Unusual Presentation of Anal Pain and Tenesmus from Rectal Arteriovenous Malformation Successfully Treated with Ethanol Sclerotherapy

Gastrointestinal arteriovenous malformation (AVM) is reported as one of the possible causes of intestinal bleeding, and its occurrence in the rectum is rare. We report the case of a rectal AVM patient who experienced uncommon symptoms of anal pain and tenesmus and was treated successfully with percu...

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Published inCase reports in gastroenterology Vol. 15; no. 1; pp. 262 - 268
Main Authors Hong, Jihoon, Lee, Sang Yub, Cha, Jung Guen, Heo, Jun
Format Journal Article
LanguageEnglish
Published Basel, Switzerland S. Karger AG 01.01.2021
Karger Publishers
Subjects
anal pain
Anemia
arteriovenous malformation
Case reports
Colonoscopy
Edema
Embolization
Ethanol
Hypertension
Medical imaging
Pain
Polyvinyl alcohol
Rectum
Sclerotherapy
Single Case
tenesmus
Thrombosis
transarterial ethanol sclerotherapy
Veins & arteries
Tenesmus
Transarterial ethanol sclerotherapy
Arteriovenous malformation
Anal pain
Rectum
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Abstract Gastrointestinal arteriovenous malformation (AVM) is reported as one of the possible causes of intestinal bleeding, and its occurrence in the rectum is rare. We report the case of a rectal AVM patient who experienced uncommon symptoms of anal pain and tenesmus and was treated successfully with percutaneous transarterial ethanol sclerotherapy. The patient underwent routine colonoscopy with biopsy at the time of visit; however, an accurate diagnosis was difficult. Subsequent contrast-enhanced computed tomography (CT) and angiography revealed a rectal AVM emerging from the distal inferior mesenteric artery with engorged superior rectal veins. The feeding artery was catheterized, and concurrent transarterial sclerotherapy with 80% ethanol was performed. There was no major complication related to the procedure. Disappearance of AVM nidus and improvement of associated venous congestion were shown by follow-up CT. There was no recurrence of symptoms after 10 months of clinical observation. Transarterial ethanol sclerotherapy is safe and effective in treating rectal AVM and can be considered as one of the nonsurgical treatment options.
AbstractList Gastrointestinal arteriovenous malformation (AVM) is reported as one of the possible causes of intestinal bleeding, and its occurrence in the rectum is rare. We report the case of a rectal AVM patient who experienced uncommon symptoms of anal pain and tenesmus and was treated successfully with percutaneous transarterial ethanol sclerotherapy. The patient underwent routine colonoscopy with biopsy at the time of visit; however, an accurate diagnosis was difficult. Subsequent contrast-enhanced computed tomography (CT) and angiography revealed a rectal AVM emerging from the distal inferior mesenteric artery with engorged superior rectal veins. The feeding artery was catheterized, and concurrent transarterial sclerotherapy with 80% ethanol was performed. There was no major complication related to the procedure. Disappearance of AVM nidus and improvement of associated venous congestion were shown by follow-up CT. There was no recurrence of symptoms after 10 months of clinical observation. Transarterial ethanol sclerotherapy is safe and effective in treating rectal AVM and can be considered as one of the nonsurgical treatment options.
Author Hong, Jihoon
Lee, Sang Yub
Heo, Jun
Cha, Jung Guen
AuthorAffiliation b Department of Radiology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
c Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
a Department of Radiology, Kyungpook National University Hospital, Daegu, Republic of Korea
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Cites_doi 10.1159/000505090
10.1007/s12328-016-0629-8
10.1136/bcr.02.2009.1635
10.1007/s005950050310
10.1016/j.jpedsurg.2010.03.026
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10.3748/wjg.v19.i25.4087
10.1001/archsurg.1976.01360220077013
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Keywords Tenesmus
Transarterial ethanol sclerotherapy
Arteriovenous malformation
Anal pain
Rectum
Language English
License This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC). Usage and distribution for commercial purposes requires written permission.
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StartPage 262
SubjectTerms anal pain
Anemia
arteriovenous malformation
Case reports
Colonoscopy
Edema
Embolization
Ethanol
Hypertension
Medical imaging
Pain
Polyvinyl alcohol
Rectum
Sclerotherapy
Single Case
tenesmus
Thrombosis
transarterial ethanol sclerotherapy
Veins & arteries
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Title Unusual Presentation of Anal Pain and Tenesmus from Rectal Arteriovenous Malformation Successfully Treated with Ethanol Sclerotherapy
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