Extensive Cecal Angioectasia Causing Chronic Occult Gastrointestinal Blood Loss and Iron-Deficiency Anemia: A Case Report

Source: PubMed Central Open Access, NCBI / U.S. National Library of Medicine

Gastrointestinal angioectasia is considered one of the leading causes of lower gastrointestinal bleeding in elderly patients. It represents the most frequent vascular abnormality within the gastrointestinal tract, with lesions most commonly found on the right side of the colon. Endoscopic management includes several techniques aimed at removing abnormal mucosal lesions. However, recurrent bleeding after endoscopic therapy is common and may require repeated endoscopic interventions or additional therapeutic modalities. Patients typically present with intermittent, painless gastrointestinal bleeding. The lesions may be solitary or multiple, most frequently located in the stomach, small intestine, or right colon. Diagnosis is mainly established through endoscopy. Initial treatment usually involves endoscopic coagulation, while more severe cases may require angiographic embolization or surgical resection. We present the case of a 78-year-old man who presented with severe transfusion-requiring iron-deficiency anemia without ongoing overt gastrointestinal bleeding and was found to have an unusually large cecal angioectasia that differed from the small, flat lesions typically described in the literature. The lesion was successfully managed with mechanical clipping rather than conventional thermal ablation, highlighting an alternative endoscopic approach for selected large vascular lesions.