Soft-tissue images. Diffuse cavernous rectal hemangioma

• Published in: Canadian Journal of Surgery Vol. 45; no. 5; pp. 365 - 366
• Main Authors: Bugra, Dursun, Bulut, Turker, Yamaner, Sumer, Gencosmanoglu, Rasim, Ozmen, Vahit, Bilge, Orhan, Cevikbas, Ugur
• Format: Journal Article
• Language: English
• Published: Canada CMA Impact, Inc 01.10.2002; Canadian Medical Association
• Subjects: Adult; Colonoscopy; Gastrointestinal Hemorrhage - diagnosis; Gastrointestinal Hemorrhage - etiology; Hemangioma, Cavernous - complications; Hemangioma, Cavernous - diagnosis; Hemangioma, Cavernous - surgery; Humans; Male; Rectal Neoplasms - complications; Rectal Neoplasms - diagnosis; Rectal Neoplasms - surgery; Surgical Images; Treatment Outcome
• ISSN: 0008-428X; 1488-2310

DCH of the rectosigmoid colon is an extremely rare malformation that is generally seen in young adults, with a male-to-female ratio of 2:1.1 Patients usually suffer painless rectal bleeding and anemia. However, there may be associated intestinal obstruction, diarrhea, constipation and hematuria.2 The presence of hemangioma in the cutaneous and mucous membranes, or Klippel-Trenaunay syndrome, should alert the clinician to the presence of rectal hemangioma.3,4 Endoscopy is the method of choice for diagnosis. Upper gastrointestinal endoscopy should be done in all patients to rule out any synchronous hemangiomas. Other diagnostic tools such as barium enema, selective angiography, computed tomography, magnetic resonance imaging or endoscopic ultrasonography may show extramural spread of the lesion and exclude other causes of rectal bleeding. The definitive treatment for DCH is excision of the involved bowel. Sphincter-saving procedures, avoiding damage to perirectal neural structures, is preferred for satisfactory long-term results." The vascular malformations that remain in the proximal anal canal, usually 1 to 2 cm above the dentate line, can be managed conservatively by argon or Nd:YAG laser therapy, or sclerotherapy in the case of rebleeding.