Vascular malformations of the digestive tract

Vascular malformations of the digestive tract result from a localised deterioration of capillary development. Also called angiomas, telangiectasias, or angiodysplasias, these malformations can be acquired or divide themselves into segments. They can also be sporadic or degenerative, but rarely congenital or hereditary. Vascular pathologies of the digestive tract can cause digestive haemorrhage.

In recent years, diagnosis and treatment of vascular pathologies of the digestive tract have greatly evolved. With a video capsule, doctors can now exhaustively study the small intestine in a non-invasive way. In fact, 70% of bowel haemorrhages have been reported in cases of these capillary malformations. Concerning treatment, it is now possible to coagulate angiodysplasia haemorrhages through an endoscopic procedure. Moreover, research on treatment options of Osler-Webber-Rendu syndrome (HHT) continues to greatly progress. This type of hereditary angioma is treated by a liver transplant and antiangiogenic treatments.

Some studies show that certain patients taking antiplatelets and/or anticoagulants often develop cardiovascular issues. Amongst other complications, these patients suffer from digestive haemorrhages, caused by angioma bleeding. The treatment should be limited to controlling the bleeding, namely to telangiectasias, of which responsibility has been established, after elimination of all other causes after an endoscopy. Despite treatment, relapse is not inevitable. In all cases, compensation for iron deficiency is primordial during endoscopic treatment.

Fiche Vascular malformations of the digestive tract

• Author : Florian Reinaud, MD
• Date : May 05, 2018