Prevalence of Angiodysplasia Detected in Upper Gastrointestinal Endoscopic Examinations.

Takumi Notsu,Kyoichi Adachi,Kanako Kishi,Shunji Ishihara,Norihisa Ishimura,Tomoko Mishiro

doi:10.7759/cureus.14353

Abstract

BackgroundThis study was performed to examine the prevalence of asymptomatic angiodysplasia detected in upper gastrointestinal endoscopic examinations and of hereditary hemorrhagic telangiectasia (HHT) suspected cases.MethodologyThe study participants were 5,034 individuals (3,206 males, 1,828 females; mean age 53.5 ± 9.8 years) who underwent an upper gastrointestinal endoscopic examination as part of a medical check-up. The presence of angiodysplasia was examined endoscopically from the pharynx to duodenal second portion. HHT suspected cases were diagnosed based on the presence of both upper gastrointestinal angiodysplasia and recurrent nasal bleeding episodes occurring in the subject as well as a first-degree relative.ResultsAngiodysplasia was endoscopically detected in 494 (9.8%) of the 5,061 subjects. Those with angiodysplasia lesions in the pharynx, larynx, esophagus, stomach, and duodenum numbered 44, 4, 155, 322, and 12, respectively. None had symptoms of upper gastrointestinal bleeding or severe anemia. Subjects with angiodysplasia showed significant male predominance and were significantly older than those without. A total of 11 (0.2%) were diagnosed as HHT suspected cases by the presence of upper gastrointestinal angiodysplasia and recurrent epistaxis episodes from childhood in the subject as well as a first-degree relative.ConclusionsAsymptomatic angiodysplasia was detected in 9.8% of the subjects who underwent screening upper gastrointestinal endoscopic examinations.

Highlights

Gastrointestinal angiodysplasia, termed angioectasia, is a vascular malformation composed of dilated and tortuous arterial or venous capillaries, usually smaller than 5 mm in diameter, and located in the mucosal and submucosal layers of the gastrointestinal tract [1,2]
hemorrhagic telangiectasia (HHT) suspected cases were diagnosed based on the presence of both upper gastrointestinal angiodysplasia and recurrent nasal bleeding episodes occurring in the subject as well as a first-degree relative
Asymptomatic angiodysplasia was detected in 9.8% of the subjects who underwent screening upper gastrointestinal endoscopic examinations

Summary

Introduction

Gastrointestinal angiodysplasia, termed angioectasia, is a vascular malformation composed of dilated and tortuous arterial or venous capillaries, usually smaller than 5 mm in diameter, and located in the mucosal and submucosal layers of the gastrointestinal tract [1,2]. It has been reported that gastrointestinal angiodysplasia is responsible for 4-7% cases of nonvariceal upper gastrointestinal bleeding [3,4,5]. While Foutch et al noted that the prevalence of colonic angiodysplasia in healthy asymptomatic individuals was 0.83% [6], its prevalence in the upper gastrointestinal tract in these individuals has not been determined, though recent advances in endoscopic equipment may facilitate better detection of gastrointestinal angiodysplasia. Hereditary hemorrhagic telangiectasia (HHT), termed Osler-Weber-Rendu syndrome, is an inherited autosomal dominant vascular disease with varying clinical manifestations, such as epistaxis, gastrointestinal bleeding, and iron deficiency anemia [7]. This study was performed to examine the prevalence of asymptomatic angiodysplasia detected in upper gastrointestinal endoscopic examinations and of hereditary hemorrhagic telangiectasia (HHT) suspected cases

Methods

Results

Conclusion