Colonic angiodysplasia occurs in approximately 1% of the adult population and is one of the most common causes of massive lower GI bleeding in patients over the age of 65. The lesions seen here are typical cecal angiodysplasia. While angiodysplasia can be found anywhere along the colon, significant bleeding occurs most frequently from those lesions located in the cecum.
Effective ablation is achieved here using a bipolar cautery device. The power setting is 15 watts and applications are continued until the lesion is completely blanched. Often a prominent feeding or draining vascular structure is identified and more cautery may be required to completely coagulate this site.
The cauterized areas are observed and repeat applications are applied as necessary.
Peter B. Kelsey, M.D., Harvard Medical School, Massachusetts General Hospital