The role of capsule endoscopy in the diagnosis of small intestine angiodysplasia

Background. According to various studies, the cause of bleeding from the gastrointestinal tract in 3-27% of cases are angiodysplasias, abnormally dilated, convoluted blood vessels from 1 to 15 mm localized in the submucosal intestinal layer. There are a number of methods for diagnosing angiodysplasias, among which capsule endoscopy (CE) occupies an important place. Clinical guidelines recommend CE as a first-line procedure for patients with suspected small intestine bleeding the after performing EGDS and colonoscopy. Description of the clinical case. The article presents a rare clinical case of diagnosis and management of a patient with arteriovenous small intestine angiodysplasias. A 58-year-old patient for a long time presented various gastrointestinal complaints. During hospitalization, there were controversial bleeding symptoms. Comprehensive examination with CE revealed vascular injection, varicose veins, arteriovenous malformations without signs of bleeding at the time of the study at the border of the jejunum and ileum and in the ileum. The most likely reason for the decrease in hemoglobin level (up to 120 g/l) was bleeding from small intestine arteriovenous malformations. The patient received therapy with enzyme preparations, proton pump inhibitors, intestinal antiseptics, motility regulators with a positive effect in the form of relief of pain and dyspeptic syndromes, and normalization of stool. Conclusion. CE helps to diagnose acute and chronic bleeding, the sources of which are small intestine angiodysplasia; this allows to start timely treatment, as well as identify asymptomatic angiodysplasia, which makes it possible to prevent life-threatening complications.

gastrointestinal bleeding, intestinal angiodysplasia, capsule endoscopy