Angiodysplasia differential diagnosis: Difference between revisions

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| style="background: #DCDCDC; padding: 5px; text-align: center;" |<small>Angiodysplasia</small>
| style="background: #DCDCDC; padding: 5px; text-align: center;" |<small>Angiodysplasia</small>
| style="background: #F5F5F5; padding: 5px;" |Asymptomatic
| style="background: #F5F5F5; padding: 5px;" |<small>Asymptomatic</small>
| style="background: #F5F5F5; padding: 5px;" |Occult lower GI bleed
| style="background: #F5F5F5; padding: 5px;" |<small>Occult lower GI bleed</small>
| style="background: #F5F5F5; padding: 5px;" |No abdominal pain
| style="background: #F5F5F5; padding: 5px;" |<small>No abdominal pain</small>
| style="background: #F5F5F5; padding: 5px;" |Signs of anemia
| style="background: #F5F5F5; padding: 5px;" |<small>Signs of anemia</small>
| style="background: #F5F5F5; padding: 5px;" |Systolic ejection murmur (if aortic stenosis)
| style="background: #F5F5F5; padding: 5px;" |<small>Systolic ejection murmur (if aortic stenosis)</small>
| style="background: #F5F5F5; padding: 5px;" |Rarely, orthostasis or hypotension
| style="background: #F5F5F5; padding: 5px;" |<small>Rarely, orthostasis or hypotension</small>
| style="background: #F5F5F5; padding: 5px;" |Microcytic anemia
| style="background: #F5F5F5; padding: 5px;" |<small>Microcytic anemia</small>
| style="background: #F5F5F5; padding: 5px;" |Renal and liver function tests
| style="background: #F5F5F5; padding: 5px;" |<small>Renal and liver function tests</small>
| style="background: #F5F5F5; padding: 5px;" |Coagulation studies
| style="background: #F5F5F5; padding: 5px;" |<small>Coagulation studies</small>
| style="background: #F5F5F5; padding: 5px;" |Radionuclide scanning
| style="background: #F5F5F5; padding: 5px;" |<small>Radionuclide scanning</small>
| style="background: #F5F5F5; padding: 5px;" |CTA/MRA
| style="background: #F5F5F5; padding: 5px;" |<small>CTA/MRA</small>
| style="background: #F5F5F5; padding: 5px;" |Upper GI endoscopy and colonoscopy
| style="background: #F5F5F5; padding: 5px;" |<small>Upper GI endoscopy and colonoscopy</small>
| style="background: #F5F5F5; padding: 5px;" |Tortuous, dilated veins, venules and capillaries in the colonic mucosa and submucosa
| style="background: #F5F5F5; padding: 5px;" |<small>Tortuous, dilated veins, venules and capillaries in the colonic mucosa and submucosa</small>
| style="background: #F5F5F5; padding: 5px;" |Endoscopy
| style="background: #F5F5F5; padding: 5px;" |<small>Endoscopy</small>
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Revision as of 12:15, 3 September 2021

Angiodysplasia Microchapters

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Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Angiodysplasia from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

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MRI

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Nikita Singh, M.D.[2]

Overview

Angiodysplasia must be differentiated from other diseases that cause hematochezia, melena, and iron deficiency anemia , such as hemorrhoids, diverticular disease and colon cancer.

Differentiating Angiodysplasia from other Diseases

Angiodysplasia must be differentiated from diverticulitis, hemorrhoids, colon cancer, massive upper GI bleed and inflammatory bowel disease.

Diseases Clinical manifestations Para-clinical findings Gold standard
Symptoms Physical examination
Lab Findings Imaging Histopathology
Symptom 1 Symptom 2 Symptom 3 Physical exam 1 Physical exam 2 Physical exam 3 Lab 1 Lab 2 Lab 3 Imaging 1 Imaging 2 Imaging 3
Diverticulitis Abdominal cramps Bloating Diarrhoea Left lower quadrant abdominal tenderness Bowel sounds hypoactive/normoactive Fever Leukocytosis Elevated ESR and CRP Radiological test of choice - CT of abdomen and pelvis with contrast Abdominal Ultrasound MRI abdomen Colonoscopy after resolution of inflammation
Hemorrhoids Hematochezia Anal pain Anal protrusion Skin tags Fistulas or fissures Prolapsed hemorrhoid External hemorrhoids - distal to dentate line.

Internal hemorrhoids - proximal to dentate line.

Anoscopy
Colon cancer Tenesmus Bowel habits change Weight loss Lmyphadenopathies Abdominal mass Hepatomegaly (metastasis) Tumor marker - CEA CT with contrast chest, abdomen and pelvis Majority of colorectal cancers are carcinomas. Colonoscopy
Massive upper GI bleed Hematemesis Abdominal pain Melena Hemodynamic instability Upper abdominal tenderness Pale skin Acute bleeding - normocytic anemia Elevated BUN-to-Creatinine ratio >30:1 CT angiography Endoscopy
Inflammatory bowel disease Bloody diarrhea Tenesmus Abdominal pain Tachycardia, fever, Occult blood on digital rectal exam Anal fistulas, abscesses Microcytic anemia Leukocytosis Elevated ESR, CRP Abdominal X ray - free air, bowel obstruction, toxic megacolon Barium studies Ultrasound/CT/MRI UC- crypt abscess

Crohn's- transmural involvement, granulomas

Endoscopy
Angiodysplasia Asymptomatic Occult lower GI bleed No abdominal pain Signs of anemia Systolic ejection murmur (if aortic stenosis) Rarely, orthostasis or hypotension Microcytic anemia Renal and liver function tests Coagulation studies Radionuclide scanning CTA/MRA Upper GI endoscopy and colonoscopy Tortuous, dilated veins, venules and capillaries in the colonic mucosa and submucosa Endoscopy

References

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