Article

Angiodysplasie du côlon

Acta Endoscopica (Impact Factor: 0.16). 14(2):93-99. DOI: 10.1007/BF02966100

ABSTRACT L’angiodysplasie du côlon est une cause très fréquente d’hémorragie digestive basse.

Entre février 1974 et mai 1983, l’angiodysplasie du côlon a été diagnostiquée chez 17 malades, dont 11 depuis 1980. Nous avons
examiné 8 hommes et 9 femmes dont l’âge se situait entre 51 et 87 ans (moyenne : 68,6 ans) ; trois patients seulement n’avaient
pas atteint l’âge de 60 ans.

Ils étaient hospitalisés ð cause d’une hémorragie digestive chronique et intermittente, une hémorragie aiguë et massive (12
%) ou pour une anémie ferriprive (18 %). Le saignement rectal peut s’exprimer par l’émission de sang rouge (47 %) ou non (59
%). Une angiographie pratiquée chez 15 patients a démontré l’angiodysplasie chez 13 (87 %) ; les 2 patients avec angiographie
négative ont subi une coloscopie avec des biopsies positives. Deux patients n’ont pas subi d’angiographie : le premier a été
opéré en urgence ð cause d’une hémorragie cataclysmique, chez l’autre le diagnostic a été posé par la coloscopie. La majorité
des angiodysplasies était localisée au côlon droit (14/17). Le traitement de choix a été une hémicolectomie droite ; une résection
du sigmoïde a été exécutée chez 2 patients ; trois patients ont subi une coagulation endoscopique.

Angiodysplasia of the colon is a common cause of lower intestinal tract bleeding. Between February 1974 and May 1983 angiodysplasia
was diagnosed in 17 patients, 11 of them since 1980. The sex ratio was 8 men and 9 women with an age distribution of 51 to
87 years (mean 68,6 years), only 3 of them being younger than 60 years. They presented with a history of chronic intermittent
gastrointestinal bleeding, massive bleeding (12 %) or chronic iron deficiency anemia (18 %). The bleeding could be bright
red (47 %) as well as melena (59 %). An arteriography was performed in 15 patients and demonstrated angiodysplasia in 13 (87
%) ; the 2 patients with a negative arteriography had a colonoscopy with positive biopsies. Two patients underwent no angiography
: the first needed an urgent operation because of massive bleeding and in the other the diagnosis was made by colonoscopy.
Most angiodysplastic lesions were located in the right colon (14/17). The treatment of choice was a right hemicolectomy; a
resection of the sigmoid was performed in 2 patients and endoscopic coagulation in 3 patients.

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