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K55.2 – Angiodysplasia of the Colon Explained
K55.2 is the ICD-10 code for angiodysplasia of the colon – abnormal, fragile blood vessels in the large intestine that can cause bleeding. It most commonly affects older adults.
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K55.2 is the ICD-10 code for angiodysplasia of the colon – abnormal, fragile blood vessels in the large intestine that can cause bleeding. It most commonly affects older adults.
Definition
K55.2 is an ICD-10 diagnosis code that refers to angiodysplasia of the colon. This condition involves abnormally enlarged and fragile blood vessels located in the mucosal and submucosal layers of the large intestine. Although not malignant, these vascular malformations can cause significant gastrointestinal bleeding and related complications.
Causes
The exact cause of colonic angiodysplasia is not fully understood. Several contributing factors have been identified:
- Aging: Degeneration of vessel walls with age is considered the primary risk factor.
- Chronic mechanical stress: Repeated muscular contractions of the colon wall may impair local blood flow, promoting abnormal vessel formation.
- Cardiac conditions: Certain heart valve disorders, particularly aortic stenosis, are associated with an increased risk of angiodysplasia (known as Heyde syndrome).
- Chronic kidney disease: Patients with renal insufficiency show a higher prevalence of this condition.
Symptoms
Many patients are asymptomatic, with the condition discovered incidentally during colonoscopy. When symptoms occur, they may include:
- Visible or occult (hidden) blood in the stool
- Recurrent episodes of intestinal bleeding
- Fatigue, pallor, and dizziness due to iron deficiency anemia
- Rarely: acute and severe gastrointestinal hemorrhage
Diagnosis
Diagnosis is typically established through endoscopic or imaging procedures:
- Colonoscopy: The gold standard, allowing direct visualization of characteristic vascular lesions in the colonic mucosa.
- Capsule endoscopy: Used when small bowel involvement is suspected or colonoscopy is not feasible.
- Angiography: Helpful in localizing active or severe bleeding sources.
- Blood tests: May reveal anemia through low hemoglobin or ferritin levels.
Treatment
Treatment depends on the severity of symptoms and frequency of bleeding.
Endoscopic Treatment
Active or recurrent bleeding lesions can be treated during colonoscopy using:
- Argon plasma coagulation (APC): The most commonly used technique, applying thermal energy to obliterate abnormal vessels.
- Electrocoagulation: An alternative method to achieve hemostasis.
Medical Therapy
When endoscopic treatment is not sufficient or feasible, medical options include:
- Hormonal therapy (estrogen-progesterone combination) – evidence remains controversial.
- Octreotide or thalidomide for refractory cases.
Treatment of Underlying Conditions
Associated conditions such as aortic valve disease or chronic kidney disease should be managed in parallel, as treating the underlying cause may reduce bleeding episodes.
Surgical Treatment
Surgery to remove the affected bowel segment is rarely required and is reserved for cases with severe, uncontrollable hemorrhage.
References
- World Health Organization (WHO): ICD-10 Classification of Mental and Behavioural Disorders. K55.2 Angiodysplasia of colon. Geneva: WHO.
- Foutch PG. Angiodysplasia of the gastrointestinal tract. Am J Gastroenterol. 1993;88(6):807-818. PubMed PMID: 8503392.
- Lenz CJ, Bick BL, Katzka D, et al. Argon Plasma Coagulation Treatment of Colonic Angiodysplasia: A Single-Center Experience. Gastrointest Endosc. 2017;85(4). DOI: 10.1016/j.gie.2016.12.022.
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