Colon (tumor & nontumor)
Other nonneoplastic
Vascular ectasia

Topic Completed: 1 November 2013

Revised: 9 January 2019, last major update November 2013

Copyright: (c) 2003-2017,, Inc.

PubMed search: vascular ectasia colonic

Raul S. Gonzalez, M.D.
Page views in 2019: 5,094
Page views in 2020 to date: 3,112
Cite this page: Gonzalez R. Vascular ectasia. website. Accessed August 8th, 2020.
Definition / general
  • Also called angiodysplasia, arteriovenous malformation
  • < 1% prevalence but accounts for 20% of patients with lower GI bleeding (#2 most common cause, after diverticulitis)
  • Incidence increases with age (J Clin Pathol 1982;35:824)
  • Acquired changes in colonic extracellular matrix which distort veins and capillaries, disposing them to bleed
  • Changes may be secondary to chronic vascular obstruction
Clinical features
  • Rectal bleeding, often in elderly
  • Bleeding episodes typically cease spontaneously but recur
  • May be associated with aortic stenosis or von Willebrand disease
  • Colonoscopy, angiography
Case reports
Clinical images

Images hosted on other servers:

Friable telangiectatic mucosal lesions

Gross description
  • Tortuous dilation of multiple small submucosal and mucosal blood vessels
  • Easier to identify by angiography than in a surgical specimen unless injected with silicone rubber and cleared with methyl salicylate
Gross images

Images hosted on other servers:

Tortuous submucosal vessels

Microscopic (histologic) description
  • Dilated and thin walled vessels (arteries, veins and capillaries) in mucosa and submucosa, often clustered
  • Overlying mucosa may be eroded
  • Changes can be subtle and focal
Microscopic (histologic) images

Images hosted on other servers:

Ectatic vessels

Secondary ulceration

Ectatic submucosal veins

Differential diagnosis
  • Colonic or anal varices: due to portal hypertension
Back to top