Aims This study aims to establish the 5-year survival of those diagnosed with bleeding
small bowel (SB) angioectasia, with the hypothesis that many will suffer deaths relating
to comorbidity rather than GI bleeding.
Methods SB capsule endoscopy (SBCE) procedures, performed for suspected SB bleeding or iron
deficiency anaemia, with angioectasia isolated as the cause of SB bleeding and at
least 5 years of follow up data were isolated (n=125) along with an age matched group
with “normal” SBCE procedures (n=125). These were retrospectively analysed with further
information on mortality and comorbidity gathered through hospital records.
Results Those with angioectasia had a median age of 72.7 years and comorbidities were common.
The 5-year survival was 64.0% (80/125) compared to 70.4% (88/125) in those with “normal”
SBCE. Those with significant cardiac or vascular comorbidity had a poorer survival
(52.9% (37/70) at 5 years) but anticoagulation/antiplatelets seemed to make little
difference.
37/125 (29.6%) were planned for endoscopic therapy, this group had a survival of 62.3%
(23/37).
In those with SB bleeding secondary to angioectasia none of the subsequent deaths
were directly attributable to gastrointestinal bleeding.
Conclusions The overall 5-year survival in those diagnosed with angioectasia on VCE was poor
at 64.0% due to those diagnosed frequently being older and comorbid. This is comparable
with the 5 year mortality seen when SB adenocarcinoma (all SEER stages combined) is
diagnosed (68%) and worse than when the cancer is localised (85% survival at 5 years)(1).
This would support the hypothesis that a diagnosis of small bowel (SB) bleeding secondary
to angioectasia suggests frailty.
(1) Noone AM, Howlader N, Krapcho M, Miller D, Brest A, Yu M, Ruhl J, Tatalovich Z,
Mariotto A, Lewis DR, Chen HS, Feuer EJ CK. Cancer Statistics Review, 1975-2015 -
SEER Statistics. SEER Cancer Stat Rev. 2017;
