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Multiple Polypoid Angiodysplasia with Obscure Overt Bleeding

Clinical Endoscopy
2016년 49권 1호 p.91 ~ p.96
 ( Lee Joo-Young ) - Seoul National University College of Medicine Department of Internal Medicine

 ( Hwang Sung-Wook ) - Seoul National University College of Medicine Department of Internal Medicine
 ( Kim Ji-Hye ) - Seoul National University College of Medicine Department of Internal Medicine
 ( Kang Jin-Woo ) - Seoul National University College of Medicine Department of Internal Medicine
 ( Kang Gyeong-Hoon ) - Seoul National University College of Medicine Department of Pathology
 ( Park Kyu-Joo ) - Seoul National University College of Medicine Department of Surgery
 ( Im Jong-Pil ) - Seoul National University College of Medicine Department of Internal Medicine
 ( Kim Joo-Sung ) - Seoul National University College of Medicine Department of Internal Medicine

Abstract

Angiodysplasia (AD) is increasingly being recognized as a major cause of gastrointestinal bleeding. Morphologically flat lesions are common types of AD, whereas the polypoid types are rare. We report a case of multiple polypoid AD in the small bowel causing severe anemia and requiring surgical treatment. A 60-year-old male patient visited our hospital with dyspnea and hematochezia. He had a history of myocardial infarction and was taking both aspirin and clopidogrel. Capsule endoscopy, enteroscopy, computed tomography, and angiography revealed multifocal vascular lesions with a polypoid shape in the jejunum. Surgical resection was performed because endoscopic treatment was considered impossible with the number and the location of lesions. The risk of recurrent bleeding related to the use of antiplatelet agents also contributed to the decision to perform surgery. AD was histologically diagnosed from the surgical specimen. He resumed taking both aspirin and clopidogrel after surgery. He fully recovered and has been doing well during the several months of follow-up.

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