Gallbladder angiodysplasia: a literature review

Abstract

Introduction: Angiodysplasia is a vascular lesion responsible for 6% of lower gastrointestinal bleeding cases. It is generally located in the cecum and ascending colon in elderly patients. Angiodysplasia of the gallbladder is a rare condition. The main objective of this literature review was to summarize the demographics, clinical signs and symptoms, gross findings, histopathology, immunohistochemistry, treatment, and follow-up of patients with gallbladder angiodysplasia. Methods and materials: The authors searched PubMed, ScienceDirect, and Google Scholar using relevant keywords. The search was performed in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, using appropriate keywords. The case reports included were those dealing exclusively with human subjects, were published in the English language, and had free, full-text, public access. Data was extracted and case reports were evaluated. Results: Of the 1097 studies initially identified, 3 (0.27%) were analyzed. There were two females (66.6%) and one male (33.3%). The mean age of presentation was 47.6 years. The most common presenting complaint was colicky right upper abdominal pain in two cases (66.6%). Elective cholecystectomy was performed in only two cases (66.6%). In one case (33.3%), petechiae were diffusely present in the gastric mucosa and patchy in the gallbladder, duodenum, jejunum, ileum, cecum, and ascending colon on autopsy. Histopathological findings were consistent with gallbladder angiodysplasia in all three cases (100%). On immunohistochemistry CD-34, CD-31, and D2-40 were positive in only one case. Conclusions: Despite conflicting data, histological and immunohistochemical analyses play major roles in the diagnosis of gallbladder angiodysplasia. Nonetheless, further clinical studies are required to provide universal guidelines for the treatment and diagnosis of angiodysplasia of the gallbladder.