A bleeding angiodysplasia of the small intestine: does utilization of modern modalities changes the roles of diagnosis and management?

Small intestinal bleeding accounts for 5–10% of all patients presenting with gastrointestinal bleeding (GIB).In the modern era of capsule endoscopy, Angiodysplasias of the small intestine turned out to be a major cause of “obscure GIB”, particularly in the elderly. Due to the multifocal nature of Angiodysplasia, effective therapy is a challenge. Recurrence rate after endoscopic treatment ranges from 20 to nearly 50%. Additional systemic therapy options are available. A 62 years old male was presented to our institute with an acute recurrent upper GI bleeding originating from several angiodysplasia foci. Using capsule video endoscopy, followed by push enteroscopy and argon plasma coagulation temporary hemostasis was done. Due to the nature of the lesions, recurrent bleeding episodes recurred and mandated the need of systemic treatment with somatostatin.