach portion), is rarely required but may be considered in extreme cases where other treatments fail. Regular follow-ups and lifestyle modifications, including managing hypertension and avoiding blood thinners when possible, are essential to prevent recurrence.