title: Multiple Polypoid Angiodysplasia with Obscure Overt Bleeding.
abstract: Angiodysplasia (AD) is increasingly being recognized as a major cause of gastrointestinal bleeding. Morphologically flat lesions are common types of AD, whereas the polypoid types are rare. We report a case of multiple polypoid AD in the small bowel causing severe anemia and requiring surgical treatment. A 60-year-old male patient visited our hospital with dyspnea and hematochezia. He had a history of myocardial infarction and was taking both aspirin and clopidogrel. Capsule endoscopy, enteroscopy, computed tomography, and angiography revealed multifocal vascular lesions with a polypoid shape in the jejunum. Surgical resection was performed because endoscopic treatment was considered impossible with the number and the location of lesions. The risk of recurrent bleeding related to the use of antiplatelet agents also contributed to the decision to perform surgery. AD was histologically diagnosed from the surgical specimen. He resumed taking both aspirin and clopidogrel after surgery. He fully recovered and has been doing well during the several months of follow-up.
authors: Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.
authors: Jooyoung
authors: J
authors: Lee
authors: Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea; Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Sung Wook
authors: SW
authors: Hwang
authors: Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.
authors: Jihye
authors: J
authors: Kim
authors: Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.
authors: Jinwoo
authors: J
authors: Kang
authors: Department of Pathology, Seoul National University College of Medicine, Seoul, Korea.
authors: Gyeong Hoon
authors: GH
authors: Kang
authors: Division of Colorectal Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
authors: Kyu Joo
authors: KJ
authors: Park
authors: Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.
authors: Jong Pil
authors: JP
authors: Im
authors: Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.
authors: Joo Sung
authors: JS
authors: Kim
keywords: Angiodysplasia; Capsule endoscopy; Gastrointestinal hemorrhage