Vascular Lesions of the Gastrointestinal Tract

Vascular disorders of the GI tract are being more accurately documented as our diagnostic modalities become more sophisticated. Among the diagnostic techniques commonly used today are upper and lower tract endoscopy, single- and double-balloon enteroscopy (SBE and DBE), capsule endoscopy (CE), and advanced radiologic imaging techniques such as CTA and MRA. Vascular lesions are a common cause of GI hemorrhage and may be solitary or multiple, benign or malignant, isolated, a result of treatment, part of a syndrome or systemic disorder, or due to an anatomic abnormality of the vasculature. It is important at the outset to understand the nomenclature of vascular lesions. Vas and its derivative vascular are Latin words meaning “vessel”; the Greek equivalent is angeion. Ectasia is a word of Greek derivation that refers to the process whereby a blood vessel becomes dilated or lengthened; the resulting lesion also can be referred to as an ectasia. Telangiectasia results from dilatation of the terminal aspect (tele) of a vessel. Angiodysplasia is used as a general term to describe the lesion or process whereby an abnormally formed (dys, “bad”; plasis, “molded”) vessel develops. An arteriovenous (AV) malformation is a congenital lesion, whereas an angioma is a neoplasm. This chapter discusses the clinically important vascular lesions of the GI tract, most of which cause GI bleeding.