Conservative management of diffuse cavernous haemangioma of the sigmoid and rectum

Cotzias, E; Rehman, Sheik; Zadeh, Reza Arsalani; Smith, D.

doi:10.1308/rcsann.2019.0088

Cited by 6 publications

(7 citation statements)

References 13 publications

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“…Although this seems to be a valid option and many publications considered it as the best one if technically feasible, we preferred to ensure the complete resolution of the bleeding and excided the whole tumor and so preferred the patient even though the need of permanent colostomy. Cotzias et al have successfully managed conservatively with tranexamic acid avoiding the need for resection a DCH of the sigmoid and rectum 15 .…”

Section: Discussionmentioning

confidence: 99%

Hemangioma cavernoso difuso rectal

Hermosa¹,

Ortúzar²,

Valle-Hernández³

2021

CIRU

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Diffuse cavernous hemangioma (DCH) is a rare benign vascular lesion. The rectosigmoid colon is the most common site of this disease. It affects mainly young adults. The most frequent symptom is chronic rectal bleeding which is painless, often begins in the infancy and sometimes is uncontrollable. Endoscopy is the diagnose method of choice and complete surgical excision with sphincter-saving procedure is the primary mode of treatment. A high index of suspicion and a correct diagnose is necessary. We present a 34-year-old male with a DCH of the rectum and anus who required an APR because of affection of dentate line.

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Section: Discussionmentioning

confidence: 99%

Hemangioma cavernoso difuso rectal

Hermosa¹,

Ortúzar²,

Valle-Hernández³

2021

CIRU

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“…CRVM is a rare, gastrointestinal vascular malformation. Since CRVM was rst described by Phillips 1839, more than 300 cases have been reported, and most of these have been in adults (7). Approximately 80% of CRVM lesions are located in the rectosigmoid (1,2).…”

Section: Discussionmentioning

confidence: 99%

“…Data from several studies suggest that medical therapies is an effective and relatively safe treatment for patients with refractory bleeding from gastrointestinal vascular malformations (11,26). Smith et al reported that the patient was successfully managed using a conservative approach with tranexamic acid administered as needed, avoiding the need for resection (7).…”

Section: Discussionmentioning

confidence: 99%

An Investigation of Clinical Features and Exploration of Comprehensive Treatments for Colorectal Vascular Malformation in Children

Huang

Xiao

et al. 2021

Preprint

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Objectives: To summarize the clinical features, treatment methods, and outcomes of the rare diseases of colorectal vascular malformation (CRVM).Methods: We retrospectively analyzed clinical data of CRVM patients admitted to the Department of Pediatric Surgery of Children's Hospital of Fudan University from 2004 to 2019.Results: A total of 23 cases (16 males, 7 females) were enrolled. The median age of symptom onset was 1.4 years. Eleven patients had been misdiagnosed, and the average time from symptom onset to diagnosis was 4.5±4.4 years. Associated vascular malformations in the skin and other parts were found in eight patients. All patients showed a positive anomalous vascular image in the rectum and surrounding areas with contrast-enhanced computed tomography (CT) / magnetic resonance imaging (MRI). The sensitivity of endoscopy in the diagnosis of CRVM was 82.6%. A total of 21 patients underwent a modified Soave procedure. The lesions were mostly restricted to the rectum and sigmoid, with an average length of 20±5.4cm. The median follow-up time was 78 months. Bloody stools reappeared within 6 months in three patients, but were cured by sclerotherapy or fulguration. At the last time of follow-up, bloody stool symptoms were absent and hemoglobin was in the normal range for all patients.Conclusions: CRVM occurs more commonly in male children than in female children. Combined with enhanced MRI, CT, and colonoscopy, CRVM diagnosis can be confirmed. The lesioned intestinal segment can be safely removed through a modified transabdominal Soave procedure, effectively curing or relieving hematochezia.

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“…Because rectal VM is rare, management options are not well established. Asymptomatic patients may be followed up with MRI or transrectal ultrasound imaging every 6 months 21 . Conservative procedures, such as radiotherapy and endoscopic sclerotherapy, and radical procedures, such as surgical resection, have been described for the management of rectal VM 5,8,9 .…”

Section: Discussionmentioning

confidence: 99%

“…Asymptomatic patients may be followed up with MRI or transrectal ultrasound imaging every 6 months. 21 Conservative procedures, such as radiotherapy and endoscopic sclerotherapy, and radical procedures, such as surgical resection, have been described for the management of rectal VM. 5,8,9 Due to the transmural involvement of rectal VM, conservative procedures are often associated with recurrence, limiting their indications mainly to patients who are poor candidates for surgical resection.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic total mesorectal excision for rectal venous malformation: A case report with a brief literature review

Bhattacharjee

Karthyarth

Suhani

et al. 2020

Asian J Endoscop Surgery

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Rectal vascular malformation is a rare disease on which few reports have been published. Here, we report the case of a 38-year-old woman who presented with severe weakness, dyspnea, and recurrent episodes of rectal bleeding. Her colonoscopy showed an extensive pigmented lesion in the lower rectum. CT angiography showed diffuse circumferential wall thickening of the rectum, perirectal fat stranding, tiny round foci of calcification, and no arterial feeders. Multiphasic MRI confirmed the diagnosis. The patient underwent a total mesorectal excision with hand-sewn coloanal anastomosis. The venous malformation was confined to the mesorectal tissue. The avascular plane between the ectodermal and mesodermal tissue was well maintained. Blood loss was 200 mL. The patient has had no recurrence of disease in the 18 months since surgery. Although total mesorectal excision is described for rectal cancer, it may be indicated for benign disease like rectal vascular malformation to achieve complete removal of the disease and to minimize intraoperative blood loss.

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Conservative management of diffuse cavernous haemangioma of the sigmoid and rectum

Cited by 6 publications

References 13 publications

Hemangioma cavernoso difuso rectal

Hemangioma cavernoso difuso rectal

An Investigation of Clinical Features and Exploration of Comprehensive Treatments for Colorectal Vascular Malformation in Children

Laparoscopic total mesorectal excision for rectal venous malformation: A case report with a brief literature review

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