B0638 - Association of Small Bowel Angioectasia with Cardiac, Pulmonary, Liver, Renal and Systemic Diseases

Monjur Ahmed, MD¹, Anna Chen, MD¹, John Bruckbauer, ¹, Jacky Reny, BS^2
1Thomas Jefferson University Hospital, Philadelphia, PA; ²Thomas Jefferson University Sidney Kimmel Medical College, Bensalem, PA

Introduction: Small bowel angioectasias (SBA) are characterized by regions of local accumulation of dilated blood vessels in the intestinal wall. While angioectasias can occur anywhere in the gastrointestinal tract, a significant source for obscure GI bleed is within the small bowel. The mechanism behind SBA development is not fully understood. Studies have shown that SBAs may be associated with conditions such as aortic valve stenosis, liver cirrhosis, and renal failure. The purpose of this study is to identify comorbid medical conditions that may be associated with SBA.

Methods: Patients admitted to Thomas Jefferson University Hospital and Methodist Hospital with small bowel angioectasia between 2018-2022 were identified using ICD-10 coding. Each patient's diagnosis was confirmed via endoscopy or capsule reports. Patients with only gastric and/or colonic angioectasias were excluded. Patient demographics and comorbidities were evaluated.

Results: 447 patients with SBA were identified. 237 were female and 210 were male. 13 patients were below 50 years old and 7 were >90 years old. 44 patients were between 51-60 years old, 140 were between 61-70, 148 were between 71-80, and 88 were between 81-90. 261 patients were white and 151 patients were black. Other racial groups were Hispanic (12), Asian (9), Native American (1), and Unknown (13).

Hypertension and hyperlipidemia were seen in 331 and 213 patients, respectively. 137 patients had diabetes. COPD affected 127 patients. CAD occurred in 123 patients. Anemia was present in 122 patients. Atrial fibrillation was seen in 115 patients. Heart failure and CKD were both seen in 111 patients. Cancer was seen in 103 patients. Other comorbidities include: GERD (99), sleep apnea (71), aortic stenosis (53), liver cirrhosis (50 patients), hypothyroidism (47), stroke (45), ESRD (45), asthma (26), mitral valve regurgitation (23), and pulmonary hypertension (23).

Discussion: This study sought to identify common comorbidities in SBA. Key characteristics were chronicity and cardiopulmonary effects. Kidney disease and malignancy were also common. Heyde syndrome (aortic stenosis with angioectasias) is a known cause of GI bleed. Yet aortic stenosis was only seen in 12% of patients in this study. Other comorbidities were more prevalent. The results demonstrate that a variety of chronic diseases may be associated with angioectasia. Further research is needed to understand the risk for GI bleeding in the presence of chronic disease.



Disclosures:


Monjur Ahmed, MD¹, Anna Chen, MD¹, John Bruckbauer, ¹, Jacky Reny, BS². B0638 - Association of Small Bowel Angioectasia with Cardiac, Pulmonary, Liver, Renal and Systemic Diseases, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.