On the nature and etiology of vascular ectasias of the colon. Degenerative lesions of aging

Scott J. Boley, R. Sammartano, A. Adams, A. DiBiase, S. Kleinhaus, Seymour Sprayregen

Research output: Contribution to journalArticle

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Abstract

Vascular lesions of the right colon are being diagnosed increasingly as a cause of lower intestinal bleeding, but their nature and occurrence, primarily in the elderly, remains unexplained. Colons from patients with clinical and angiographic diagnoses of cecal vascular lesions were studied by injection and clearing, and by histologic sections. In all injected specimens one or more mucosal vascular ectasias were identified. The mucosal lesions appeared to be secondary to dilated tortuous submucosal veins which were the more prominent feature and were often present without the mucosal ectasia. This suggests that ectasias are caused by chronic, intermittent, low grade obstruction to submucosal veins with dilation and tortuosity initially of submucosal veins, then of venules, capillaries, and arteries of the mucosal vascular unit. Ultimately, precapillary sphincters lose their competency, producing small arteriovenous communications. The concept that ectasias are degenerative lesions was evaluated by studying 15 right colons resected for carcinoma with no history of bleeding. Mucosal ectasias were identified in 4 colons and submucosal ectasias in 8. These investigations suggested that these lesions: (1) are vascular ectasias developing as a degenerative process of aging, (2) are present with or without bleeding in a significant portion of the population over 60 yr of age, (3) are multiple more often than single, and (4) may represent the commonest cause of major lower intestinal bleeding in the elderly.

Original languageEnglish (US)
Pages (from-to)650-660
Number of pages11
JournalGastroenterology
Volume72
Issue number4 1
StatePublished - 1977

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Pathologic Dilatations
Blood Vessels
Colon
Hemorrhage
Veins
Venules
Dilatation
Arteries
Communication
Carcinoma
Injections
Population

ASJC Scopus subject areas

  • Gastroenterology

Cite this

On the nature and etiology of vascular ectasias of the colon. Degenerative lesions of aging. / Boley, Scott J.; Sammartano, R.; Adams, A.; DiBiase, A.; Kleinhaus, S.; Sprayregen, Seymour.

In: Gastroenterology, Vol. 72, No. 4 1, 1977, p. 650-660.

Research output: Contribution to journalArticle

Boley, SJ, Sammartano, R, Adams, A, DiBiase, A, Kleinhaus, S & Sprayregen, S 1977, 'On the nature and etiology of vascular ectasias of the colon. Degenerative lesions of aging', Gastroenterology, vol. 72, no. 4 1, pp. 650-660.
Boley, Scott J. ; Sammartano, R. ; Adams, A. ; DiBiase, A. ; Kleinhaus, S. ; Sprayregen, Seymour. / On the nature and etiology of vascular ectasias of the colon. Degenerative lesions of aging. In: Gastroenterology. 1977 ; Vol. 72, No. 4 1. pp. 650-660.
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