Su1558 Clinical Characteristics of Angiectasia of the Colon: Case-Control Analysis

Abstract

Su1558 Clinical Characteristics of Angiectasia of the Colon: Case-Control Analysis Yusuke Sekino, Hiroshi Iida, Yasunari Sakamoto, Takashi Nonaka, Eiji Sakai, Takashi Uchiyama, Kunihiro Hosono, Hiroki Endo, Koji Fujita, Tomoko Koide, Masato Yoneda, Hirokazu Takahashi, Chikako Tokoro, Yasunobu Abe, Hiroyuki Kirikoshi, Noritoshi Kobayashi, Kensuke Kubota, Satoru Saito, Atsushi Nakajima, Shin Maeda, Masahiko Inamori Gastroenterology Division, Yokohama City University School of Medicine, Yokohama, Japan Background: Angiectasia is one of the most common lesions found in the gastrointestinal tract. With the development and widespread performance of colonoscopy, angiectasia of colon has received attention in recent years as a cause of gastrointestinal bleeding. The aim of this study was to determine whether there are risk estimates of angiectasia of colon, bleeding and rebleeding from angiectasia of colon using case-control analysis. Methods: We collected the data of all patients who underwent colonoscopy at our hospital between January 2008 and November 2010, including 90 patients who were diagnosed as having angiectasia of the colon and 5775 patients without angiectasia of the colon. For the case-control analysis, we comparatively analyzed the predictors of the presence of angiectasia and the risk of bleeding and re-bleeding between the 90 individuals with angiectasia and 180 individuals without angiectasia, as controls, after adjustments for sex and age. Results: Ninety patients (58 males and 32 females; median age, 69 years; age range, 26-92 years) who underwent colonoscopy at our hospital between January 2008 and November 2010 were diagnosed as having angiectasia of the colon. Four patients had pulmonary disease, 18 patients had cardiovascular disease (including 7 with valvular heart disease, 11 with ischemic heart disease and 6 with chronic heart failure), 15 patients had liver cirrhosis, 20 patients had diabetes mellitus, and 11 patients had chronic renal failure. Twenty patients were receiving antiplatelet therapy or anticoagulant therapy, and 2 patients were receiving steroid therapy. According to the results of a multivariate analysis, cardiovascular disease (odds ratio (OR), 3.369; 95% confidence interval (CI), 1.081-10.504; p value, 0.0363), liver cirrhosis (OR, 12.786; 95% CI, 3.434-47.609; p value, 0.0001) and chronic renal failure (OR, 7.137; 95% CI, 1.742-29.243; p value, 0.0063) were identified as significant predictors of the presence of angiectasia in the colon. Only cardiovascular disease was identified as a significant risk factor for active bleeding from the colonic angiectasia (p-value was 0.0478) (Table 1). Conclusions: From this case-control analysis of angiectasia of colon, it was found that patients with liver cirrhosis (3.1% of the individuals who underwent colonoscopy) were at an approximately 13-fold higher risk, patients with chronic renal failure (2.0%) were at a 7-fold higher risk, and patients with cardiovascular disease (6.8%) were at a 3.4-fold higher risk of angiectasia of the colon as compared to control individuals. In cases of anemia of unknown cause or occult gastrointestinal bleeding, careful consideration must be given to colonoscopic observation, especially in patients with liver cirrhosis, chronic renal failure or cardiovascular disease.