Colonic angiodysplasia: a culprit of obscure gastrointestinal bleeding in a patient with Heyde syndrome
A 77-year-old woman presented with obscure gastrointestinal bleeding requiring multiple hospitalisations and blood transfusions. The patient underwent repeated investigations over four hospital admissions across a span of two months. These included upper and lower gastrointestinal endoscopy, video c...
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| Veröffentlicht in: | BMJ case reports 2022-01, Vol.15 (1), p.e247595 |
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| creator | Shaw, Ming Yoke Vera Asokkumar, Ravishankar Tan Kwong Wei, Emile John Seow-En, Isaac |
| description | A 77-year-old woman presented with obscure gastrointestinal bleeding requiring multiple hospitalisations and blood transfusions. The patient underwent repeated investigations over four hospital admissions across a span of two months. These included upper and lower gastrointestinal endoscopy, video capsule endoscopy as well as CT enterography, without definitive localisation or treatment of the source of bleeding. Finally, a technetium-99m-labelled red blood cell scan demonstrated a 'blush' at the proximal transverse colon on delayed imaging. Targeted colonoscopic evaluation showed a subcentimetre angiodysplastic lesion in the corresponding spot at the proximal transverse colon with slow persistent oozing. Endoscopic clips were applied with successful haemostasis. The patient recovered well without further symptom recurrence 5 months postdischarge. We review the literature on colonic angiodysplasias and discuss the diagnostic challenges in obscure gastrointestinal bleeding. |
| doi_str_mv | 10.1136/bcr-2021-247595 |
| format | Article |
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The patient underwent repeated investigations over four hospital admissions across a span of two months. These included upper and lower gastrointestinal endoscopy, video capsule endoscopy as well as CT enterography, without definitive localisation or treatment of the source of bleeding. Finally, a technetium-99m-labelled red blood cell scan demonstrated a 'blush' at the proximal transverse colon on delayed imaging. Targeted colonoscopic evaluation showed a subcentimetre angiodysplastic lesion in the corresponding spot at the proximal transverse colon with slow persistent oozing. Endoscopic clips were applied with successful haemostasis. The patient recovered well without further symptom recurrence 5 months postdischarge. We review the literature on colonic angiodysplasias and discuss the diagnostic challenges in obscure gastrointestinal bleeding.</description><identifier>ISSN: 1757-790X</identifier><identifier>EISSN: 1757-790X</identifier><identifier>DOI: 10.1136/bcr-2021-247595</identifier><identifier>PMID: 35027388</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>Aftercare ; Aged ; Anemia ; Angiodysplasia - complications ; Angiodysplasia - diagnosis ; Aortic stenosis ; Capsule Endoscopy ; Case Report ; Case reports ; Colon ; Colonoscopy ; Endoscopy ; Endoscopy, Gastrointestinal ; Female ; Gastrointestinal Hemorrhage - etiology ; Hemoglobin ; Hemorrhoids ; Humans ; Large intestine ; Localization ; Medical imaging ; Patient Discharge ; Patients ; Scintigraphy</subject><ispartof>BMJ case reports, 2022-01, Vol.15 (1), p.e247595</ispartof><rights>BMJ Publishing Group Limited 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>2022 BMJ Publishing Group Limited 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ . Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>BMJ Publishing Group Limited 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. 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The patient underwent repeated investigations over four hospital admissions across a span of two months. These included upper and lower gastrointestinal endoscopy, video capsule endoscopy as well as CT enterography, without definitive localisation or treatment of the source of bleeding. Finally, a technetium-99m-labelled red blood cell scan demonstrated a 'blush' at the proximal transverse colon on delayed imaging. Targeted colonoscopic evaluation showed a subcentimetre angiodysplastic lesion in the corresponding spot at the proximal transverse colon with slow persistent oozing. Endoscopic clips were applied with successful haemostasis. The patient recovered well without further symptom recurrence 5 months postdischarge. We review the literature on colonic angiodysplasias and discuss the diagnostic challenges in obscure gastrointestinal bleeding.