Diagnosis of angiodysplasia on the caudal aspect of the pylorus: need for side-viewing endoscopy.

Recurrent gastrointestinal bleeding in patients with upper gastrointestinal angiodysplasia is common after treatment. This probably is related to the difficulty identifying all the lesions because they frequently are multiple and can be located in areas not easily visualized with forward-viewing endoscopy. We report two cases of patients with gastrointestinal bleeding in whom angiodysplasia as found at surgical enteroscopy on the caudal aspect of the pylorus that could not be identified with forward-viewing endoscopy. The lesions were ablated at the time of surgery or subsequently after location with side-viewing endoscopy, and no further bleeding occurred.