Hereditary hemorrhagic telangiectasia and other intestinal vascular anomalies.

Vascular lesions in the gastrointestinal tract have been increasingly recognized as important causes of bleeding. Patients with bleeding gastric and small bowel vascular ectasia often pose difficult diagnostic and management problems; they require numerous transfusions, repeated hospital admissions, and multiple endoscopic procedures. With improving endoscopic options and emerging medical therapies, management of these patients is changing. This set of disorders requires a variety of approaches tailored to the particular disorder and clinical manifestations. Hereditary hemorrhagic telangiectasia (HHT) is a disorder that can involve multiple organ systems outside the gastrointestinal tract in a variety of clinical presentations. Screening all patients with HHT for pulmonary and cerebral arteriovenous malformations to prevent significant sequelae is a critical element of care. This review focuses on advances in our knowledge and treatment of HHT and other gastric and small intestinal vascular ectasia.