Angiodysplasia of the colon in children.

Angiodysplasia of the colon as a cause of lower intestinal bleeding is diagnosed frequently in the elderly, with defined clinical characteristics. In the pediatric population there is little experience; only six cases have been reported. The present study evaluates the clinical, radiological, and surgical aspects of nine children with angiodysplasia of the colon who were treated at the National Institute of Pediatrics in Mexico City between 1970 and 1993. The mean age of clinical onset was 2.3 years. In six patients, symptoms appeared before the first year of life. Lower intestinal bleeding and severe anemia were present in all cases. The diagnosis and localization of the lesions were established by selective visceral angiography. Six patients were treated by operative resection of the affected colonic segments. For four patients with lesions in the rectum and sigmoid, a Swenson pull-through was performed. In one patient the lesion was recurrent because of incomplete resection. Follow-up ranges from 8 months to 4 years; all patients have had normal hemoglobin levels and negative stool results. Unlike in the elderly and the cases reported in the literature, the left hemicolon was the most frequently involved area.