gastrointestinal disorders
Vascular Gastrointestinal Lesions
Introduction
Several distinct congenital or acquired syndromes involve abnormal mucosal or submucosal blood vessels in the gastrointestinal tract. These vessels may cause recurrent bleeding, which is rarely massive. Diagnosis is by endoscopy and sometimes angiography. Treatment is endoscopic hemostasis; occasionally, angiographic embolization or surgical resection may be needed. (See also Overview of Gastrointestinal Bleeding .) age 60 and are the most common cause of lower Etiology in that age group. They are thought to be degenerative and do not occur in association with other vascular abnormalities. Most patients have 2 or 3 lesions, which are typically 0.5 to 1.0 cm, bright red, flat or slightly raised, and covered by very thin epithelium. Vascular ectasias also occur in association with a number of systemic diseases (eg, renal failure, aortic stenosis, cirrhosis, CREST syndrome [calcinosis cutis, Raynaud phenomenon, esophageal dysmotility, sclerodactyly, telangiectasias]) and after radiation to the bowel. Gastric antral vascular ectasia(watermelon stomach or GAVE) consists of large dilated veins running linearly along the stomach, creating a striped appearance suggestive of a watermelon. The condition occurs mainly in older women and is of unknown etiology. Hereditary Hemorrhagic Telangiectasia None Dieulafoy lesionis an abnormally large artery that penetrates the gut wall, occasionally eroding through the mucosa and causing massive bleeding. It occurs mainly in the proximal stomach. Arteriovenous malformationsandhemangiomas,both congenital disorders of blood vessels, can occur in the GI tract but are rare. 