Case history
Case history #1
A 70-year-old man presents with an 8-month history of painless intermittent self-limited haematochezia. He finds it increasingly difficult to walk longer distances, as he quickly becomes short of breath. Relatives have told him he has been looking very pale and washed-out recently.
Case history #2
A 72-year-old woman with aortic stenosis has recurrent anaemia, and her haemoglobin level drops to 80 g/L (8 g/dL). Oesophago-gastro-duodenoscopy and colonoscopy findings are normal. Video capsule endoscopy after her second presentation with iron deficiency anaemia shows several angioectasia in her proximal and mid small bowel.
Other presentations
The clinical presentation varies depending on the lesion location and the rate of bleeding. As lesions may be located throughout the gastrointestinal tract, presentation can range from melaena and haematemesis to haematochezia and iron deficiency anaemia. Typically the presentation is one of chronic, mild, intermittent bleeding but can occasionally present with massive haemorrhage (15% of patients).[5] Bleeding stops spontaneously in >90% of presentations.[6]
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