 Gastrointestinal angiodysplasia GIAD, a.k.a. angioectasia, arteriovenous malformations or AVM, and vascular ectasia are mucosal or submucosal dilated blood vessels lined by epithelium with no overlying mucosal lesion formed due to a combination of sub-mucosal vein obstruction, hypoxemia and neovascularization. It is a frequent cause of obscure GI bleeding, and the most common finding when evaluating mid-small bowel hemorrhage. It is also more common in patients with underlying valvular heart disease especially aortic stenosis, end-stage renal disease, and von Willebrand disease acquired or congenital. These lesions are usually multifocal as forty to 60 of the patients will have more than one About half stop bleeding spontaneously but at least a quarter of patients will suffer recurrent GI bleeding manifested by overt bleeding melena or hematochezia, persistent fecal occult blood or persistent iron deficiency anemia. 