Illustrated here are examples of angiodysplastic lesions from four different patients with chronic gastrointestinal blood loss. These lesions were all found in the cecum and more than the one lesion may be found on careful examination. Note their delicate frond-like appearance. Often a prominent feeding vessel can be identified. In this example, the lesion was pale and could easily have been missed. Administration of naloxone causes vasodilation and enhanced visualization of the lesion. Angiodysplasia is a common cause of lower gastrointestinal bleeding. When these lesions are found incidentally during colonoscopy, ablation may not be indicated.
Peter B. Kelsey, M.D., Harvard Medical School, Massachusetts General Hospital