</description><subject>Aftercare</subject><subject>Aged</subject><subject>Anemia</subject><subject>Angiodysplasia - complications</subject><subject>Angiodysplasia - diagnosis</subject><subject>Aortic stenosis</subject><subject>Capsule Endoscopy</subject><subject>Case Report</subject><subject>Case reports</subject><subject>Colon</subject><subject>Colonoscopy</subject><subject>Endoscopy</subject><subject>Endoscopy, Gastrointestinal</subject><subject>Female</subject><subject>Gastrointestinal Hemorrhage - etiology</subject><subject>Hemoglobin</subject><subject>Hemorrhoids</subject><subject>Humans</subject><subject>Large intestine</subject><subject>Localization</subject><subject>Medical imaging</subject><subject>Patient Discharge</subject><subject>Patients</subject><subject>Scintigraphy</subject><issn>1757-790X</issn><issn>1757-790X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNpdkc1LHDEYxkNpqbL13JsEvPQyms_JrIdCWeoHCF4UegvvJJkxkk3WZKZl__tmWRU1hySQ533e98kPoe-UnFLK27Pe5IYRRhsmlFzKT-iQKqkatSR_Pr-5H6CjUh5JXZyKTvCv6IBLwhTvukM0rlJI0RsMcfTJbssmQPFwjgGbOWyyn3AacOqLmbPDI5QpJx8nVyYfIeA-OGd9HLGPtWIDk3dxwv_89ICv3NY6XLbR5rR239CXAUJxR8_nAt1f_L5bXTU3t5fXq183jRGMTo2zSg5G9mCACS6gswQkA2paO_TU9UpKAXRQRom2bhIo43agQvWmFYMhfIF-7n03c7921tRxMgRdg6whb3UCr9-_RP-gx_RXd6pllNBq8OPZIKenuebUa1-MCwGiS3PRrGWEqLZrd71OPkgf05zrt-xUdMkVYTXEAp3tVSanUrIbXoehRO846spR7zjqPcdacfw2w6v-hRr_D7uym8o</recordid><startdate>20220113</startdate><enddate>20220113</enddate><creator>Shaw, Ming Yoke Vera</creator><creator>Asokkumar, Ravishankar</creator><creator>Tan Kwong Wei, Emile John</creator><creator>Seow-En, Isaac</creator><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-8287-6812</orcidid></search><sort><creationdate>20220113</creationdate><title>Colonic angiodysplasia: a culprit of obscure gastrointestinal bleeding in a patient with Heyde syndrome</title><author>Shaw, Ming Yoke Vera ; Asokkumar, Ravishankar ; Tan Kwong Wei, Emile John ; Seow-En, Isaac</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c421t-ed75fc5baca2434a8d0a52a1c6dfb1eb7554a1f7c7467c75a123df147bc64fc03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Aftercare</topic><topic>Aged</topic><topic>Anemia</topic><topic>Angiodysplasia - complications</topic><topic>Angiodysplasia - diagnosis</topic><topic>Aortic stenosis</topic><topic>Capsule Endoscopy</topic><topic>Case Report</topic><topic>Case reports</topic><topic>Colon</topic><topic>Colonoscopy</topic><topic>Endoscopy</topic><topic>Endoscopy, Gastrointestinal</topic><topic>Female</topic><topic>Gastrointestinal Hemorrhage - etiology</topic><topic>Hemoglobin</topic><topic>Hemorrhoids</topic><topic>Humans</topic><topic>Large intestine</topic><topic>Localization</topic><topic>Medical imaging</topic><topic>Patient Discharge</topic><topic>Patients</topic><topic>Scintigraphy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shaw, Ming Yoke Vera</creatorcontrib><creatorcontrib>Asokkumar, Ravishankar</creatorcontrib><creatorcontrib>Tan Kwong Wei, Emile John</creatorcontrib><creatorcontrib>Seow-En, Isaac</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMJ case reports</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shaw, Ming Yoke Vera</au><au>Asokkumar, Ravishankar</au><au>Tan Kwong Wei, Emile John</au><au>Seow-En, Isaac</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Colonic angiodysplasia: a culprit of obscure gastrointestinal bleeding in a patient with Heyde syndrome</atitle><jtitle>BMJ case reports</jtitle><addtitle>BMJ Case Rep</addtitle><date>2022-01-13</date><risdate>2022</risdate><volume>15</volume><issue>1</issue><spage>e247595</spage><pages>e247595-</pages><issn>1757-790X</issn><eissn>1757-790X</eissn><abstract>A 77-year-old woman presented with obscure gastrointestinal bleeding requiring multiple hospitalisations and blood transfusions. The patient underwent repeated investigations over four hospital admissions across a span of two months. These included upper and lower gastrointestinal endoscopy, video capsule endoscopy as well as CT enterography, without definitive localisation or treatment of the source of bleeding. Finally, a technetium-99m-labelled red blood cell scan demonstrated a 'blush' at the proximal transverse colon on delayed imaging. Targeted colonoscopic evaluation showed a subcentimetre angiodysplastic lesion in the corresponding spot at the proximal transverse colon with slow persistent oozing. Endoscopic clips were applied with successful haemostasis. The patient recovered well without further symptom recurrence 5 months postdischarge. We review the literature on colonic angiodysplasias and discuss the diagnostic challenges in obscure gastrointestinal bleeding.</abstract><cop>England</cop><pub>BMJ Publishing Group LTD</pub><pmid>35027388</pmid><doi>10.1136/bcr-2021-247595</doi><orcidid>https://orcid.org/0000-0001-8287-6812</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Aftercare Aged Anemia Angiodysplasia - complications Angiodysplasia - diagnosis Aortic stenosis Capsule Endoscopy Case Report Case reports Colon Colonoscopy Endoscopy Endoscopy, Gastrointestinal Female Gastrointestinal Hemorrhage - etiology Hemoglobin Hemorrhoids Humans Large intestine Localization Medical imaging Patient Discharge Patients Scintigraphy |
| title | Colonic angiodysplasia: a culprit of obscure gastrointestinal bleeding in a patient with Heyde syndrome |
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