This patient had a perplexing anemia (low red blood cell count) that kept getting worse for no particular reason. Stool tests did show some hidden blood, but a colonoscopy exam was normal. So the patient returned to Three Rivers Endoscopy Center for an "upper scope" test, or a gastroscopy. Above on the left is a picture of the lining of the first portion of the small intestine just beyond the stomach. This area is called the duodenum. You can plainly see a red patch called angiodysplasia. This is a collection of small arteries that have come to the surface and become fragile. When food goes down the intestine, these exposed vessels can begin to bleed small amounts of blood. Usually the amount of bleeding daily is so small that it can not be seen in the stool. But, over time this will cause enough loss of blood to lead to anemia. This explains why this patient kept developing anemia. In this case, the area was painlessly cauterized during the upper scope exam - as you can see on the photo on the right. This was done with the Olympus Heater Probe that applies a small amount of heat to cauterize the abnormal vessels. This was done during this patients gastroscopy exam as a simple outpatient procedure. Since this procedure there has been no further bleeding. On iron replacement pills, the anemia has resolved and the patient feels well. Angiodysplasia is an "abnormal growth" of a small artery in the digestive tract that is fairly common, but seldom causes bleeding. When bleeding occurs and the lesion is within reach of the scope, endoscopic therapy can be curative and major surgery avoided.

Text & Images Courtesy of Three Rivers Endoscopy Center
© Dr. Robert Fusco, Three Rivers Endoscopy Center, All Rights Reserved